IHU HealthAge, Frailty Clinic, Toulouse University Hospital, La Cité de la Santé, Hôpital La Grave, Place Lange, Toulouse 31059, France; Division of Subacute Care, IRCCS, Istituti Clinici Scientifici Maugeri, Milan, Italy.
IHU HealthAge, Frailty Clinic, Toulouse University Hospital, La Cité de la Santé, Hôpital La Grave, Place Lange, Toulouse 31059, France.
Clin Nutr. 2024 Mar;43(3):701-707. doi: 10.1016/j.clnu.2024.01.028. Epub 2024 Jan 30.
BACKGROUND & AIMS: The association between sarcopenia and malnutrition has been poorly studied in the older population. The purpose of this study is to address the association between sarcopenia, according to different validated definitions, and nutritional status in a large population of community-dwelling older adults.
Observational, cross-sectional study of the Geriatric Frailty Clinic (GFC) for Assessment of Frailty and Prevention of Disability, held by the "Gérontopôle" of the Toulouse University Hospital. Patients aged above 65 years who benefitted from a Dual X-ray Densitometry (DXA) during their assessment at the GFC from June 5th 2013 to January 28th 2020 were included. Sarcopenia was defined according to proposed validated definitions. The Mini Nutritional Assessment (MNA) was used to stratify nutritional status, and identify patients with a poor nutritional status (at risk of malnutrition or malnourished, MNA <24). Multiple logistic regression analyses were performed between MNA and each sarcopenia definition adjusted for confounders.
Among the 938 patients with DXA data, a total of 809 (86.2 %) subjects were included in the analysis (mean age 81.8 ± 6.9 years, 527 females (65.1 %)). Prevalence of sarcopenia ranged from 12.6 % to 44.9 %, according to various definitions. Overall 244 (30.2 %) of the patients had a poor nutritional status (MNA-score <24), Baumgartner and Newman definitions of sarcopenia were both associated with low MNA-scores (OR = 4.69, CI 3.15-6.98 and OR = 2.30, CI 1.55-3.14, respectively), EWGSOP2 "confirmed sarcopenia" definition was also associated with low MNA-scores (OR = 3.68, CI 2.30-5.89), as well as for the lean mass definition according EWGSOP2 cut-off (OR 5.22 CI 3.52-7.73). Both FNIH and EWGSOP2 "probable sarcopenia" definitions were not associated with the risk of malnutrition.
In this study, the prevalence of sarcopenia ranged from 12.6 to 44.9 % according to various definitions. A score of MNA under 24, was associated with almost all of the sarcopenia definitions. This study reinforces the concept that malnutrition and sarcopenia are strictly related. When facing malnutrition in daily clinical practice, body composition should be assessed and the proposed nutritional intervention should be tailored by these results in order to prevent the onset of late-life disability.
肌肉减少症与营养不良之间的关联在老年人群中研究甚少。本研究的目的是探讨根据不同的经过验证的定义，肌肉减少症与营养状况在大量社区居住的老年人中的关联。
这是一项观察性、横断面研究，涉及 Toulouse 大学医院“Gérontopôle”的老年虚弱诊所（GFC）的虚弱评估和残疾预防。2013 年 6 月 5 日至 2020 年 1 月 28 日期间，在 GFC 评估期间接受双能 X 线吸收法（DXA）检查的年龄在 65 岁以上的患者纳入研究。根据提出的经过验证的定义，将肌肉减少症定义为：通过 DXA 检查，测量四肢骨骼肌质量（kg），男性＜7.26kg/m2，女性＜5.45kg/m2，或通过生物电阻抗分析（BIA），男性＜7.0kg/m2，女性＜5.7kg/m2。采用 Mini Nutritional Assessment（MNA）量表对营养状况进行分层，确定营养状况不良（有营养不良风险或营养不良，MNA<24）的患者。采用多因素逻辑回归分析，对 MNA 与经过校正混杂因素的每一种肌肉减少症定义进行分析。
在 938 名有 DXA 数据的患者中，共有 809 名（86.2%）患者纳入分析（平均年龄 81.8±6.9 岁，527 名女性（65.1%））。根据不同的定义，肌肉减少症的患病率从 12.6%到 44.9%不等。总体而言，244 名（30.2%）患者存在营养状况不良（MNA 评分<24）。Baumgartner 和 Newman 定义的肌肉减少症均与较低的 MNA 评分相关（OR=4.69，CI 3.15-6.98 和 OR=2.30，CI 1.55-3.14），EWGSOP2“确诊的肌肉减少症”定义也与较低的 MNA 评分相关（OR=3.68，CI 2.30-5.89），以及根据 EWGSOP2 截断值的瘦体重定义（OR 5.22 CI 3.52-7.73）。FNIH 和 EWGSOP2“可能的肌肉减少症”定义均与营养不良风险无关。
在这项研究中，根据不同的定义，肌肉减少症的患病率从 12.6%到 44.9%不等。MNA 评分<24 与几乎所有的肌肉减少症定义有关。本研究进一步证实了营养不良和肌肉减少症密切相关的概念。在日常临床实践中，当面对营养不良时，应评估身体成分，并根据这些结果进行适当的营养干预，以预防老年失能的发生。
