Cutpoints for Low Appendicular Lean Mass That Identify Older Adults With Clinically Significant Weakness
Cutpoints for Low Appendicular Lean Mass That Identify Older Adults With Clinically Significant Weakness
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DOI：
10.1093/gerona/glu023
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发表时间：
2014-05-01
影响因子：
5.1
通讯作者：
Alley, Dawn E.
中科院分区：
文献类型：
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作者：
Cawthon, Peggy M.;Peters, Katherine W.;Alley, Dawn E.
低瘦体重在老年人中具有潜在的临床重要性，但标准尚未得到经验验证。作为FNIH的一部分，（美国国立卫生研究院基金会）肌肉减少症项目，这项分析试图通过双能x射线吸收测定法来确定瘦体重的临界点，该测定法可以区分是否存在虚弱（在该系列的先前报告中定义为男性握力<26 kg，女性<16 kg）。（7，582名男性和3，688名女性），使用分类和回归树（CART）分析来推导出最能区分存在或不存在虚弱的非典型瘦体重（ALM）的临界点。混合效应逻辑回归用于量化瘦体重类别和虚弱之间的关联强度。在初步分析中，CART模型确定了低瘦体重的临界点（男性ALM <19.75 kg，女性<15.02 kg）。使用ALM除以身体质量指数（BMI：ALM（BMI））的敏感性分析确定了次要定义（男性ALM（BMI）< 0.789，女性ALM（BMI）< 0.512）。正如预期的那样，在考虑了学习和年龄之后，低瘦体重（与较高的瘦体重相比）与两种主要的虚弱有关。（男性，比值比[OR]：6.9 [95% CI：5.4，8.9];女性，OR：3.6 [95% CI：2.9，4.3]）和次要定义（男性，OR：4.3 [95%CI：3.4，5.5];女性，OR：2.2 [95%CI：1.8，2.8]）源自老年人的大的、多样的样本的ALM切割点确定了瘦体重阈值，低于该阈值的老年人具有更高的虚弱可能性。
Low lean mass is potentially clinically important in older persons, but criteria have not been empirically validated. As part of the FNIH (Foundation for the National Institutes of Health) Sarcopenia Project, this analysis sought to identify cutpoints in lean mass by dual-energy x-ray absorptiometry that discriminate the presence or absence of weakness (defined in a previous report in the series as grip strength < 26kg in men and < 16kg in women).In pooled cross-sectional data stratified by sex (7,582 men and 3,688 women), classification and regression tree (CART) analysis was used to derive cutpoints for appendicular lean body mass (ALM) that best discriminated the presence or absence of weakness. Mixed-effects logistic regression was used to quantify the strength of the association between lean mass category and weakness.In primary analyses, CART models identified cutpoints for low lean mass (ALM < 19.75kg in men and < 15.02kg in women). Sensitivity analyses using ALM divided by body mass index (BMI: ALM(BMI)) identified a secondary definition (ALM(BMI) < 0.789 in men and ALM(BMI) < 0.512 in women). As expected, after accounting for study and age, low lean mass (compared with higher lean mass) was associated with weakness by both the primary (men, odds ratio [OR]: 6.9 [95% CI: 5.4, 8.9]; women, OR: 3.6 [95% CI: 2.9, 4.3]) and secondary definitions (men, OR: 4.3 [95% CI: 3.4, 5.5]; women, OR: 2.2 [95% CI: 1.8, 2.8]).ALM cutpoints derived from a large, diverse sample of older adults identified lean mass thresholds below which older adults had a higher likelihood of weakness.