采用不同标准对北京社区男性老年肌少症检出率比较的研究

Compare different measurement for prevalence of sarcopenia in a cohort of healthy community dwellingely in Beijing area

目的比较不同标准对北京社区老年人肌少症的检出率,探讨适合我国的肌少症诊断标准。方法采用横断面研究,以85名健康年轻志愿者与169名60岁以上到门诊查体的老年男性为研究对象。使用综合评估量表对研究对象进行综合评估,采用双光能X线骨密度仪测定四肢骨骼肌质量,计算相对四肢骨骼肌指数(RASM),测定6 m步行速度及握力。将研究结果与台湾地区、韩国、美国、西班牙、法国研究结果进行比较。结果北京地区诊断肌量减少的RASM截点为6.53 kg/m2,低于欧美国家的诊断标准。根据单一骨骼肌含量诊断老年肌少症,采用Baumgartner诊断标准对北京社区老年男性肌少症的检出率为36%,高于台湾地区、韩国、美国、西班牙、法国的检出率;根据骨骼肌含量+肌肉功能双重指标诊断老年肌少症,采用欧洲工作组标准对北京社区老年男性肌少症前期、肌少症、严重肌少症的检出率分别为9.1%、18.2%、15.2%,肌少症总体的检出率为33.3%;采用国际肌少症会议工作组标准对北京社区老年男性肌少症总体的检出率为62.9%。结论应制定并统一适合我国的老年肌少症诊断标准。北京地区老年男性肌少症患病率高,应重视早期检出早期干预。

Objective To compare different measurement for prevalence of sarcopenia in a cohort of healthy community dwelling elderly in Beijing area, in order to evaluate applicable diagnostic criteria for local community. Methods We prospectively evaluated 169 ages 60 ＋ elderly in the community and 85 young volunteer by cross-sectional study. We performed a comprehensive geriatric assessment and determined anthropometric data. Measurement of appendicular skeletal muscle mass was achieved by Dual Energy X-ray Absorptiometry,which used to calculated relative appendicular skeletal muscle mass （RASM）. We also measured 6 meter walking speed and grip strength. Compared with studies undertaken in the Taiwan,Korean,USA,Spain and France. Results The cut-off points obtained were 6.53 kg/m2 for Beijing, below to those observed in Europe and USA. According to single skeletal muscle content as diagnostic criteria for sarcopenia, based on Baumgartner standard of diagnosis, the prevalence of sarcopenia observed was 36% for elderly male, higher than Taiwan, Korean, USA, Spain and France. According skeletal muscle content and muscle function as diagnostic criteria for sarcopenia, based on European Working Group on Sarcopenia in Older People （EWGSOP） ,the detection rate for early stage, medium term and advanced sarcopenia are 9.1%, 18.2%, 15.2%, and the overall detection rate for sarcopenia are 33.3%. Based on ISCGW,the detection rate for Beijing area elderly male were 62.9%. Conclusion We shall establish and unify the applicable diagnostic criteria for sarcopenia based on the characteristic of Chinese senior citizen. Because of the high morbidity of sarcopenia in senior citizen, it＇s essential for us to put high attention on detection of early stage and intervention.