Juby Angela G, Davis Christopher M J, Minimaana Suglo, Mager Diana R
Department of Medicine, Division of Geriatrics, Faculty of Medicine and Dentistry, University of Alberta.
Faculty of Kinesiology, University of Alberta.
Can Geriatr J. 2023 Dec 1;26(4):493-501. doi: 10.5770/cgj.26.626. eCollection 2023 Dec.
Sarcopenia is associated with increased morbidity and mortality. Clinically, sarcopenia can be overlooked, especially in obesity. Sarcopenia diagnostic criteria include muscle mass (MM) and function assessments. Muscle function can be readily assessed in a clinic setting (grip strength, chair stand test). However, MM requires dual-energy X-ray absorptiometry (DXA) Body Composition (BC) or other costly tools, not readily available.
Observational cohort pilot study of independently mobile, community dwelling older adults, comparing MM using two office-based, direct-to-consumer bioimpedance (BIA) scales (Ozeri [manufactured in China] and OMRON [OMRON HBF-510 Full Body Sensor, Shiokoji Horikawa, Kyoto, Japan] to DXA. The OMRON differs from the Ozeri scale because the OMRON also includes hand sensors. The European Working Group on Sarcopenia in Older People (EWGSOP) DXA or BIA low MM diagnostic cut-offs were used to classify participants as having low or normal MM.
Fifty participants: 11 men, 39 women. Forty-two completed DXA. Age 75.8 yrs [67-90]. 81% obese based on body fat cut-offs. With DXA [ASM/height], 15 had low MM. Using BIA [mmass/height], 7 with Ozeri, and 27 with OMRON, had low MM. Positive predictive value for low MM versus DXA (as the gold standard) for Ozeri was 73.3% and OMRON was 92.8%. Good correlation between BIA scales and DXA for body fat estimates.
OMRON captured all low MM participants identified by DXA plus all on DXA diagnostic borderline. Prevalence of obesity was high. Clinically, sarcopenic obese is the most difficult phenotype, as obesity masks low muscle mass. Low cost, readily available, direct-to-consumer BIA BC scales, especially with hand sensors, provide immediate, reliable information on muscle and fat mass. This can prompt appropriate investigation and/or intervention for sarcopenia or sarcopenic obesity.
肌肉减少症与发病率和死亡率增加相关。临床上，肌肉减少症可能被忽视，尤其是在肥胖人群中。肌肉减少症的诊断标准包括肌肉量（MM）和功能评估。肌肉功能可在临床环境中轻松评估（握力、椅子站立试验）。然而，MM需要双能X线吸收法（DXA）身体成分（BC）或其他昂贵工具，且不易获得。
对能够独立活动的社区居住老年人进行观察性队列试点研究，将使用两种基于办公室的直接面向消费者的生物电阻抗（BIA）秤（奥泽里[中国制造]和欧姆龙[欧姆龙HBF-510全身传感器，日本京都四条堀川]）测量的MM与DXA进行比较。欧姆龙与奥泽里秤不同，因为欧姆龙还包括手部传感器。采用欧洲老年人肌肉减少症工作组（EWGSOP）的DXA或BIA低MM诊断临界值将参与者分类为低MM或正常MM。
50名参与者：11名男性，39名女性。42人完成了DXA检查。年龄75.8岁[67 - 90岁]。根据体脂临界值，81%为肥胖。采用DXA[ASM/身高]，15人MM低。采用BIA[mmass/身高]，奥泽里秤测量有7人MM低，欧姆龙秤测量有27人MM低。奥泽里秤对低MM相对于DXA（作为金标准）的阳性预测值为73.3%，欧姆龙秤为92.8%。BIA秤与DXA在体脂估计方面具有良好相关性。
欧姆龙检测出了DXA识别出的所有低MM参与者以及所有处于DXA诊断临界值的参与者。肥胖患病率较高。临床上，肌肉减少性肥胖是最难处理的表型，因为肥胖掩盖了低肌肉量。低成本、易于获得、直接面向消费者的BIA BC秤，尤其是带有手部传感器的，可提供关于肌肉和脂肪量的即时、可靠信息。这可以促使对肌肉减少症或肌肉减少性肥胖进行适当的调查和/或干预。
