等长膝关节伸展力量作为老年女性肌肉减少症标准的诊断准确性。

Diagnostic accuracy of isometric knee extension strength as a sarcopenia criteria in older women.

作者信息

Pérez-Ros Pilar, Barrachina-Igual Joaquín, Pablos Ana, Fonfria-Vivas Rosa, Cauli Omar, Martínez-Arnau Francisco M

机构信息

Department of Nursing, Universitat de València, C/ Menendez Pelayo 19, Valencia, 46010, Spain.

Conselleria de Educación, Cultura, Universidades y Empleo de Valencia, C/Av de Campanar 32, Valencia, 46015, Spain.

出版信息

BMC Geriatr. 2024 Dec 2;24(1):988. doi: 10.1186/s12877-024-05569-y.

DOI:10.1186/s12877-024-05569-y

PMID:39623326

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11610306/

Abstract

BACKGROUND

Muscle strength is one of the most reliable measures used for the identification of sarcopenia. The European Working Group on Sarcopenia in Older People update (EWGSOP2) proposed the use of grip strength and chair stand tests, while clarifying that isometric torque methods can be used when performing the grip strength test is impossible. This study aims to evaluate the diagnostic accuracy of isometric knee extension strength in screening for sarcopenia.

METHODS

This cross-sectional study included community-dwelling women aged 70 years and over. IKE and sarcopenia criteria (EWGSOP2) were assessed. Skeletal muscle mass was assessed by bioelectrical impedance analysis; muscle mass strength by handgrip; and physical performance by the 5 times sit-to-stand test, the Short Physical Performance Battery, and gait speed. The diagnostic accuracy for each sarcopenia criterion was calculated using sensitivity, specificity, positive and negative predictive value, and the area under the curve (AUC). Cutoff points for sarcopenia from IKE were defined with the ROC curve.

RESULTS

The sample comprised 94 women with a mean age of 75.9 years (standard deviation 5.6, range 70-92), of whom 25.5% (n = 24) met criteria for sarcopenia-mainly severe sarcopenia (73.8%, n = 17). Correlations were observed between IKE and each individually analyzed sarcopenia criterion except skeletal muscle mass, with AUC values exceeding 0.70 in all cases. The IKE cutoff showing the highest accuracy for the diagnosis of sarcopenia was 12.5 kg or less (AUC 0.76, 95% confidence interval [CI] 0.64-0.88; sensitivity: 65.2%, 95% CI 45.7-84.7; specificity 77.4%, 95% CI 60.3-94.5; positive predictive value 62.5%, 95 CI% 42.7-82.3; negative predictive value 88.8%, 95% CI 75.9-100).

CONCLUSIONS

IKE could be a suitable tool for measuring muscular strength in sarcopenia when other strength parameters cannot be assessed or in people with walking difficulties.

摘要

背景

肌肉力量是用于识别肌肉减少症的最可靠指标之一。欧洲老年人肌肉减少症工作组更新版（EWGSOP2）建议使用握力和椅子起立测试，同时明确指出，在无法进行握力测试时可使用等长扭矩法。本研究旨在评估等长膝关节伸展力量在筛查肌肉减少症中的诊断准确性。

方法

这项横断面研究纳入了70岁及以上的社区居住女性。评估了等长膝关节伸展力量（IKE）和肌肉减少症标准（EWGSOP2）。通过生物电阻抗分析评估骨骼肌质量；通过握力评估肌肉质量力量；通过5次坐立试验、简短体能测试电池组和步速评估身体机能。使用敏感性、特异性、阳性和阴性预测值以及曲线下面积（AUC）计算每个肌肉减少症标准的诊断准确性。通过ROC曲线确定IKE诊断肌肉减少症的切点。

结果

样本包括94名女性，平均年龄75.9岁（标准差5.6，范围70 - 92岁），其中25.5%（n = 24）符合肌肉减少症标准，主要是严重肌肉减少症（73.8%，n = 17）。除骨骼肌质量外，观察到IKE与每个单独分析的肌肉减少症标准之间存在相关性，所有情况下AUC值均超过0.70。诊断肌肉减少症准确性最高的IKE切点为12.5千克或更低（AUC 0.76，95%置信区间[CI] 0.64 - 0.88；敏感性：65.2%，95% CI 45.7 - 84.7；特异性77.4%，95% CI 60.3 - 94.5；阳性预测值62.5%，95 CI% 42.7 - 82.3；阴性预测值88.8%，95% CI 75.9 - 100）。