无脂肪质量指数作为用于筛查肌少症中低肌肉量的四肢骨骼肌质量指数的替代标志物。
Fat-Free Mass Index as a Surrogate Marker of Appendicular Skeletal Muscle Mass Index for Low Muscle Mass Screening in Sarcopenia.
作者信息
Kawakami Ryoko, Tanisawa Kumpei, Ito Tomoko, Usui Chiyoko, Miyachi Motohiko, Torii Suguru, Midorikawa Taishi, Ishii Kaori, Muraoka Isao, Suzuki Katsuhiko, Sakamoto Shizuo, Higuchi Mitsuru, Oka Koichiro
机构信息
Cancer Prevention and Control Division, Kanagawa Cancer Center Research Institute, Kanagawa, Japan; Department of Genetic Medicine, Kanagawa Cancer Center, Kanagawa, Japan; Waseda Institute for Sport Sciences, Waseda University, Saitama, Japan.
Faculty of Sport Sciences, Waseda University, Saitama, Japan.
出版信息
J Am Med Dir Assoc. 2022 Dec;23(12):1955-1961.e3. doi: 10.1016/j.jamda.2022.08.016. Epub 2022 Sep 28.
OBJECTIVES
We aimed to examine the relationship between the fat-free mass index (FFMI; FFM/height) and appendicular skeletal muscle mass index (ASMI; ASM/height), measured using both bioelectrical impedance analysis (BIA) and dual-energy X-ray absorptiometry (DXA), and investigate the effects of age and obesity. We also evaluated the suitability of BIA-measured FFMI as a simple surrogate marker of the ASMI and calculated the optimal FFMI cutoff value for low muscle mass screening to diagnose sarcopenia.
DESIGN
Cross-sectional study.
SETTING AND PARTICIPANTS
This study included 1313 adults (women, 33.6%) aged 40-87 years (mean age, 55 ± 10 years) from the WASEDA'S Health Study.
METHODS
Body composition was measured using multifrequency BIA and DXA. Low muscle mass was defined according to the criteria of the Asian Working Group for Sarcopenia 2019.
RESULTS
BIA-measured FFMI showed strong positive correlations with both BIA- (r = 0.96) and DXA-measured (r = 0.95) ASMIs. Similarly, in the subgroup analysis according to age and obesity, the FFMI was correlated with the ASMI. The areas under the receiver operating characteristic curve for screening low muscle mass defined by DXA-measured ASMI using BIA-measured FFMI values were 0.95 (95% CI 0.93-0.97) for men and 0.91 (95% CI 0.87-0.94) for women. The optimal BIA-measured FFMI cutoff values for screening low muscle mass defined by DXA-measured ASMI were 17.5 kg/m (sensitivity 89%, specificity 88%) for men and 14.6 kg/m (sensitivity 80%, specificity 86%) for women.
CONCLUSIONS AND IMPLICATIONS
The FFMI showed a strong positive correlation with BIA- and DXA-measured ASMIs, regardless of age and obesity. The FFMI could be a useful simple surrogate marker of the ASMI for low muscle mass screening in sarcopenia in community settings. The suggested FFMI cutoff values for predicting low muscle mass are <18 kg/m in men and <15 kg/m in women.
目的
我们旨在研究使用生物电阻抗分析（BIA）和双能X线吸收法（DXA）测量的去脂体重指数（FFMI；FFM/身高）与四肢骨骼肌质量指数（ASMI；ASM/身高）之间的关系，并调查年龄和肥胖的影响。我们还评估了通过BIA测量的FFMI作为ASMI简单替代指标的适用性，并计算了用于低肌肉量筛查以诊断肌肉减少症的最佳FFMI临界值。
设计
横断面研究。
地点和参与者
本研究纳入了来自早稻田大学健康研究的1313名40 - 87岁（平均年龄55±10岁）的成年人（女性占33.6%）。
方法
使用多频BIA和DXA测量身体成分。根据2019年亚洲肌肉减少症工作组的标准定义低肌肉量。
结果
通过BIA测量的FFMI与通过BIA测量的ASMI（r = 0.96）和通过DXA测量的ASMI（r = 0.95）均呈强正相关。同样，在根据年龄和肥胖进行的亚组分析中，FFMI与ASMI相关。使用通过BIA测量的FFMI值筛查由DXA测量的ASMI定义的低肌肉量时，男性的受试者操作特征曲线下面积为0.95（95%CI 0.93 - 0.97），女性为0.91（95%CI 0.87 - 0.94）。通过DXA测量的ASMI定义的筛查低肌肉量的最佳BIA测量的FFMI临界值，男性为17.5 kg/m²（敏感性89%，特异性88%），女性为14.6 kg/m²（敏感性80%，特异性86%）。
结论和启示
无论年龄和肥胖情况如何，FFMI与通过BIA和DXA测量的ASMI均呈强正相关。在社区环境中，FFMI可能是用于肌肉减少症低肌肉量筛查的ASMI的有用简单替代指标。预测低肌肉量的建议FFMI临界值为男性<18 kg/m²，女性<15 kg/m²。
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