International Clinical Practice Guidelines for Sarcopenia (ICFSR): Screening, Diagnosis and Management
International Clinical Practice Guidelines for Sarcopenia (ICFSR): Screening, Diagnosis and Management
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DOI：
10.1007/s12603-018-1139-9
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发表时间：
2018-12-01
影响因子：
5.8
通讯作者：
Vellas, B.
中科院分区：
文献类型：
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作者：
Dent, E.;Morley, J. E.;Vellas, B.
肌肉减少症，定义为与年龄相关的骨骼肌功能和肌肉质量的丧失，发生在大约6 - 22%的老年人中。本文介绍了以证据为基础的临床实践指南的筛选，诊断和管理的肌肉减少症的工作组的国际会议上肌肉减少症和虚弱的研究（ICSFR）。MethodsTo制定的指南，我们借鉴了最好的证据，从两个系统的审查配对的共识声明，由国际工作组肌肉减少症。为建议选择了八个主题：（一）定义肌肉减少症;（二）筛查和诊断;（三）体力活动处方;（四）蛋白质补充;（五）维生素D补充;（六）合成代谢激素处方;（七）正在开发的药物;和（八）研究。ICSFR工作组评估了每个主题背后的证据，包括证据质量、治疗的效益平衡、患者偏好/价值观和成本效益。根据GRADE（建议评估、发展和评价分级）方法，建议被分为强有力或有条件（弱）的等级。共识是通过一个面对面的研讨会和修改后的德尔菲process.RecommendationsWe取得了一个有条件的建议，使用国际公认的测量工具，包括EWGSOP和FNIH的定义，肌肉减少症的诊断，并主张快速筛查使用步态速度或SARC-F。为了治疗肌肉减少症，我们强烈推荐基于抵抗力的体力活动处方，并有条件地推荐蛋白质补充剂/富含蛋白质的饮食。没有推荐维生素D补充剂或合成代谢激素处方。缺乏有力的证据来评估其他治疗方案的优势。
ObjectivesSarcopenia, defined as an age-associated loss of skeletal muscle function and muscle mass, occurs in approximately 6 - 22 % of older adults. This paper presents evidence-based clinical practice guidelines for screening, diagnosis and management of sarcopenia from the task force of the International Conference on Sarcopenia and Frailty Research (ICSFR).MethodsTo develop the guidelines, we drew upon the best available evidence from two systematic reviews paired with consensus statements by international working groups on sarcopenia. Eight topics were selected for the recommendations: (i) defining sarcopenia; (ii) screening and diagnosis; (iii) physical activity prescription; (iv) protein supplementation; (v) vitamin D supplementation; (vi) anabolic hormone prescription; (vii) medications under development; and (viii) research. The ICSFR task force evaluated the evidence behind each topic including the quality of evidence, the benefitharm balance of treatment, patient preferences/values, and cost-effectiveness. Recommendations were graded as either strong or conditional (weak) as per the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach. Consensus was achieved via one face-to-face workshop and a modified Delphi process.RecommendationsWe make a conditional recommendation for the use of an internationally accepted measurement tool for the diagnosis of sarcopenia including the EWGSOP and FNIH definitions, and advocate for rapid screening using gait speed or the SARC-F. To treat sarcopenia, we strongly recommend the prescription of resistance-based physical activity, and conditionally recommend protein supplementation/a protein-rich diet. No recommendation is given for Vitamin D supplementation or for anabolic hormone prescription. There is a lack of robust evidence to assess the strength of other treatment options.