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老年人中肌少症的流行率以及欧洲老年人肌少症工作组 2(EWGSOP2)提出的诊断工具之间的一致性水平。

Prevalence of sarcopenia in older women and level of agreement between the diagnostic instruments proposed by the European Working Group on Sarcopenia in Older People 2 (EWGSOP2).

机构信息

Universidade Federal de Santa Catarina (Federal University of Santa Catarina), Araranguá, SC, Brazil.

Universidade Federal dos Vales do Jequitinhonha e Mucuri (Federal University of the Jequitinhonha and Mucuri Valleys), Diamantina, MG, Brazil.

出版信息

BMC Musculoskelet Disord. 2023 Mar 11;24(1):182. doi: 10.1186/s12891-023-06287-z.

Abstract

BACKGROUND

The European Working Group on Sarcopenia in Older People 2 (EWGSOP2) proposed the use of different diagnostic tools to assess sarcopenia. This study aimed to determine prevalence rates of sarcopenia according to the diagnostic instruments proposed by EWGSOP2 and to assess their level of agreement in older Brazilian women.

METHODS

A cross-sectional study with 161 community-dwelling older Brazilian women. Probable sarcopenia was assessed through Handgrip Strength (HGS) and the 5-times sit-to-stand test (5XSST). In addition to reduced strength, Appendicular Skeletal Muscle Mass (ASM) (obtained by Dual-energy X-ray absorptiometry) and ASM/height² were considered for diagnosis confirmation. Sarcopenia severity was determined by reduced muscle strength and mass and poor functional performance assessed by Gait Speed (GS), Short Physical Performance Battery (SPPB), and Timed Up and Go test (TUG). McNemar's test and Cochran's Q-test were used to compare sarcopenia prevalence. Cohen's Kappa and Fleiss's Kappa tests were used to assess the level of agreement.

RESULTS

The prevalence of probable sarcopenia was significantly different (p < 0.05) when using HGS (12.8%) and 5XSST (40.6%). Regarding confirmed sarcopenia, the prevalence was lower when using ASM/height² than with ASM. Regarding severity, the use of SPPB resulted in a higher prevalence in relation to GS and TUG.

CONCLUSION

There were differences in the prevalence rates of sarcopenia and low agreement between the diagnostic instruments proposed by the EWGSOP2. The findings suggest that these issues must be considered in the discussion on the concept and assessment of sarcopenia, which could ultimately help to better identify patients with this disease in different populations.

摘要

背景

欧洲老年人肌少症工作组 2 (EWGSOP2)提出使用不同的诊断工具来评估肌少症。本研究旨在根据 EWGSOP2 提出的诊断工具确定肌少症的患病率,并评估它们在巴西老年女性中的一致性水平。

方法

这是一项横断面研究,共纳入 161 名居住在社区的巴西老年女性。通过握力(HGS)和 5 次坐站测试(5XSST)评估疑似肌少症。除了肌肉力量降低外,还考虑通过双能 X 线吸收法(DXA)获得的四肢骨骼肌质量(ASM)和 ASM/身高²来确诊。肌少症的严重程度通过肌肉力量和质量降低以及步态速度(GS)、简短体能状况量表(SPPB)和计时起立行走测试(TUG)评估的功能表现不良来确定。采用 McNemar 检验和 Cochran's Q 检验比较肌少症的患病率。采用 Cohen's Kappa 和 Fleiss's Kappa 检验评估一致性水平。

结果

当使用 HGS(12.8%)和 5XSST(40.6%)时,疑似肌少症的患病率存在显著差异(p<0.05)。在确诊肌少症方面,使用 ASM/身高²时的患病率低于使用 ASM 时的患病率。在严重程度方面,与 GS 和 TUG 相比,使用 SPPB 会导致更高的患病率。

结论

EWGSOP2 提出的诊断工具在肌少症的患病率和一致性方面存在差异。这些发现表明,在讨论肌少症的概念和评估时必须考虑这些问题,这最终有助于更好地识别不同人群中患有这种疾病的患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f701/10007796/6e8deb03fa9d/12891_2023_6287_Fig1_HTML.jpg

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