Division of Nephrology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 97004, Taiwan.
School of Medicine, Tzu Chi University, Hualien 97004, Taiwan.
Nutrients. 2022 Feb 22;14(5):923. doi: 10.3390/nu14050923.
Sarcopenia is frequently encountered in patients undergoing peritoneal dialysis (PD). We evaluated and compared the diagnostic performance of a strength, assistance walking, rise from a chair, climb stairs, and falls (SARC-F) questionnaire, SARC-F combined with calf circumference (SARC-CalF), and calf circumference (CC) for screening sarcopenia among patients undergoing PD. We measured the appendicular skeletal muscle mass, evaluated using a multifrequency bioimpedance spectroscopy device, handgrip strength, and 6-m gait speed. SARC-F, SARC-CalF, and CC were obtained in all participants. Sarcopenia was defined using four different diagnostic criteria, including the Asian Working Group for Sarcopenia (AWGS) 2019, revised European Working Group on Sarcopenia in Older People (EWGSOP2), Foundation for the National Institutes of Health (FNIH), and International Working Group on Sarcopenia (IWGS). Among 186 enrolled patients undergoing PD (mean age 57.5 ± 14.1 years), the sarcopenia prevalence was 25.8-38.2% using the four definitions. The discriminative powers of SARC-CalF (range 0.648-0.748) and CC (range 0.652-0.813) against the four definitions were better than those exhibited by SARC-F (range 0.587-0.625), which achieved significant difference, except when adopting the criteria of the FNIH. After stratification by gender, the superiority of SARC-CalF and CC over SARC-F was maintained when AWGS 2019, EWGSOP2, and IWGS were applied. In conclusion, CC and SARC-CalF outperformed SARC-F in the diagnostic accuracy of sarcopenia among patients undergoing PD.
肌肉减少症在接受腹膜透析(PD)的患者中很常见。我们评估并比较了力量、辅助行走、从椅子上站起来、爬楼梯和跌倒(SARC-F)问卷、SARC-F 联合小腿围(SARC-CalF)和小腿围(CC)在筛查 PD 患者肌肉减少症中的诊断性能。我们使用多频生物阻抗谱仪测量四肢骨骼肌质量,评估握力和 6 米步行速度。所有参与者均获得 SARC-F、SARC-CalF 和 CC。肌肉减少症使用亚洲肌肉减少症工作组(AWGS)2019、修订后的欧洲老年人肌肉减少症工作组(EWGSOP2)、美国国立卫生研究院基金会(FNIH)和国际肌肉减少症工作组(IWGS)四个不同的诊断标准进行定义。在 186 名接受 PD 的患者中(平均年龄 57.5±14.1 岁),使用四种定义,肌肉减少症的患病率为 25.8-38.2%。SARC-CalF(范围 0.648-0.748)和 CC(范围 0.652-0.813)对四种定义的判别能力优于 SARC-F(范围 0.587-0.625),差异具有统计学意义,但采用 FNIH 标准时除外。按性别分层后,当应用 AWGS 2019、EWGSOP2 和 IWGS 时,SARC-CalF 和 CC 优于 SARC-F 的优势仍然存在。总之,在诊断 PD 患者肌肉减少症的准确性方面,CC 和 SARC-CalF 优于 SARC-F。