Chalermsri Chalobol, Aekplakorn Wichai, Srinonprasert Varalak
Division of Geriatric Medicine, Department of Preventive and Social Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
Front Nutr. 2022 Jun 30;9:881121. doi: 10.3389/fnut.2022.881121. eCollection 2022.
Body mass index (BMI) and sarcopenia are common indicators of nutritional status. Possible sarcopenia, defined as low muscle strength or performance, was recently introduced by the Asian Working Group for Sarcopenia (AWGS) in 2019. We investigated for association between all-cause mortality and BMI combined with possible sarcopenia severity in Asian older adults.
This study included a subpopulation (8,195 participants aged ≥60 years; male gender: 49.4%; mean age: 69.2 ± 6.8 years) from the Fourth Thai National Health Examination Survey (NHES-IV). BMI was classified using Asia-Pacific cut-offs. Possible sarcopenia was defined using quadriceps strength based on AWGS 2019 criteria, and possible sarcopenia severity was determined using study population quartile cut-offs. All-cause mortality data was derived from the national vital registry in 2020.
The prevalence of underweight status and possible sarcopenia was 11.8 and 38.9%, respectively. Multivariate analysis showed underweight individuals with severe possible sarcopenia to be at highest risk for increased mortality [adjusted hazard ratio (aHR): 3.98, 95% confidence interval (CI): 2.89-5.48], and higher risk was found in men compared to women (aHR: 5.35, 95% CI: 1.19-8.97). Obese status without possible sarcopenia was an independent protective factor (aHR: 0.61, 95% CI: 0.38-0.97).
BMI combined with possible sarcopenia severity is a better predictor of mortality risk than either parameter alone.
体重指数（BMI）和肌肉减少症是营养状况的常见指标。亚洲肌肉减少症工作组（AWGS）于2019年引入了可能的肌肉减少症，定义为肌肉力量或功能低下。我们调查了亚洲老年人全因死亡率与BMI以及可能的肌肉减少症严重程度之间的关联。
本研究纳入了泰国第四次全国健康检查调查（NHES-IV）的一个亚人群（8195名年龄≥60岁的参与者；男性占49.4%；平均年龄：69.2±6.8岁）。BMI根据亚太地区的临界值进行分类。根据AWGS 2019标准，使用股四头肌力量定义可能的肌肉减少症，并使用研究人群四分位数临界值确定可能的肌肉减少症严重程度。全因死亡率数据来自2020年的国家人口动态登记处。
体重不足状态和可能的肌肉减少症的患病率分别为11.8%和38.9%。多变量分析显示，患有严重可能肌肉减少症的体重不足个体死亡率增加的风险最高[调整后风险比（aHR）：3.98，95%置信区间（CI）：2.89-5.48]，男性的风险高于女性（aHR：5.35，95%CI：1.19-8.97）。没有可能肌肉减少症的肥胖状态是一个独立的保护因素（aHR：0.61，95%CI：0.38-0.97）。
BMI与可能的肌肉减少症严重程度相结合比单独使用任何一个参数更能预测死亡风险。
