3种诊断标准下北京社区老年男性的肌少症患病率比较

Comparison of prevalence of sarcopenia diagnosed with three different diagnostic criteria among elderly men in a community in Beijing

目的比较不同诊断标准下北京社区老年男性的肌少症患病率及各诊断标准的一致性。方法以北京某社区527例60~94岁老年男性为研究对象,采用面对面问卷方法,记录一般情况及SARC-F问卷评分;通过生物电阻抗分析法检测骨骼肌的肌量,计算骨骼肌质量指数;测试握力、5次起坐时间及步速。分别用3种不同标准进行肌少症诊断。结果采用SARC-F问卷、AWGS标准、EWGSOP2标准,肌少症患病率分别为6.45%、17.08%、17.46%,其中80岁以上人群的肌少症患病率明显增高,达39.36%(P<0.01)。AWGS标准与EWGSOP2标准下肌少症患病率的差异无统计学意义(χ^2=485.92,P=0.69),2个标准具有几乎完全的一致性(Kappa值为0.96,P<0.05)。采用SARC-F问卷,肌少症患病率明显偏低,与AWGS标准、EWGSOP2标准相比,差异均有统计学意义(χ^2=90.53、χ^2=87.84,P=0.00);灵敏度为28.89%、28.26%,特异度为98.17%、98.16%;诊断一致性偏低(Kappa值为0.36、0.35,P<0.05)。结论尽管EWGSOP2标准和AWGS标准诊断流程不同,但2者对肌少症的诊断有很好的一致性。SARC-F问卷具有特异度高、灵敏度低的特点,可用于缺乏测试设备的基层医疗机构进行筛查,但可能会低估肌少症的患病率。

Objective To compare the prevalence of sarcopenia diagnosed with three different diagnostic criteria among community-dwelling elderly men in Beijing and the consistency of three diagnostic criteria.Methods A total of 527 elderly men aged 60~94 years in a community in Beijing were selected as the research subjects.Face-to-face questionnaire was used to investigated the general situation and the score of SARC-F questionnaire.Skeletal muscle mass was measured by bioelectrical impedance analysis and the appendicular skeletal muscle mass index(ASMI)was calculated,and the grip strength,five-time sit-to-stand test and walking speed were measured.Sarcopenia was diagnosed by SARC-F questionnaire,European working group on sarcopenia in older people(EWGSOP2)criteria and Asian working group on sarcopenia(AWGS)criteria.Results Based on SARC-F questionnaire,AWGS criteria and EWGSOP2 criteria,the prevalence of sarcopenia was 6.45%,17.08%and 17.46%,respectively,and the prevalence of sarcopenia among people over 80 years old increased significantly,reaching 39.36%(P<0.01).There was no statistically significant difference in the prevalence of sarcopenia between AWGS criteria and EWGSOP2 criteria(χ^2=485.92,P=0.69),they had almost complete consistency(Kappa value=0.96,P<0.05).Compared with AWGS criteria and EWGSOP2 criteria,SARC-F questionnaire showed statistically significant differences in the prevalence of sarcopenia(χ^2=90.53,χ^2=87.84,P=0.00),the sensitivity was 28.89%,28.26%,the specificitywas 98.17%,98.16%,with low consistency of diagnosis(Kappa value=0.36,Kappa value=0.35,P<0.05).Conclusion EWGSOP2 criteria and AWGS criteria have a good consistency in the diagnosis of sarcopenia.SARC-F questionnaire has the characteristics of high specificity and low sensitivity.It can be used for screening in primary medical institutions that lack test equipment,but it may underestimate the prevalence of sarcopenia.