生物电阻抗法与简易五项问卷诊断社区老年人肌少症的一致性分析

Consistency between bioelectrical impedance analysis method and SARC-F questionnaire for diagnosing sarcopenia among elderly people from communities

目的分析生物电阻抗分析(BIA)法和简易五项(SARC-F)问卷筛查社区老年人肌少症的一致性。方法抽取477名社区老年人,采用SARC-F问卷筛查肌少症,采用BIA法测定骨骼肌质量指数(SMI),以SARC-F问卷评分≥4分、男性SMI切值≤7.0 kg/m^(2)、女性SMI切值≤5.7 kg/m^(2)为判断肌少症的标准,分析两种方法诊断肌少症的一致性。结果SARC-F问卷共筛查出肌少症阳性53人,阳性率为11.1%;BIA法共诊断肌少症患者81例,阳性率为17.0%。BIA法诊断肌少症的阳性率高于SARC-F问卷筛查;SMI值与SARC-F问卷总评分呈负相关(P<0.05);一致性分析结果显示两种方法诊断肌少症的Kappa值为0.690(P<0.05);以BIA法为“金标准”,SARC-F问卷诊断肌少症的灵敏度为60.5%,特异度为99.0%。结论SARC-F问卷和BIA法诊断肌少症具有一定的一致性。SARC-F问卷评分诊断肌少症的灵敏度较低而特异度高,存在漏诊的可能;BIA法可以直接测定SMI,相对更准确,但需要体成分分析仪,社区肌少症筛查中可以根据情况进行选择。

Objective To analyze the consistency between the bioelectrical impedance analysis(BIA)method and the Strength,Assistance in walking,Rise from a chair,Climb stairs,Falls(SARC-F)questionnaire for screening out sarcopenia among elderly people from communities.Methods Among 477 elderly people selected from communities,a sarcopenia screening was conducted using the SARC-F questionnaire,and the BIA method was utilized to determine the skeletal muscle mass index(SMI).With the SARC-F questionnaire score≥4,the cutoff value of male SMI≤7.0 kg/m^(2),and the cutoff value of female SMI≤5.7 kg/m^(2) as the diagnostic criteria for sarcopenia,the consistency between the two methods for diagnosing sarcopenia was analyzed.Results Totally 53 sarcopenia-positive cases were screened out by the SARC-F questionnaire,with a positive rate of 11.1%.Totally 81 sarcopenia patients were identified by the BIA method,with a positive rate of 17.0%.For diagnosing sarcopenia,the BIA method yielded a higher positive rate than the screening using the SARC-F questionnaire,and the SMI value negatively correlated with the total score of the SARC-F questionnaire(P<0.05);the results of consistency analysis showed that the Kappa value of the two methods for diagnosing sarcopenia was 0.690(P<0.05).Using the BIA method as the gold standard,the SARC-F questionnaire yielded a sensitivity of 60.5%and a specificity of 99.0%for diagnosing sarcopenia.Conclusion Certain consistency is found between the SARC-F questionnaire and the BIA method for the diagnosis of sarcopenia.The SARC-F questionnaire score yields a relatively low sensitivity and a high specificity for diagnosing sarcopenia,with a possibility of missed diagnosis.The BIA method can detect SMI directly and is relatively more accurate,but it needs an InBody body composition analyzer.Therefore,option should be made based on the actual situation in the community-level screening for sarcopenia.