Zhao Xin, Yan Pengdong, Chen Ningxin, Han Tingting, Wang Bin, Hu Yaomin
Department of Geriatrics, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Guangdong Institute of Intelligence Science and Technology, Hengqin, Zhuhai, China.
Front Nutr. 2024 Dec 12;11:1505655. doi: 10.3389/fnut.2024.1505655. eCollection 2024.
Sarcopenia, a condition characterized by low muscle mass, plays a critical role in the health of older adults. Early identification of individuals at risk is essential to prevent sarcopenia-related complications. This study aimed to develop a predictive model using readily available clinical nutrition indicators to facilitate early detection.
A total of 1,002 participants were categorized into two groups: 819 with normal skeletal muscle mass (SMM) and 183 with low muscle mass (sarcopenia). A predictive model was developed for sarcopenia risk via multivariate logistic regression, and its performance was assessed using four analyses: receiver operating characteristic (ROC) curve analysis, decision curve analysis (DCA), a nomogram chart, and external validation. These methods were used to evaluate the model's discriminative ability and clinical applicability.
In the low-SMM group, more females (55.73% vs. 40.42%) and older individuals (median 61 vs. 55 years) were observed. These patients had lower albumin (41.00 vs. 42.50 g/L) and lymphocyte levels (1.60 vs. 2.02 × 10/L) but higher HDL (1.45 vs. 1.16 mmol/L) and calcium levels (2.24 vs. 2.20 mmol/L) (all < 0.001). Using LASSO regression, we developed a nutritional AHLC (albumin + HDL cholesterol + lymphocytes + calcium) model for sarcopenia risk prediction. AUROC and DCA analyses, as well as nomogram charts and external validation, confirmed the robustness and clinical relevance of the AHLC model for predicting sarcopenia.
Our study employs serum nutrition indicators to aid clinicians in promoting healthier aging. The AHLC model stands out for weight-independent evaluations. This novel approach could assess sarcopenia risk in the Chinese population, thereby enhancing aging and quality of life.
肌肉减少症是一种以肌肉量低为特征的病症,在老年人健康中起着关键作用。早期识别有风险的个体对于预防与肌肉减少症相关的并发症至关重要。本研究旨在利用现成的临床营养指标开发一种预测模型,以促进早期检测。
总共1002名参与者被分为两组:819名骨骼肌质量(SMM)正常者和183名肌肉量低者(肌肉减少症患者)。通过多变量逻辑回归建立了肌肉减少症风险预测模型,并使用四种分析方法评估其性能:受试者工作特征(ROC)曲线分析、决策曲线分析(DCA)、列线图以及外部验证。这些方法用于评估模型的判别能力和临床适用性。
在低SMM组中,观察到更多女性(55.73%对40.42%)和年长者(中位数61岁对55岁)。这些患者的白蛋白(41.00对42.50g/L)和淋巴细胞水平较低(1.60对2.02×10/L),但高密度脂蛋白(HDL)(1.45对1.16mmol/L)和钙水平较高(2.24对2.20mmol/L)(均P<0.001)。使用LASSO回归,我们开发了一种用于肌肉减少症风险预测的营养AHLC(白蛋白+HDL胆固醇+淋巴细胞+钙)模型。AUROC和DCA分析以及列线图和外部验证证实了AHLC模型在预测肌肉减少症方面的稳健性和临床相关性。
我们的研究采用血清营养指标来帮助临床医生促进更健康的衰老。AHLC模型在独立于体重的评估方面表现突出。这种新方法可以评估中国人群的肌肉减少症风险,从而改善衰老状况和生活质量。