评估握力不对称性以评估慢性腰痛老年患者的肌肉减少症：一项回顾性横断面研究。

Evaluation of Handgrip Strength Asymmetry to Assess Sarcopenia in Older Patients with Chronic Low Back Pain: A Retrospective Cross-Sectional Study.

机构信息

Shin Hyung Kim, MD, PhD, Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea Tel: 82-2-2228-7500, Fax: 82-2-364-2951, E-mail:

出版信息

J Frailty Aging. 2024;13(4):421-426. doi: 10.14283/jfa.2024.64.

DOI:10.14283/jfa.2024.64

PMID:39574262

Abstract

BACKGROUND

Handgrip strength (HGS) is a crucial measurement for diagnosing sarcopenia, and HGS asymmetry indicates functional impairment and correlates with adverse health outcomes. Although chronic low back pain (CLBP) often coexists with sarcopenia in older people, the association between HGS asymmetry and sarcopenia in that population has not been investigated.

OBJECTIVES

This study examines the association between HGS asymmetry and sarcopenia in older patients with CLBP and explores differences in the proportion of sarcopenia and severe sarcopenia according to the severity of HGS asymmetry.

DESIGN

A retrospective observational study.

SETTING

The study included patients who visited the outpatient department for pain management at a university hospital.

PARTICIPANTS

Ambulatory patients 65 years and older with CLBP assessed for sarcopenia per the Asian Working Group for Sarcopenia (AWGS) 2019 protocol were enrolled.

MEASUREMENTS

HGS asymmetry was categorized into three groups (< 10%, 10-20%, and > 20%) based on the difference between the hands.

RESULTS

A total of 575 CLBP patients aged 65-90 years was analyzed. In females, physical performance scores declined as HGS asymmetry severity increased (p < 0.001), alongside a proportional rise in the proportion of sarcopenia (p = 0.006) and severe sarcopenia (p = 0.002). Conversely, males showed no such association. Moreover, patients with low HGS (meeting the AWGS 2019 criteria) had a higher proportion of sarcopenia (p = 0.019) and severe sarcopenia (p = 0.017) as HGS asymmetry severity increased. The multivariable analysis identified > 20% HGS asymmetry as an independent predictor of sarcopenia (adjusted odds ratio (OR) 3.296, 95% confidence interval (CI) 1.595-6.811, p = 0.001) and severe sarcopenia (adjusted OR 3.092, 95% CI 1.467-6.517, p = 0.003) exclusively in females.

CONCLUSIONS

Severe HGS asymmetry was associated with poor physical performance and a higher proportion of sarcopenia in older female patients with CLBP.

摘要

背景

握力（HGS）是诊断肌少症的关键测量指标，HGS 不对称表明存在功能障碍，并与不良健康结果相关。尽管慢性下腰痛（CLBP）在老年人中常与肌少症共存，但该人群中 HGS 不对称与肌少症之间的关系尚未得到研究。

目的

本研究旨在探讨 CLBP 老年患者中 HGS 不对称与肌少症之间的关系，并探讨根据 HGS 不对称的严重程度，肌少症和严重肌少症的比例差异。

设计

回顾性观察性研究。

地点

该研究纳入了在一所大学医院门诊就诊的疼痛管理患者。

参与者

符合 2019 年亚洲肌少症工作组（AWGS）肌少症评估标准的 65 岁及以上的有 CLBP 的门诊患者。

测量

根据双手之间的差异，将 HGS 不对称分为三组（<10%、10-20%和>20%）。

结果

共分析了 575 名 65-90 岁的 CLBP 患者。在女性中，随着 HGS 不对称严重程度的增加，身体表现评分下降（p<0.001），同时肌少症（p=0.006）和严重肌少症（p=0.002）的比例也相应增加。相反，男性则没有这种关联。此外，低握力（符合 2019 年 AWGS 标准）患者随着 HGS 不对称严重程度的增加，肌少症（p=0.019）和严重肌少症（p=0.017）的比例更高。多变量分析确定>20%的 HGS 不对称是女性肌少症（调整后的优势比（OR）3.296，95%置信区间（CI）1.595-6.811，p=0.001）和严重肌少症（调整后的 OR 3.092，95%CI 1.467-6.517，p=0.003）的独立预测因子。