社区老年人不同阶段肌少症中 PhA 和 MNA-SF 的筛查效果。
Screening efficacy of PhA and MNA-SF in different stages of sarcopenia in the older adults in community.
机构信息
Department of Child, Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, No.10 YOU'anmenwai Xitoutiao, Fengtai District, Beijing, 100069, China.
Fangzhuang Community Health Center, Capital Medical University, Beijing, 100078, China.
出版信息
BMC Geriatr. 2023 Jan 9;23(1):13. doi: 10.1186/s12877-022-03716-x.
OBJECTIVE
To compare the screening ability of the phase Angle (PhA) and the Short-Form Mini Nutritional Assessment (MNA-SF) alone and combined detection in the different stages of sarcopenia among the older adults in the community.
METHODS
The older adults aged 65 and above were enlisted during community outpatient service and their nutritional status was evaluated by MNA-SF scale. PhA was measured by bioelectrical impedance analysis (BIA). AWGS2019 and EWGSOP2010 were used to define the different stages of sarcopenia. We measured skeletal mass index (SMI) and grip strength with BIA and electronic grip apparatus and measured body function with 6-m pace, SPPB test, and standing test.
RESULTS
The AUC of PhA in the screening of possible sarcopenia was 0.640, the sensitivity was 58.49%, the specificity was 66.67%, and the cut-off value was 4.5. The AUC of the combined PhA and MNA-SF for possible sarcopenia was 0.642, the sensitivity was 57.55%, and the specificity was 70.00%. The AUC of MNA-SF for the screening of pre-sarcopenia was 0.805, the sensitivity was 66.67%, the specificity was 85.83%, and the cut-off value was 12. The AUC of the combined PhA and MNA-SF was 0.826, the sensitivity was 75.00%, and the specificity was 85.00%. The AUC of PhA in the screening of sarcopenia (common type) was 0.808, the sensitivity was 82.35%, the specificity was 73.33%, the cut-off value was 4.4. The AUC of the combined PhA and MNA-SF for sarcopenia (common type) was 0.835, the sensitivity was 76.47% and the specificity was 81.67%. The AUC of PhA and for the screening of severe sarcopenia was 0.935, the sensitivity was 93.33%, the specificity was 92.50%, and the cut-off value was 4.1. The AUC of the combined PhA and MNA-SF was 0.943, the sensitivity was 86.67%, and the specificity was 93.33%.
CONCLUSION
The screening ability of PhA alone or in combination was higher than that of MNA-SF in the screening of possible sarcopenia. The screening ability of the combined detection was higher than that of PhA alone in the screening of pre-sarcopenia. The combination of PhA and MNA-SF or PhA alone all performed better value in the screening of sarcopenia (common type). Compared to MNA-SF, the PhA performed better in the screening of severe sarcopenia, which provided references for identifying patients with different stages of sarcopenia in the community.
目的
比较相位角（PhA）和简易营养评估量表（MNA-SF）单独及联合检测在社区老年人不同阶段肌少症中的筛查能力。
方法
招募年龄在 65 岁及以上的社区门诊老年人，用 MNA-SF 量表评估其营养状况。用生物电阻抗分析法（BIA）测量 PhA。用 AWGS2019 和 EWGSOP2010 定义不同阶段的肌少症。用 BIA 和电子握力计测量骨骼质量指数（SMI）和握力，用 6 米步速、SPPB 测试和站立测试测量身体功能。
结果
PhA 筛查可能肌少症的 AUC 为 0.640，灵敏度为 58.49%，特异性为 66.67%，截断值为 4.5。PhA 和 MNA-SF 联合筛查可能肌少症的 AUC 为 0.642，灵敏度为 57.55%，特异性为 70.00%。MNA-SF 筛查前肌少症的 AUC 为 0.805，灵敏度为 66.67%，特异性为 85.83%，截断值为 12。PhA 和 MNA-SF 联合筛查前肌少症的 AUC 为 0.826，灵敏度为 75.00%，特异性为 85.00%。PhA 筛查常见型肌少症的 AUC 为 0.808，灵敏度为 82.35%，特异性为 73.33%，截断值为 4.4。PhA 和 MNA-SF 联合筛查常见型肌少症的 AUC 为 0.835，灵敏度为 76.47%，特异性为 81.67%。PhA 筛查严重型肌少症的 AUC 为 0.935，灵敏度为 93.33%，特异性为 92.50%，截断值为 4.1。PhA 和 MNA-SF 联合筛查严重型肌少症的 AUC 为 0.943，灵敏度为 86.67%，特异性为 93.33%。
结论
PhA 单独或联合检测在筛查可能肌少症时的筛查能力均高于 MNA-SF。联合检测在筛查前肌少症时的筛查能力高于 PhA 单独检测。PhA 和 MNA-SF 联合或 PhA 单独检测在筛查常见型肌少症时均具有较好的效果。与 MNA-SF 相比，PhA 在前肌少症的筛查中表现更好，为识别社区中不同阶段肌少症患者提供了参考。
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