Sui Sophia X, Holloway-Kew Kara L, Hyde Natalie K, Williams Lana J, Tembo Monica C, West Emma, Pasco Julie A
IMPACT-Institute for Mental and Physical Health and Clinical Translation, Deakin University, Geelong, VIC 3220, Australia.
Department of Medicine-Western Campus, The University of Melbourne, St Albans, VIC 3010, Australia.
J Clin Med. 2022 May 20;11(10):2906. doi: 10.3390/jcm11102906.
We aimed to examine associations between skeletal muscle deficits and indices of poor health. Cut-points for skeletal muscle deficits were derived using data from the Geelong Osteoporosis Study and definitions from the revised European Consensus on Definition and Diagnosis and the Foundation for the National Institutes of Health. Participants ( = 665; 323 women) aged 60-96 year had handgrip strength measured by dynamometry and appendicular lean mass by whole-body dual-energy X-ray absorptiometry. Physical performance was assessed using the Timed Up and Go test. Sex-specific cut-points were equivalent to two standard deviations below the mean young reference range from the Geelong Osteoporosis Study. Indices of poor health included fractures, falls, and hospitalisations. Low trauma fractures since age 50 year (excluding skull, face, digits) were self-reported and confirmed using radiological reports. Falls (≥1 in the past 12 months) and hospitalisations (past month) were self-reported. Logistic regression models (age- and sex-adjusted) were used to examine associations. Receiver Operating Characteristic curves were applied to determine optimal cut-points for handgrip strength, Timed Up and Go, appendicular lean mass/height, and appendicular lean mass/body mass index that discriminated poor health outcomes. There were 48 participants (6.9%) with hospitalisations, 94 (13.4%) with fractures, and 177 (25.3%) with at least one fall (≥1). For all cut-points, low handgrip strength was consistently associated with falls. There was little evidence to support an association between low appendicular lean mass, using any cut-point, and indices of poor health. Optimal cut-offs for predicting falls (≥1) were: handgrip strength 17.5 kg for women and 33.5 kg for men; Timed Up and Go 8.6 s for women and 9.9 s for men; appendicular lean mass/height 6.2 kg/m for women and 7.46 kg/m for men; and appendicular lean mass/body mass index 0.6 m for women and 0.9 m for men. In conclusion, muscle strength and function performed better than lean mass to indicate poor health. These findings add to the growing evidence base to inform decisions regarding the selection of skeletal muscle parameters and their optimal cut-points for identifying sarcopenia.
我们旨在研究骨骼肌缺陷与健康状况不佳指标之间的关联。骨骼肌缺陷的切点是根据吉朗骨质疏松症研究的数据以及修订后的欧洲定义与诊断共识和美国国立卫生研究院基金会的定义得出的。60至96岁的参与者（n = 665；323名女性）通过握力计测量握力，并通过全身双能X线吸收法测量四肢瘦体重。使用定时起立行走测试评估身体机能。特定性别的切点相当于低于吉朗骨质疏松症研究中年轻参考范围均值两个标准差。健康状况不佳的指标包括骨折、跌倒和住院。50岁以后（不包括颅骨、面部、手指）的低创伤骨折通过自我报告并经放射学报告确认。跌倒（过去12个月内≥1次）和住院（过去一个月内）通过自我报告。使用逻辑回归模型（按年龄和性别调整）来研究关联。应用受试者工作特征曲线来确定握力、定时起立行走、四肢瘦体重/身高以及四肢瘦体重/体重指数的最佳切点，这些切点能够区分健康状况不佳的结果。有48名参与者（6.9%）住院，94名（13.4%）发生骨折，177名（25.3%）至少跌倒过一次（≥1次）。对于所有切点，握力低始终与跌倒相关。几乎没有证据支持使用任何切点定义的低四肢瘦体重与健康状况不佳指标之间存在关联。预测跌倒（≥1次）的最佳临界值为：女性握力17.5千克，男性握力33.5千克；女性定时起立行走8.6秒，男性定时起立行走9.9秒；女性四肢瘦体重/身高6.2千克/米，男性四肢瘦体重/身高7.46千克/米；女性四肢瘦体重/体重指数0.6米，男性四肢瘦体重/体重指数0.9米。总之，肌肉力量和功能在指示健康状况不佳方面比瘦体重表现更好。这些发现为不断增加的证据基础添砖加瓦，有助于就选择骨骼肌参数及其用于识别肌肉减少症的最佳切点做出决策。
