Combination of DXA and BIS Predicts Jump Power Better Than Traditional Measures of Sarcopenia.
Combination of DXA and BIS Predicts Jump Power Better Than Traditional Measures of Sarcopenia.
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DOI：
10.1002/jbm4.10527
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发表时间：
2021-08
期刊：
影响因子：
3.8
通讯作者：
Kuchnia AJ
中科院分区：
文献类型：
--
作者：
Rush B;Binkley N;Krueger D;Yamada Y;Kuchnia AJ
肌肉减少症的传统诊断标准是使用双能X线吸收仪（DXA）测量的阑尾瘦质量（ALM），归一化到身高（ALM/ht2）或体重指数（ALM/BMI）来定义低肌肉质量。然而，在ALM检测到肌肉质量损失之前，肌肉功能随着年龄的增长而下降。这可能部分是由于肌肉的质变，如细胞外和细胞内的液体隔室移位，而DXA没有捕捉到。我们建议将生物阻抗谱（BIS）与DXA相结合，以更准确地预测肌肉功能，BIS可以估计细胞外和细胞内的间隔体积。这种组合可能有助于结合肌肉质量，从而改善肌肉减少症的诊断。我们横断面分析了248名年龄在25至75岁的黑人和白人参与者的数据，这些参与者来自美国进修队列的中年。我们提出了两种新的肌肉测量方法：由BIS衍生的全身细胞外液与细胞内液比（E/I）校正的ALM和由腿部特异性E/I校正的腿瘦质量（LLM），分别产生（ALM/(E/I)W）和（LLM/(E/I)L）。我们比较了传统的肌肉测量，ALM/(E/I)W和LLM/(E/I)L与握力和下肢力量的关系。与ALM/(E/I)W相比，LLM/(E/I)L在r2 = 0.803时最能解释跳跃能力（p < 0.0001）。ALM/(E/I)W对起跳力的解释第二好（r2 = 0.759），但并不比传统肌肉测量好。在预测握力时，没有任何肌肉测量比协变量表现更好。LLM/(E/I)L预测跳跃力优于ALM/ht2和ALM/BMI。我们认为LLM/(E/I)L是一种强大且与临床相关的方法，可以解释肌肉质量。©2021作者。JBMR Plus由Wiley期刊有限责任公司代表美国骨骼和矿物研究协会出版。我们发现，DXA和BIS结合得出的由细胞外液与细胞内液之比校正的腿瘦质量比由身高或体重指数校正的阑尾瘦质量更能预测跳跃能力。经身高、体重指数或细胞内液与细胞外液之比校正后的阑尾瘦质量或腿瘦质量，并不比仅用协变量更好地预测握力。
Traditional diagnostic criteria for sarcopenia use dual‐energy X‐ray absorptiometry (DXA)‐measured appendicular lean mass (ALM), normalized to height (ALM/ht2) or body mass index (ALM/BMI) to define low muscle mass. However, muscle function declines with aging before the loss of muscle mass is detected by ALM. This is likely due, in part, to qualitative muscle changes such as extracellular and intracellular fluid compartment shifts uncaptured by DXA. We propose combining bioimpedance spectroscopy (BIS), which estimates extracellular and intracellular compartment volume, with DXA to more accurately predict muscle function. This combination may help incorporate muscle quality, thereby improving sarcopenia diagnosis. We cross‐sectionally analyzed data from 248 Black and White participants aged 25 to 75 years from the Midlife in the United States Refresher Cohort. We proposed two novel muscle measures: ALM corrected by the BIS‐derived whole‐body extracellular to intracellular fluid ratio (E/I) and leg lean mass (LLM) corrected by leg‐specific E/I, creating (ALM/(E/I)W) and (LLM/(E/I)L), respectively. We compared the associations of traditional muscle measures, ALM/(E/I)W, and LLM/(E/I)L, with grip strength and lower limb power using jumping mechanography. LLM/(E/I)L explained jump power best at R 2 = 0.803 compared with ALM/(E/I)W (p < 0.0001) and all other measures. ALM/(E/I)W explained jump power second best (R 2 = 0.759) but not significantly better than traditional muscle measures. No muscle measure performed better than covariates when predicting handgrip strength. LLM/(E/I)L outperformed ALM/ht2 and ALM/BMI when predicting jump power. We propose LLM/(E/I)L is a powerful and clinically relevant method that accounts for muscle quality. © 2021 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research. We show that the combination of DXA and BIS derived leg lean mass corrected by the ratio of extracellular fluid in intracellular fluid better predicts jump power than appendicular lean mass adjusted by height or body mass index. Appendicular lean mass or leg lean mass corrected by height, body mass index, or the ratio of intracellular fluid to extracellular fluid did not predict handgrip strength better than covariates only.