上海地区老年人肌少症骨骼肌质量诊断标准建立和流行病学调查

Establishment of muscle mass diagnostic standard of sarcopenia using a bioelectrical impedance analysis and epidemioiogical investigation of the elderly in Shanghai

目的应用生物电阻抗法（BIA）建立上海地区老年人肌少症骨骼肌质量诊断标准并开展上海地区老年人肌少症患病率的调查。方法对40例志愿者（年龄20～77岁）进行BIA和双能X线吸收仪（DEXA）检测，验证BIA测定瘦体组织的可靠性。对219例（年龄20440岁）健康青年人（男：女为100：119）进行BIA检测，获得峰值肌量和老年人肌少症诊断切点。对657例≥60岁医院体检和社区老年人（男：女为318：339）进行BIA检测，了解上海地区老年人肌少症患病率。结果BIA和DEXA检测瘦体组织差异无统计学意义（P=0．307）。健康青年人四肢肌肉组织和身高平方的比值（ASM／身高2）男性和女性分别为（7.90±0．62）kg／m2和（6．12±0．44）kg／m2，老年人肌少症诊断标准男性和女性分别为≤6．66kg／m2和≤5．24kg／m2。将老年人分为3个年龄段，60～岁、70～岁和≥80岁3个年龄段男性肌少症的患病率分别为14．6％、25．0％和36．0％，女性分别为6．8％、12．6Vo和27．9％。老年男性整体患病率为23．6％，女性为11．8％。结论BIA检测人体肌肉组织是可靠的，且随增龄肌少症患病率明显上升，男性高于女性。

Objective To establish diagnostic standard of sarcopenia using bioelectrical impedance analysis （BIA） and to obtain the prevalence of sarcopenia in the elderly in Shanghai. Methods 40 volunteers aged 20 77 years were enrolled and received BIA and dual-energy X-ray absorptiometry （DEXA） measurements in order to verify the reliability of BIA for measuring lean mass. 219 healthy young volunteers aged 20 to 40 years with ratio of gender men： women 100：119 had BIA measurements to obtain peak muscle mass and sarcopenia diagnostic cut-off point of the elderly. 657 elderly aged ~ 60 years with ratio of gendermen：women 318：339 took BIA measurements to obtain the prevalence of sarcopenia in the elderly in Shanghai. Results No statistical difference between BIA-measured and DEXA-measured LM was observed （P = 0. 307）. The appendicular skeletal muscle mass/height2 （ASM/h2） was （7.90±0.62） kg/m2 in young men, and （6.12±0.44） kg/m2 in young women, the cut off in elderly men and women were ≤6.66 kg/m2 and ≤ 5.24 kg/m2 respectively. Elderly people were divided into three age groups： aged60-69 years group, aged 70-69 years group, aged ≥80 years group, The prevalence of sarcopenia were 14.6%, 25.0% and 36.0% in men and 6.8%, 12.6% and 27.9% in women in aged 60-69 years, aged 70-69 years, aged ≥ 80 years groups, respectively. The overall prevalence in elderly men and women were 23.6% and 11.8% respectively. Conclusions Measurement of LM by BIA is validated in Shanghai volunteers. The prevalence of sarcopenia in the elderly is increased with age, which is higher in elderly men than in elderly women.