老年人肌肉衰减综合征不同诊断标准的比较研究

A comparative study on different diagnostic criteria of sarcopenia in the elderly

目的:了解我国老年人在肌衰减综合征不同诊断标准下的发病特征。方法:131名(男性49名,女性82名)60岁及以上的老年人,采用双能X射线法和生物电阻抗分析方式对肌肉质量进行测量,握力取三次测量的最大值,并选取日常步速作为功能能力指标,分别比较他们在欧洲肌衰减组织、国际肌衰减组织、亚洲肌衰减组织、美国国立卫生研究院提出的诊断方法与判定标准下的发病率,同时以中国人口数据为参考比较其差异。结果:不同诊断标准下老年人肌肉衰减综合征的发病率为0.8~16%,男性发病率为2.0~22.4%,女性为0~14.6%。当肌肉质量以低于我国青年人两倍标准差为参考值时,肌少症的发病率极低,其中测量方法采用双能X射线法时发病率为0.8%,生物电阻抗分析时发病率为2.3%。结论:不同诊断方法下,我国社区老年人肌肉衰减综合征发病具有较大的差异,因此建立我国肌衰减诊断的具体参照标准对该疾病的诊断与预防有着重要的意义。

Objective:To study the prevalence of sarcopenia in elderly Chinese men and women under different diagnostic criteria.Methods:A total of 131 elderly community-dwelling Chinese volunteers(49 men and 82 women),aged 60 years and older,was undertaken in this survey.Muscle mass was estimated by dual-energy Xray absorptiometry and bio-impedance analysis.Grip strength is the maximum of three measurements and the daily walking speed was selected as the index of physical performance.To compared the prevalence of sarcopenia under the diagnostic criteria that were proposed by EWGSOP,IWGS,AWGS,FNIH and the muscle mass data of Chinese youth were used as a reference.Results:Under different diagnostic criteria,the prevalence of sarcopenia in the elderly was 0.8%~16%,2.0%~22.4%in men,0.0%~14.6%in women.Using 2 standard deviations below the mean muscle mass of young reference group,the prevalence is very low that is 0.8%measured by DXA and 2.3%measured by BIA.Conclusion:The incidence of the sarcopenia varies greatly with different diagnostic methods.It is necessary to establish specific reference standard for the diagnosis of sarcopenia in China which is beneficial to the diagnosis and prevention of the disease.