生物电阻抗分析法和双能X射线吸收法测定住院老年人肌肉质量的对比研究

Comparison of bioelectrical impedance consumer device with dual-energy X-ray absorptiometry in the assessment of muscle mass in Chinese geriatric inpatients

目的比较生物电阻抗分析法(BIA)和双能X射线吸收法(DXA)测定住院老年人肌肉质量结果的一致性,为住院老年病人肌少症筛查提供方法学基础。方法选择100例老年住院病人,分别采用DXA和BIA方法测定上肢、下肢及全身肌肉质量,应用相关分析、配对t检验、Bland-Altman法检验2种方法测定结果的一致性。结果相关分析显示,BIA与DXA各指标测定值之间r值范围为0.67~0.92(P均<0.001);配对t检验显示,BIA与DXA测定上肢及全身肌肉质量差异无统计学意义(P>0.05),下肢测定值差异有统计学意义(P<0.001),BIA法倾向于高估老年病人下肢肌肉质量;Bland-Altman分析显示,2种方法各指标测定值均具有较高的一致性;2种方法对女性肌肉质量减少检出率差异无统计学意义(P=0.5),对男性检出率差异有统计学意义(P=0.016)。结论 BIA法在住院老年人肌肉质量测定中有较好的应用价值,但应注意BIA与DXA测定下肢肌肉质量之间的差异,差异可能是来源于对人体组织划分方法的不同而不是测量方法误差。

Objective To investigate the consistency between bioelectrical impedance analysis（ BIA） and dual-energy X-ray absorptiometry（ DXA） in the measurement of muscle mass of hospitalized patients,and to provide the application evidence for screening sarcopenia. Methods Muscle mass measurements of upper extremities,lower extremities and whole body were detected by BIA and DXA in100 patients. Correlation analysis,paired t tests and Bland-Altman analyses were used to evaluate the consistency between the two methods. Results Correlation analysis displayed r values of all indexes ranging from 0. 67 to 0. 92（ P〈0. 001）. Paired t test showed that there were no significant differences in upper extremities and whole body muscle mass（ P〉 0. 05）,but showed significant differences in lower extremities（ P〈0. 001）; BIA tended to overestimate lower extremities muscle mass. Bland-Altman analysis showed that there was a good consisitency between the two methods. There was no significant difference in the positive rate of low muscle mass in women（ P = 0. 5） between two methods; However,there was significant difference in men（ P = 0. 016）. Conclusions BIA device shows good application value in assessing muscle mass in Chinese geriatric inpatients,but the difference in lower extremities muscle mass from DXA should be noticed,which may be due to different anatomical division rather than measuring error.