Kenji Toyoshima, Department of Diabetes, Metabolism, and Endocrinology, Tokyo Metropolitan Geriatric Hospital, 35-2 Sakae-cho, Itabashi-ku, Tokyo, Japan, E-mail:
J Nutr Health Aging. 2022;26(5):501-509. doi: 10.1007/s12603-022-1786-8.
This study aimed to (1) develop the physical fitness age, which is the biological age based on physical function, (2) evaluate the validity of the physical fitness age for the assessment of sarcopenia, and (3) examine the factors associated with the difference between physical fitness age and chronological age.
Cross-sectional study.
Community-dwelling older adults and outpatients.
A formula for calculating the physical fitness age was created based on the usual walking speed, handgrip strength, one-leg standing time, and chronological age of 4,076 older adults from the pooled data of community-dwelling and outpatients using the principal component analysis. For the validation of the physical fitness age, we also used pooled data from community-dwelling older adults (n = 1929) and outpatients (n = 473). Sarcopenia was diagnosed according to the Asian Working Group for Sarcopenia 2019 consensus. The association of D-age (the difference between physical and chronological ages) with cardiovascular risk factors, renal function, and cardiac function was examined.
The receiver operating characteristic analysis, with sarcopenia as the outcome, showed that the area under the curve (AUC) of physical fitness age was greater than that of chronological age (AUC 0.87 and 0.77, respectively, p < 0.001). Binomial logistic regression analysis revealed that the D-age was significantly associated with sarcopenia after adjustment for covariates (odds ratio 1.22, 95% confidence interval 1.19-1.26; p <0.001). In multivariate linear regression analysis with D-age as the dependent variable, D-age was independently associated with a history of diabetes mellitus (or hemoglobin A1c as a continuous variable), obesity, depression, and low serum albumin level. D-age was also correlated with estimated glomerular filtration rate derived from serum cystatin C, brain natriuretic peptide, and ankle-brachial index, reflecting some organ function and arteriosclerosis.
Compared to chronological age, physical fitness age calculated from handgrip strength, one-leg standing time, and usual walking speed was a better scale for sarcopenia. D-age, which could be a simple indicator of physical function, was associated with modifiable factors, such as poor glycemic control, obesity, depressive symptoms, and malnutrition.
本研究旨在：(1) 制定体能年龄，即基于身体功能的生物学年龄；(2) 评估体能年龄对肌少症评估的有效性；(3) 检验体能年龄与实际年龄之间差异的相关因素。
横断面研究。
社区居住的老年人和门诊患者。
基于社区居住和门诊老年人汇总数据（n=4076）的常规步行速度、握力、单腿站立时间和年龄，采用主成分分析法建立计算体能年龄的公式。为了验证体能年龄，我们还使用了社区居住老年人（n=1929）和门诊患者（n=473）的汇总数据。根据亚洲肌少症工作组 2019 年共识，诊断肌少症。检验 D 年龄（体能年龄与实际年龄之间的差异）与心血管危险因素、肾功能和心功能的关系。
以肌少症为结局的受试者工作特征曲线分析显示，体能年龄的曲线下面积（AUC）大于实际年龄（AUC 分别为 0.87 和 0.77，p<0.001）。二项逻辑回归分析显示，在调整协变量后，D 年龄与肌少症显著相关（比值比 1.22，95%置信区间 1.19-1.26；p<0.001）。在以 D 年龄为因变量的多元线性回归分析中，D 年龄与糖尿病病史（或血红蛋白 A1c 作为连续变量）、肥胖、抑郁和低血清白蛋白水平独立相关。D 年龄与血清胱抑素 C、脑利钠肽和踝臂指数所反映的一些器官功能和动脉硬化相关。
与实际年龄相比，从握力、单腿站立时间和常规步行速度计算得出的体能年龄是肌少症更好的评估指标。D 年龄是身体功能的一个简单指标，与可改变的因素相关，如血糖控制不佳、肥胖、抑郁症状和营养不良。
