Xu Zeru, Zhang Ping, Chen Yifei, Jiang Jiahong, Zhou Zijun, Zhu Hong
Department of Endocrinology and Metabolism, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
Department of Endocrinology, The Second People's Hospital of Xining, Xining, China.
Front Nutr. 2022 Mar 31;9:803924. doi: 10.3389/fnut.2022.803924. eCollection 2022.
The prevalence of sarcopenia is high in older people with type 2 diabetes mellitus (T2DM) and is now considered a critical problem in the healthcare sector. However, the preferred screening tool for identifying sarcopenia remains unknown. Thus, the aim of this study was to ensure that the diagnostic values of the SARC-F (strength, assisting with walking, rising from a chair, climbing stairs, and falling) and SARC-CalF (SARC and calf circumference) scales were compared with five reference diagnostic criteria for sarcopenia.
This was a cross-sectional study. Patients diagnosed with diabetes were treated at the First Affiliated Hospital of Wenzhou Medical University. Appendicular skeletal muscle mass, muscle strength, and physical performance were assessed using dual-energy X-ray absorptiometry, handgrip strength, and gait speed assessment. Five diagnostic criteria for sarcopenia (Asian Working Group for Sarcopenia, International Working Group on Sarcopenia, Foundation for the National Institutes of Health, Sarcopenia Project, Society on Sarcopenia Cachexia and Wasting Disorders, and European Working Group on Sarcopenia in Older People criteria) were utilized. Sensitivity and specificity analyses were performed on the SARC-CalF and SARC-F scales. The diagnostic precision of both instruments was determined using the receiver-operating characteristic (ROC) curves and area under the ROC curves (AUC).
This study included 689 subjects (459 men and 230 women) with a mean age of 58.1 ± 13.2 years. In accordance with the five reference diagnostic parameters, the prevalence of sarcopenia was between 4.5 and 19.2%. In addition, the range of sensitivity of SARC-F and SARC-CalF ranged from 61.4 to 67.4 and 82.6 to 91.8%, respectively. Concurrently, the specificity ranged from 63.1 to 67.3 and 51.5 to 61.2%, respectively. Overall, AUC values for SARC-CalF were higher than those for SARC-F, regardless of the diagnostic standard, sex, or age.
The results of this study suggest that SARC-CalF significantly enhances the sensitivity and overall diagnosis of SARC-F. SARC-CalF appears to be an optimal screening tool for sarcopenia in adults with T2DM.
2型糖尿病（T2DM）老年患者中肌肉减少症的患病率较高，目前已被视为医疗保健领域的一个关键问题。然而，用于识别肌肉减少症的首选筛查工具仍不明确。因此，本研究的目的是比较SARC-F（力量、行走辅助、从椅子上起身、爬楼梯和跌倒）和SARC-CalF（SARC和小腿围）量表的诊断价值与肌肉减少症的五项参考诊断标准。
这是一项横断面研究。在温州医科大学附属第一医院对确诊为糖尿病的患者进行治疗。使用双能X线吸收法、握力和步态速度评估来评估四肢骨骼肌质量、肌肉力量和身体表现。采用了五项肌肉减少症诊断标准（亚洲肌肉减少症工作组、国际肌肉减少症工作组、美国国立卫生研究院基金会、肌肉减少症项目、肌肉减少症恶病质和消瘦症学会以及欧洲老年人肌肉减少症工作组标准）。对SARC-CalF和SARC-F量表进行敏感性和特异性分析。使用受试者工作特征（ROC）曲线和ROC曲线下面积（AUC）来确定两种工具的诊断准确性。
本研究纳入了689名受试者（459名男性和230名女性），平均年龄为58.1±13.2岁。根据五项参考诊断参数，肌肉减少症的患病率在4.5%至19.2%之间。此外，SARC-F和SARC-CalF的敏感性范围分别为61.4%至67.4%和82.6%至91.8%。同时，特异性范围分别为63.1%至67.3%和51.5%至61.2%。总体而言，无论诊断标准、性别或年龄如何，SARC-CalF的AUC值均高于SARC-F。
本研究结果表明，SARC-CalF显著提高了SARC-F的敏感性和总体诊断能力。SARC-CalF似乎是T2DM成人肌肉减少症的最佳筛查工具。
