National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Center of Gerontology and Geriatrics, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Front Public Health. 2024 Jun 6;12:1356878. doi: 10.3389/fpubh.2024.1356878. eCollection 2024.
In 2022, the European Society for Clinical Nutrition and Metabolism (ESPEN) and the European Association for the Study of Obesity (EASO) launched a consensus on the diagnostic methods for sarcopenic obesity (SO). The study aimed to identify the prevalence and diagnostic agreement of SO using different diagnostic methods in a cohort of subjects from West China aged at least 50 years old.
A large multi-ethnic sample of 4,155 participants from the West China Health and Aging Trend (WCHAT) study was analyzed. SO was defined according to the newly published consensus of the ESPEN/EASO. Furthermore, SO was diagnosed as a combination of sarcopenia and obesity. The criteria established by the Asian Working Group for Sarcopenia 2019 (AWGS2019) were used to define sarcopenia. Obesity was defined by four widely used indicators: percent of body fat (PBF), visceral fat area (VFA), waist circumference (WC), and body mass index (BMI). Cohen's kappa was used to analyze the diagnostic agreement of the above five diagnostic methods.
A total of 4,155 participants were part of the study, including 1,499 men (63.76 ± 8.23 years) and 2,656 women (61.61 ± 8.20 years). The prevalence of SO was 0.63-7.22% with different diagnostic methods. The diagnosis agreement of five diagnostic methods was poor-to-good (κ: 0.06-0.67). The consensus by the ESPEN/EASO had the poorest agreement with other methods (κ: 0.06-0.32). AWGS+VFA had the best agreement with AWGS+WC (κ = 0.67), and consensus by the ESPEN/EASO had the best agreement with AWGS+ PBF (κ = 0.32).
The prevalence and diagnostic agreement of SO varies considerably between different diagnostic methods. AWGS+WC has the highest diagnostic rate in the diagnosis of SO, whereas AWGS+BMI has the lowest. AWGS+VFA has a relatively good diagnostic agreement with other diagnostic methods, while the consensus of the ESPEN/EASO has a poor diagnostic agreement. AWGS+PBF may be suitable for the alternative diagnosis of the 2022 ESPEN/EASO.
2022 年，欧洲临床营养与代谢学会（ESPEN）和欧洲肥胖研究协会（EASO）发布了关于肌少症性肥胖（SO）诊断方法的共识。本研究旨在通过分析来自中国西部年龄至少 50 岁的队列中不同诊断方法的 SO 患病率和诊断一致性。
分析了来自中国西部健康与老龄化趋势研究（WCHAT）的 4155 名多民族大样本。根据 ESPEN/EASO 的最新共识，SO 被定义为肌少症和肥胖的组合。亚洲肌少症工作组 2019 年（AWGS2019）制定的标准用于定义肌少症。肥胖用四种广泛使用的指标定义：体脂百分比（PBF）、内脏脂肪面积（VFA）、腰围（WC）和体重指数（BMI）。采用 Cohen's kappa 分析上述五种诊断方法的诊断一致性。
共纳入 4155 名参与者，其中男性 1499 名（63.76±8.23 岁），女性 2656 名（61.61±8.20 岁）。不同诊断方法的 SO 患病率为 0.63%-7.22%。五种诊断方法的诊断一致性为差-好（κ：0.06-0.67）。ESPEN/EASO 的共识与其他方法的一致性最差（κ：0.06-0.32）。AWGS+VFA 与 AWGS+WC 的一致性最好（κ=0.67），ESPEN/EASO 的共识与 AWGS+PBF 的一致性最好（κ=0.32）。
不同诊断方法的 SO 患病率和诊断一致性差异较大。AWGS+WC 诊断 SO 的诊断率最高，而 AWGS+BMI 诊断率最低。AWGS+VFA 与其他诊断方法具有较好的诊断一致性，而 ESPEN/EASO 的共识与其他诊断方法的一致性较差。AWGS+PBF 可能是 2022 年 ESPEN/EASO 替代诊断的合适选择。
