Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Neuherberg, Germany.
Institute of Medical Epidemiology, Biometrics and Informatics, Interdisciplinary Center for Health Sciences, Medical Faculty of the Martin Luther University Halle-Wittenberg, Halle (Saale), Germany.
Age Ageing. 2023 Jan 8;52(1). doi: 10.1093/ageing/afac324.
The European Working Group on Sarcopenia in Older People (EWGSOP) updated in 2018 the cut-off points for low grip strength to assess sarcopenia based on pooled data from 12 British studies.
Comparison of the EWGSOP2 cut-off points for low grip strength to those derived from a large German sample.
We assessed the grip strength distribution across age and derived low grip strength cut-off points for men and women (peak mean -2.5 × SD) based on 200,389 German National Cohort (NAKO) participants aged 19-75 years. In 1,012 Cooperative Health Research in the Region of Augsburg (KORA)-Age participants aged 65-93 years, we calculated the age-standardised prevalence of low grip strength and time-dependent sensitivity and specificity for all-cause mortality.
Grip strength increased in the third and fourth decade of life and declined afterwards. Calculated cut-off points for low grip strength were 29 kg for men and 18 kg for women. In KORA-Age, the age-standardised prevalence of low grip strength was 1.5× higher for NAKO-derived (17.7%) compared to EWGSOP2 (11.7%) cut-off points. NAKO-derived cut-off points yielded a higher sensitivity and lower specificity for all-cause mortality.
Cut-off points for low grip strength from German population-based data were 2 kg higher than the EWGSOP2 cut-off points. Higher cut-off points increase the sensitivity, thereby suggesting an intervention for more patients at risk, while other individuals might receive additional diagnostics/treatment without the urgent need. Research on the effectiveness of intervention in patients with low grip strength defined by different cut-off points is needed.
欧洲老年人肌肉减少症工作组(EWGSOP)于 2018 年更新了基于 12 项英国研究汇总数据评估肌肉减少症的低握力截断值。
比较 EWGSOP2 低握力截断值与来自大型德国样本的截断值。
我们评估了年龄范围内的握力分布,并根据 200,389 名年龄在 19-75 岁的德国国家队列(NAKO)参与者的峰值平均握力减去 2.5×标准差,得出男性和女性的低握力截断值。在年龄在 65-93 岁的 1,012 名奥格斯堡合作健康研究(KORA)-Age 参与者中,我们计算了所有原因死亡率的低握力标准化患病率以及年龄依赖性敏感性和特异性。
握力在第三和第四十年增加,然后下降。计算得出的低握力截断值为男性 29 公斤,女性 18 公斤。在 KORA-Age 中,与 EWGSOP2 (11.7%)截断值相比,NAKO 衍生的低握力标准化患病率高 1.5 倍(17.7%)。NAKO 衍生的截断值对所有原因死亡率具有更高的敏感性和更低的特异性。
基于德国人群数据的低握力截断值比 EWGSOP2 截断值高 2 公斤。更高的截断值提高了敏感性,从而表明更多有风险的患者需要进行干预,而其他患者可能需要进行额外的诊断/治疗,但并不紧急。需要研究不同截断值定义的低握力患者干预的有效性。