Hatanaka Sho, Osuka Yosuke, Kojima Narumi, Motokawa Keiko, Hayakawa Misato, Mikami Yurie, Iwasaki Masanori, Inagaki Hiroki, Miyamae Fumiko, Okamura Tsuyoshi, Hirano Hirohiko, Awata Shuichi, Sasai Hiroyuki
Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan; Integrated Research Initiative for Living Well with Dementia, Tokyo Metropolitan Institute for Geriatrics and Gerontology.
Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan; Department of Frailty Research, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Aichi, Japan.
Nutrition. 2024 Mar;119:112289. doi: 10.1016/j.nut.2023.112289. Epub 2023 Oct 31.
Evaluating muscle quality instead of its mass has gained attention in diagnosing sarcopenia. The aim of this study was to examine whether phase angle (PhA) as a bioelectrical impedance analysis (BIA)-derived muscle quality indicator is associated with overall lower extremity function better than appendicular skeletal muscle mass index (ASMI) in community-dwelling older adults.
This cross-sectional study used data from the Itabashi Longitudinal Study on Aging, a community-based cohort study. A sex-stratified multivariate logistic regression analysis was conducted using PhA and ASMI as exposures, and low physical function defined as short physical performance battery score <10 as the outcome, adjusted for age, being overweight, knee pain, and non-communicable diseases. Discrimination of low physical function was compared using the receiver operating characteristic curve.
This study included 1464 participants (age 76 [73-80] y; 757 women), with 58 men (8%) and 66 women (9%) exhibiting low physical function. The multivariate odds ratio (OR; 95% confidence interval [CI]) for low physical function among the highest quartile, compared with the lowest quartile were significant in PhA in multiple sites (e.g., OR, 0.09; 95% CI, 0.03-0.32] for men and 0.12; 95% CI, 0.04-0.33 for women in the left leg) but not in ASMI (OR, 0.51; 95% CI, 0.19-1.34 for men and 0.56; 95% CI, 0.21-1.47 for women). Legs and whole-body PhA outperformed the ASMI in discriminating low physical function (P < 0.001).
PhA reflected physical function better than ASMI; using PhA instead of ASMI in BIA-based morphometric evaluation may add information on low physical function and enhance the diagnostic value of sarcopenia.
在肌少症诊断中，评估肌肉质量而非其数量已受到关注。本研究的目的是检验在社区居住的老年人中，作为生物电阻抗分析（BIA）衍生的肌肉质量指标的相位角（PhA）是否比四肢骨骼肌质量指数（ASMI）与整体下肢功能的关联更强。
这项横断面研究使用了来自板桥老龄化纵向研究的数据，这是一项基于社区的队列研究。以PhA和ASMI作为暴露因素，以身体表现电池评分短<10定义的低身体功能作为结局，进行性别分层的多变量逻辑回归分析，并对年龄、超重、膝关节疼痛和非传染性疾病进行校正。使用受试者工作特征曲线比较低身体功能的辨别力。
本研究纳入了1464名参与者（年龄76[73 - 80]岁；757名女性），其中58名男性（8%）和66名女性（9%）表现出低身体功能。与最低四分位数相比，最高四分位数中低身体功能的多变量优势比（OR；95%置信区间[CI]）在多个部位的PhA中具有显著性（例如，左腿男性的OR为0.09；95%CI为0.03 - 0.32，女性为0.12；95%CI为0.04 - 0.33），但在ASMI中不具有显著性（男性的OR为0.51；95%CI为0.19 - 1.34，女性为0.56；95%CI为0.21 - 1.47）。在辨别低身体功能方面，腿部和全身PhA优于ASMI（P < 0.001）。
PhA比ASMI能更好地反映身体功能；在基于BIA的形态学评估中使用PhA而非ASMI可能会增加有关低身体功能的信息，并提高肌少症的诊断价值。
