相位角在社区老年人肌少症筛查中的应用

Application of phase angle on screening for sarcopenia of elderly in community

目的:探讨相位角在社区老年人肌少症筛查中的应用价值,并明确其筛查肌少症的截断值。方法:于2019年6月—9月采用分层整群随机抽样方法抽取湖南省1044名社区居住的老年人作为研究对象,采用生物电阻抗分析法测量肌肉质量、相位角,采用测力仪测量握力,采用红外线测量仪测量身高,采用电子体质量秤测量体重,根据老年人6 m步行时间计算步速。采用Spearman相关分析法分析相位角与肌少症及其诊断指标的相关性,采用受试者工作特征曲线明确相位角筛查肌少症的截断值。结果:湖南省社区居住的老年人肌少症患病率为26.9%,其中男性98例,女性183例。Spearman相关分析表明相位角与肌少症、握力、骨骼肌指数、步速均相关。受试者工作特征曲线表明,当男性相位角为5.15°时,约登指数为0.356,灵敏度为0.582,特异度为0.774,曲线下面积为0.748(0.691,0.804),差异有统计学意义(P<0.05);当女性相位角为4.75°时,约登指数为0.351,灵敏度为0.612,特异度为0.739,曲线下面积为0.736(0.694,0.777),差异有统计学意义(P<0.05)。结论:相位角与肌少症及其诊断指标具有相关性,可以作为筛查肌少症的指标,但其截断值还需要进一步探索。

Objective:To explore application value of phase angle on screening for sarcopenia of elderly in community,and to clarify its cutoff value for screening sarcopenia.Methods:1044 elderly living in communities in Hunan province were selected as subjects by stratified cluster random sampling from June to September 2019.The muscle mass and phase angle were measured by bioelectrical impedance analysis,the grip strength was measured by grip strength meter,the height was measured by infrared height meter,the weight was measured by electronic mass scale,and the pace was calculated according to elderly's 6 m walking time.Correlation between phase angle and sarcopenia and its diagnostic indicators was analyzed by Spearman correlation.Cutoff value of phase angle for screening sarcopenia was got by receiver operating characteristic curve.Results:The prevalence of sarcopenia among elderly living in communities in Hunan province was 26.9%,with 98 males and 183 females.Spearman correlation analysis showed that phase angle was correlated with sarcopenia,grip strength,skeletal muscle mass index,and pace.The receiver operating characteristic curve showed that when the phase angle of male was 5.15°,the Youden index was 0.356,the sensitivity was 0.582,the specificity was 0.774,and the area under curve was 0.748(0.691,0.804).When the phase angle of female was 4.75°,the Youden index was 0.351,the sensitivity was 0.612,the specificity was 0.739,and the area under curve was 0.736(0.694,0.777).The differences were statistically significant(P<0.05).Conclusions:Phase angle is correlated with sarcopenia and its diagnostic indicators,and can be used as screening indicator for sarcopenia.However,its cutoff value still needs further exploration.