The Predictive Value of the EWGSOP Definition of Sarcopenia: Results From the InCHIANTI Study
The Predictive Value of the EWGSOP Definition of Sarcopenia: Results From the InCHIANTI Study
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DOI：
10.1093/gerona/glv129
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发表时间：
2016-02-01
影响因子：
5.1
通讯作者：
Volpato, Stefano
中科院分区：
文献类型：
--
作者：
Bianchi, Lara;Ferrucci, Luigi;Volpato, Stefano
背景肌肉减少症与老年人不良结局的风险增加有关。本研究的目的是探讨欧洲老年人肌肉减少症工作组（EWGSOP）诊断算法在残疾、住院和死亡方面的预测价值，并分析握力和步行速度作为肌肉减少症诊断标准的具体作用。对InCHIANTI研究中招募的538名参与者进行了纵向分析。肌肉减少症被定义为具有低肌肉质量加上低握力或低步态速度（EWGSOP标准）。使用生物阻抗分析评估肌肉质量。考克斯比例和逻辑回归模型被用来评估死亡的风险，住院，和残疾的肌肉减少的人，并调查握力和步行速度的EWGSOP的算法的预测值的个人贡献。基线时EWGSOP定义的肌肉减少症的患病率为10.2%。调整潜在混杂因素后，肌肉减少症与残疾（比值比3.15; 95%置信区间[CI] 1.41-7.05）、住院（风险比[HR] 1.57; 95% CI 1.03-2.41）和死亡率（HR 1.88; 95% CI 0.91-3.91）相关。仅通过低肌肉质量和低握力定义的替代性肌肉减少表型与残疾和死亡率之间的关联与通过低肌肉质量和低步行速度或EWGSOP算法定义的表型之间的关联相似。EWGSOP的表型是一个很好的预测事件残疾，住院和死亡。除了低肌肉质量之外，仅肌肉无力的评估提供了与原始算法相似的预测值。
Background. Sarcopenia is associated with increased risk of adverse outcomes in older people. Aim of the study was to explore the predictive value of the European Working Group on Sarcopenia in Older People (EWGSOP) diagnostic algorithm in terms of disability, hospitalization, and mortality and analyze the specific role of grip strength and walking speed as diagnostic criteria for sarcopenia.Methods. Longitudinal analysis of 538 participants enrolled in the InCHIANTI study. Sarcopenia was defined as having low muscle mass plus low grip strength or low gait speed (EWGSOP criteria). Muscle mass was assessed using bioimpedance analysis. Cox proportional and logistic regression models were used to assess risk of death, hospitalization, and disability for sarcopenic people and to investigate the individual contributions of grip strength and walking speed to the predictive value of the EWGSOP's algorithm.Results. Prevalence of EWGSOP-defined sarcopenia at baseline was 10.2%. After adjusting for potential confounders, sarcopenia was associated with disability (odds ratio 3.15; 95% confidence interval [CI] 1.41-7.05), hospitalization (hazard ratio [HR] 1.57; 95% CI 1.03-2.41), and mortality (HR 1.88; 95% CI 0.91-3.91). The association between an alternative sarcopenic phenotype, defined only by the presence of low muscle mass and low grip strength, and both disability and mortality were similar to the association with the phenotypes defined by low muscle mass and low walking speed or by the EWGSOP algorithm.Conclusions. The EWGSOP's phenotype is a good predictor of incident disability, hospitalization and death. Assessment of only muscle weakness, in addition to low muscle mass, provided similar predictive value as compared to the original algorithm.