Bone Quality and Health Centre, Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Shatin, Hong Kong.
Jockey Club Centre for Osteoporosis Care and Control, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong.
J Cachexia Sarcopenia Muscle. 2021 Dec;12(6):2163-2173. doi: 10.1002/jcsm.12825. Epub 2021 Oct 4.
This study aimed to adjust and cross-validate skeletal muscle mass measurements between bioimpedance analysis (BIA) and dual-energy X-ray absorptiometry (DXA) for the screening of sarcopenia in the community and to estimate the prevalence of sarcopenia in Hong Kong.
Screening of sarcopenia was provided to community-dwelling older adults. Appendicular skeletal muscle mass (ASM) was evaluated by BIA (InBody 120 or 720) and/or DXA. Handgrip strength and/or gait speed were assessed. Diagnosis of sarcopenia was based on the 2019 revised Asian Working Group for Sarcopenia cut-offs. Agreement analysis was performed to cross-validate ASM measurements by BIA and DXA. Multiple regression was used to explore contribution of measured parameters in predicting DXA ASM from BIA.
A total of 1587 participants (age = 72 ± 12 years) were recruited; 1065 participants were screened by BIA (InBody 120) with 18 followed up by DXA, while the remaining 522 participants were assessed by the BIA (InBody 720) and DXA. The appendicular skeletal muscle mass index (ASMI) evaluated by BIA showed a mean difference of 2.89 ± 0.38 kg/m (InBody 120) and 2.97 ± 0.45 kg/m (InBody 720) against DXA gold standard. A significant overestimation of muscle mass was measured by BIA compared with DXA (P < 0.005). BIA data were adjusted using prediction equation and mean difference reduced to -0.02 ± 0.31 kg/m in cross-validation. Prevalence of sarcopenia in older adults ≥65 ranged from 39.4% (based on ASMI by DXA) to 40.8% (based on predicted DXA ASMI from BIA). Low ASMI by DXA was found in 68.5% of the older adults screened. The percentage of older adults exhibited low handgrip strength ranged from 31.3% to 56%, while 49% showed low gait speed.
Bioimpedance analysis was found to overestimate skeletal muscle mass compared with DXA. With adjustment equations, BIA can be used as a quick and reliable tool for screening sarcopenia in community and clinical settings with limited access to better options.
本研究旨在调整和验证生物电阻抗分析（BIA）和双能 X 射线吸收法（DXA）在社区中筛查肌肉减少症的骨骼肌质量测量值，并估计香港肌肉减少症的患病率。
为社区居住的老年人提供肌肉减少症筛查。通过 BIA（InBody 120 或 720）和/或 DXA 评估四肢骨骼肌质量（ASM）。评估握力和/或步态速度。肌肉减少症的诊断基于 2019 年修订的亚洲工作组肌肉减少症切点。进行一致性分析以交叉验证 BIA 和 DXA 的 ASM 测量值。多元回归用于探索测量参数对从 BIA 预测 DXA ASM 的贡献。
共纳入 1587 名参与者（年龄=72±12 岁）；1065 名参与者通过 BIA（InBody 120）进行筛查，其中 18 名参与者随后进行了 DXA 检查，而其余 522 名参与者同时接受了 BIA（InBody 720）和 DXA 检查。通过 BIA 评估的四肢骨骼肌质量指数（ASMI）与 DXA 金标准相比，平均差值为 2.89±0.38kg/m（InBody 120）和 2.97±0.45kg/m（InBody 720）。与 DXA 相比，BIA 测量的肌肉质量存在显著高估（P<0.005）。通过预测方程调整 BIA 数据后，交叉验证时平均差值缩小至-0.02±0.31kg/m。≥65 岁老年人肌肉减少症的患病率范围为 39.4%（基于 DXA 的 ASMI）至 40.8%（基于 BIA 预测的 DXA ASMI）。68.5%的老年人经 DXA 检查发现 ASMI 低。握力低的老年人比例范围为 31.3%至 56%，而 49%的老年人步态速度低。
与 DXA 相比，生物电阻抗分析被发现高估了骨骼肌质量。通过调整方程，BIA 可作为在社区和临床环境中筛查肌肉减少症的快速可靠工具，在这些环境中，获得更好选择的机会有限。
