Lin X, Li M, Li Z, Zhu L, Liu L, Chen X
Xiaoyan Chen, MD; Address:Southwest Medical University Zigong Affiliated Hospital; Zigong Mental Health Center; Zigong, Sichuan Province, China; Email:
J Nutr Health Aging. 2021;25(9):1119-1123. doi: 10.1007/s12603-021-1680-9.
We aimed to evaluate the comparative effectiveness and applicability of using calf circumference (CC), strength, need for assistance with walking, rising from a sitting position, climbing stairs, and the incidence of falls (SARC-F), as well as SARC-F plus CC (SARC-CalF) and the Ishii test, for assessing sarcopenia in older adult nursing home occupants.
In this cross-sectional study, the diagnostic criteria of the AWGS2019 were used as the standard, and the accuracy of the four screening methods determined by indicators, including sensitivity, specificity, receiver operating characteristic (ROC) curve, positive predictive values (PPV), and negative predictive values (NPV).
One hundred and ninety-nine older adults, 97 male and 102 female, were included. The prevalence of sarcopenia was 48.7%. Over all the participants, the sensitivity and specificity of CC were 74.22% and 51.96%, respectively, and 40.21% and 83.33%, respectively, for SARC-F. The use of SARC-CalF raised the SARC-F sensitivity (71.14%) while reducing the specificity (60.78%). The Ishii test had a sensitivity of 89.7% and a specificity of 74.51%. The PPV and NPV of CC, SARC-F, SARC-CalF, Ishii test were 0.6/0.68, 0.7/0.59, 0.55/0.63, and 0.77/0.88, respectively. The areas under the curve for CC, SARC-F, SARC-CalF, and the Ishii test were 0.67(95%CI, 0.59-0.74), 0.71(95%CI, 0.64-0.79), 0.71(95%CI, 0.64-0.79), and 0.86 (95% CI,0.81-0.92), respectively. The sensitivity and specificity of CC, SARC-F, SARC-CalF, and the Ishii test for sarcopenia screening in males were 71.69%/56.41%, 29.31%/79.49%, 67.24%/64.10%, and 94.83%/56.41%, respectively, and in females were 79.49%/49.21%, 56.41%/85.71%, 76.92%/58.73%, and 82.05%/85.71%, respectively. The PPV and NPV of CC, SARC-F, SARC-CalF, and the Ishii test in males were 0.71/0.56, 0.68/0.43, 0.74/0.57, and 0.76/0.88, respectively, while in females the values were 0.49/0.79, 0.71/0.76, 0.54/0.8, and 0.78/0.89, respectively.The areas under the curve for CC, SARC-F, SARC-CalF, and the Ishii test in males were 0.7(95%CI, 0.59-0.8), 0.63(95%CI, 0.52-0.75), 0.68(95%CI, 0.57-0.8), and 0.86(95% CI, 0.78-0.94), respectively, and in females 0.69(95%CI, 0.58-0.8), 0.81(95%CI, 0.72-0.89), 0.76(95%CI, 0.67-0.86), and 0.85 (95%CI, 0.77-0.94), respectively.
The overall screening ability of the Ishii test for sarcopenia was superior to that of the CC, SARC-F, and SARC-CalF in older adults in nursing homes.
我们旨在评估使用小腿围（CC）、力量、行走辅助需求、从坐姿站起、爬楼梯以及跌倒发生率（SARC - F），以及SARC - F加CC（SARC - CalF）和石井试验，用于评估老年疗养院居住者肌肉减少症的比较有效性和适用性。
在这项横断面研究中，将AWGS2019的诊断标准用作标准，并通过灵敏度、特异性、受试者工作特征（ROC）曲线、阳性预测值（PPV）和阴性预测值（NPV）等指标确定四种筛查方法的准确性。
纳入了199名老年人，其中男性97名，女性102名。肌肉减少症的患病率为48.7%。在所有参与者中，CC的灵敏度和特异性分别为74.22%和51.96%，SARC - F的灵敏度和特异性分别为40.21%和83.33%。使用SARC - CalF提高了SARC - F的灵敏度（71.14%），同时降低了特异性（60.78%）。石井试验的灵敏度为89.7%，特异性为74.51%。CC、SARC - F、SARC - CalF、石井试验的PPV和NPV分别为0.6/0.68、0.7/0.59、0.55/0.63和0.77/0.88。CC、SARC - F、SARC - CalF和石井试验的曲线下面积分别为0.67（95%CI，0.59 - 0.74）、0.71（95%CI，0.64 - 0.79）、0.71（95%CI，0.64 - 0.79）和0.86（95%CI，0.81 - 0.92）。CC、SARC - F、SARC - CalF和石井试验在男性中筛查肌肉减少症的灵敏度和特异性分别为71.69%/56.41%、29.31%/79.49%、67.24%/64.10%和94.83%/56.41%，在女性中分别为79.49%/49.21%、56.41%/85.71%、76.92%/58.73%和82.05%/85.71%。CC、SARC - F、SARC - CalF和石井试验在男性中的PPV和NPV分别为0.71/0.56、0.68/0.43、0.74/0.57和0.76/0.88，而在女性中的值分别为0.49/0.79、0.71/0.76、0.54/0.8和0.78/0.89。CC、SARC - F、SARC - CalF和石井试验在男性中的曲线下面积分别为0.7（95%CI，0.59 - 0.8）、0.63（95%CI，0.52 - 0.75）、0.68（95%CI，0.57 - 0.8）和0.86（95%CI，0.78 - 0.94），在女性中分别为0.69（95%CI，0.58 - 0.8）、0.81（95%CI，0.72 - 0.89）、0.76（95%CI，0.67 - 0.86）和0.85（95%CI，0.77 - 0.94）。
在老年疗养院居住者中，石井试验对肌肉减少症的总体筛查能力优于CC、SARC - F和SARC - CalF。
