三种肌少症评估工具筛查社区老年人肌少症效果比较

Comparison of three sarcopenia screening tools in community-dwelling older adults

目的探讨适用于社区老年人肌少症筛查的工具,为早发现、早干预提供依据。方法对山西省吕梁市13个县市城区社区的1455名老年人,分别采用肌肉减少症五条目(SARC-F)量表、肌肉减少症五条目联合小腿围(SARC-CalF)量表、肌肉减少症五条目结合老龄和体重指数(SARC-F+EBM)量表进行测量,以2019年亚洲肌少症工作组肌少症诊断标准为依据,计算SARC-F、SARC-CalF、SARC-F+EBM的敏感度、特异度、阳性预测值、阴性预测值及ROC曲线下面积(AUC)。结果社区老年人肌少症发病率为18.69%。SARC-F、SARC-CalF及SARC-F+EBM诊断敏感度分别为21.32%、66.67%、43.75%,特异度分别为86.19%、92.73%、87.24%,阳性预测值分别为25.89%、66.70%、44.07%,阴性预测值分别为82.62%、91.65%、87.09%,AUC分别为0.665、0.755、0.752。结论SARC-CalF、SARC-F+EBM比SARC-F具有更好的诊断性,可作为我国社区老年人肌少症的快速筛查工具。

Objective To identify a sarcopenia screening tool for community-dwelling older adults,and to provide evidence for early detection and intervention.Methods A total of 1455 older adults were selected from urban communities of 13 counties in Lvliang City of Shanxi Province and were screened for sarcopenia by utilizing the SARC-F,SARC-CalF and SARC-F+EBM.The sensitivity,specificity,positive predictive value(PPV),negative predictive value(NPV)and the area under the receiver operating characteristic(ROC)curve(AUC)of SARC-F,SARC-CalF and SARC-F+EBM were calculated by using the Asian Working Group for Sarcopenia(AWGS)2019 consensus as the"gold standard".Results The prevalence of sarcopenia was 18.69%in community-dwelling older adults according to the AWGS 2019 criteria.The sensitivity of SARC-F,SARC-CalF and SARC-F+EBM was 21.32%,66.67%and 43.75%respectively.The specificity was 86.19%,92.73%and 87.24%respectively.The PPV was 25.89%,66.70%and 44.07%respectively.The NPV was 82.62%,91.65%and 87.09%respectively.The AUC was 0.665,0.755 and 0.752,respectively.Conclusion The SARC-CalF and SARC-F+EBM were more accurate for screening sarcopenia compared with the SARC-F,which can be used as rapid sarcopenia screening tools for community-dwelling older adults in China.