Kerminen Hanna, Jyväkorpi Satu, Urtamo Annele, Huhtala Heini, Öhman Hanna, Calvani Riccardo, Marzetti Emanuele, Pitkälä Kaisu, Strandberg Timo
Faculty of Medicine and Health Technology, The Gerontology Research Center (GEREC), Tampere University, Arvo Ylpön Katu 34, 33520, Tampere, Finland.
Department of Geriatrics, Orthopedics and Rheumatology, Università Cattolica del Sacro Cuore, Rome, Italy.
Eur Geriatr Med. 2024 Dec;15(6):1817-1826. doi: 10.1007/s41999-024-01060-4. Epub 2024 Sep 19.
We compared the performance of SARC-F, SARC-CalF, calf circumference (CC), and body mass index (BMI)-adjusted CC for sarcopenia case-finding in community-dwelling older adults.
Data of Finnish participants (women/men n = 192/36, mean age (SD) of 76.9 (4.8) years) recruited in the SPRINTT trial (NCT02582138) were used. Sarcopenia was determined as a combination of low muscle function (chair-stand-test) and low appendicular lean mass (ALM) detected by whole-body dual-energy X-ray absorptiometry. Associations of case-finding tools with sarcopenia were analysed using ROC curves and logistic regression.
The rates of probable and confirmed sarcopenia were 95% and 18% in women and 94% and 36% in men, respectively. Performance of CC for sarcopenia (women AUC 0.85 [95% CI 0.78-0.92]/ men 0.85 [95% CI 0.71-1.0]) was superior to that of other tools; (AUC in women/men for SARC-F was 0.57/0.50, for SARC-CalF 0.76/0.79, and for BMI-adjusted CC 0.68/0.66). The best performance was found for a CC cut-off point of ≤ 34 cm in women with sensitivity/specificity 82.4/75.3% and ≤ 36 cm in men with sensitivity/specificity 76.9/87.0%. For each cm decrease in CC, adjusted for age and BMI, there was a 30% increase in the odds of sarcopenia in women (OR 1.30, 95% CI 1.09─1.56). Although there was a similar pattern in men, the results did not reach statistical significance (OR 1.34, 95% CI 0.84- 2.14).
CC was superior to other tools for sarcopenia case-finding. The best performance was found for a CC cut-off point of ≤ 34 cm in women and ≤ 36 cm in men.
我们比较了SARC-F、SARC-CalF、小腿围(CC)以及体重指数(BMI)校正后的CC在社区居住的老年人中用于肌少症病例筛查的性能。
使用在SPRINTT试验(NCT02582138)中招募的芬兰参与者(女性/男性n = 192/36,平均年龄(标准差)为76.9(4.8)岁)的数据。肌少症被定义为低肌肉功能(椅子站立试验)和通过全身双能X线吸收法检测到的低四肢瘦体重(ALM)的组合。使用受试者工作特征(ROC)曲线和逻辑回归分析病例筛查工具与肌少症之间的关联。
女性可能的和确诊的肌少症发生率分别为95%和18%,男性分别为94%和36%。CC用于肌少症筛查的性能(女性AUC 0.85 [95% CI 0.78 - 0.92]/男性0.85 [95% CI 0.71 - 1.0])优于其他工具;(女性/男性中SARC-F的AUC为0.57/0.50,SARC-CalF为0.76/0.79,BMI校正后的CC为0.68/0.66)。女性CC截止点≤34 cm时表现最佳,敏感性/特异性为82.4/75.3%,男性CC截止点≤36 cm时表现最佳,敏感性/特异性为76.9/87.0%。在校正年龄和BMI后,女性CC每降低1 cm,肌少症的几率增加30%(OR 1.30,95% CI 1.09─1.56)。虽然男性有类似趋势,但结果未达到统计学显著性(OR 1.34,95% CI 0.84 - 2.14)。
CC在肌少症病例筛查方面优于其他工具。女性CC截止点≤34 cm、男性CC截止点≤36 cm时表现最佳。