Department of Neurology, Inha University Hospital, Incheon, South Korea.
Department of Neurology, Seoul Metropolitan Government - Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, South Korea.
Parkinsonism Relat Disord. 2024 Aug;125:107039. doi: 10.1016/j.parkreldis.2024.107039. Epub 2024 Jun 14.
To investigate the accuracy of the SARC-F questionnaire to identify sarcopenia in patients with Parkinson's disease (PD).
We prospectively recruited patients with PD who had a score of 3 or lower on the Hoehn and Yahr (H&Y) scale. Appendicular skeletal muscle mass (ASM), hand grip strength, and the SARC-F were used to assess sarcopenia. The cutoffs for the ASM index and hand grip strength to diagnose sarcopenia were based on the Asian Working Group for Sarcopenia 2019 consensus. A score ≥4 on the SARC-F was considered at risk for sarcopenia.
A total of 365 patients with PD were included (mean age, 71.1 years; men, 53.2 %), and 73 (20.0 %) were diagnosed with sarcopenia. The area under the receiver operating characteristic curve of the SARC-F was 0.702 (95 % confidence interval, 0.634-0.770). Using the recommended cutoff score of ≥4, the SARC-F showed a sensitivity of 38.4 %, specificity of 85.6 %, positive predictive value (PPV) of 40.0 %, and negative predictive value (NPV) of 84.7 %. The Youden's index was the highest at a cutoff score of ≥2, in which the SARC-F showed a sensitivity of 67.1 %, specificity of 65.4 %, PPV of 32.7 %, and NPV of 88.8 %. These predictive values were similar to those obtained using a cutoff score of ≥2.5 or 3 on the H&Y scale.
The application of the SARC-F to the mild-to moderate PD population is not appropriate as a first-step screening tool to diagnose sarcopenia. Given the comparable predictive values of the SARC-F and H&Y scale, this questionnaire may be considered only for ruling out sarcopenia in patients with similar disease severity.
研究 SARC-F 问卷识别帕金森病(PD)患者肌少症的准确性。
我们前瞻性招募 Hoehn 和 Yahr(H&Y)量表评分为 3 分或以下的 PD 患者。四肢骨骼肌质量(ASM)、手握力和 SARC-F 用于评估肌少症。基于亚洲肌少症工作组 2019 年共识,ASM 指数和手握力的切点用于诊断肌少症。SARC-F 评分为≥4 分被认为有肌少症风险。
共纳入 365 例 PD 患者(平均年龄 71.1 岁;男性占 53.2%),73 例(20.0%)被诊断为肌少症。SARC-F 的受试者工作特征曲线下面积为 0.702(95%置信区间,0.634-0.770)。使用推荐的≥4 分切点,SARC-F 的敏感性为 38.4%,特异性为 85.6%,阳性预测值(PPV)为 40.0%,阴性预测值(NPV)为 84.7%。在≥2 分的切点,Youden 指数最高,此时 SARC-F 的敏感性为 67.1%,特异性为 65.4%,PPV 为 32.7%,NPV 为 88.8%。这些预测值与使用 H&Y 量表≥2.5 或 3 分的切点相似。
在轻度至中度 PD 人群中,SARC-F 不适宜作为诊断肌少症的第一步筛查工具。鉴于 SARC-F 和 H&Y 量表具有相当的预测值,仅在疾病严重程度相似的患者中考虑使用该问卷来排除肌少症。