比较欧洲老年人肌肉减少症工作组（EWGSOP）2010 年和 2019 年的肌肉减少症诊断标准在两个瑞典老年人队列中的应用。
Comparison of the 2010 and 2019 diagnostic criteria for sarcopenia by the European Working Group on Sarcopenia in Older People (EWGSOP) in two cohorts of Swedish older adults.
机构信息
Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Clinical Nutrition Unit, Sahlgrenska University hospital, Gothenburg, Sweden.
出版信息
BMC Geriatr. 2021 Oct 26;21(1):600. doi: 10.1186/s12877-021-02533-y.
BACKGROUND
The operational definition of sarcopenia has been updated (EWGSOP2) and apply different cut-off points compared to previous criteria (EWGSOP1). Therefore, we aim to compare the sarcopenia prevalence and the association with mortality and dependence in activities of daily living using the 2010 (EWGSOP1 and 2019 (EWGSOP2 operational definition, applying cut-offs at two levels using T-scores.
METHODS
Two birth cohorts, 70 and 85-years-old (n = 884 and n = 157, respectively), were assessed cross-sectionally (57% women). Low grip strength, low muscle mass and slow gait speed were defined below - 2.0 and - 2.5 SD from a young reference population (T-score). Muscle mass was defined as appendicular lean soft tissue index by DXA. The EWGSOP1 and EWGSOP2 were applied and compared with McNemar tests and Cohen's kappa. All-cause mortality was analyzed with the Cox-proportional hazard model.
RESULTS
Sarcopenia prevalence was 1.4-7.8% in 70-year-olds and 42-62% in 85 years-old's, depending on diagnostic criteria. Overall, the prevalence of sarcopenia was 0.9-1.0 percentage points lower using the EWGSOP2 compared to EWGSOP1 when applying uniform T-score cut-offs (P < 0.005). The prevalence was doubled (15.0 vs. 7.5%) using the - 2.0 vs. -2.5 T-scores with EWGSOP2 in the whole sample. The increase in prevalence when changing the cut-offs was 5.7% (P < 0.001) in the 70-year-olds and 17.8% (P < 0.001) in the 85-year-olds (EWGSP2). Sarcopenia with cut-offs at - 2.5 T-score was associated with increased mortality (hazard ratio 2.4-2.8, P < 0.05) but not at T-score - 2.0.
CONCLUSIONS
The prevalence of sarcopenia was higher in 85-year-olds compared to 70-year-olds. Overall, the differences between the EWGSOP1 and EWGSOP2 classifications are small. Meaningful differences between EWGSOP1 and 2 in the 85-year-olds could not be ruled out. Prevalence was more dependent on cut-offs than on the operational definition.
背景
肌少症的操作定义已经更新（EWGSOP2），并与之前的标准（EWGSOP1）相比采用了不同的截断值。因此，我们旨在使用 2010 年（EWGSOP1）和 2019 年（EWGSOP2）的操作定义（使用 T 分数在两个水平上应用截断值），比较肌少症的患病率以及与死亡率和日常生活活动依赖的相关性。
方法
两个出生队列，70 岁和 85 岁（分别为 n=884 和 n=157，57%为女性）进行横断面评估。低握力、低肌肉量和慢步速定义为低于年轻参考人群（T 分数）的-2.0 和-2.5 SD。肌肉量通过 DXA 定义为四肢瘦软组织指数。应用 EWGSOP1 和 EWGSOP2，并进行 McNemar 检验和 Cohen's kappa 比较。使用 Cox 比例风险模型分析全因死亡率。
结果
70 岁时肌少症的患病率为 1.4-7.8%，85 岁时为 42-62%，具体取决于诊断标准。总体而言，与 EWGSOP1 相比，使用 EWGSOP2 时，当应用统一的 T 分数截断值时，肌少症的患病率低 0.9-1.0 个百分点（P<0.005）。在整个样本中，使用 EWGSOP2 时，与-2.0 T 分数相比，-2.5 T 分数的患病率增加了 15.0%（7.5%）。当改变截断值时，70 岁时患病率增加 5.7%（P<0.001），85 岁时增加 17.8%（P<0.001）（EWGSP2）。使用-2.5 T 分数截断值的肌少症与死亡率增加相关（危险比 2.4-2.8，P<0.05），但与-2.0 T 分数无关。
结论
与 70 岁相比，85 岁的肌少症患病率更高。总体而言，EWGSOP1 和 EWGSOP2 分类之间的差异较小。在 85 岁的人群中，EWGSOP1 和 2 之间可能存在有意义的差异。患病率更多地取决于截断值而不是操作定义。
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