Definitions of Sarcopenia: Associations with Previous Falls and Fracture in a Population Sample.
Definitions of Sarcopenia: Associations with Previous Falls and Fracture in a Population Sample.
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肌肉减少症的定义：与以前的跌倒和骨折的关联。
DOI：
10.1007/s00223-015-0044-z
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发表时间：
2015-11
影响因子：
4.2
通讯作者：
Cooper C
中科院分区：
文献类型：
--
作者：
Clynes MA;Edwards MH;Buehring B;Dennison EM;Binkley N;Cooper C
肌肉减少症在晚年很常见，可能与残疾、跌倒和骨折等不良健康后果有关。尽管欧洲老年人肌少症工作组 (EWGSOP)、国际肌少症工作组 (IWGS) 和美国国立卫生研究院肌少症项目基金会 (FNIH) 提出了诊断算法，但对其诊断尚未达成共识。最近，宾克利和同事设计了一种基于评分的系统来诊断“活动障碍综合征”，试图结合不利的肌肉骨骼表型，包括肌肉减少症和骨质疏松症，以便识别处于特定风险的老年人。我们将这些标准应用于赫特福德郡队列研究 (HCS) 的参与者，以确定他们在未经选择的英国社区居住老年人队列中的患病率，并评估他们与之前跌倒和骨折的关系。使用双能 X 射线吸收测定法 (DXA) 测量身体成分和面骨矿物质密度 (BMD)，通过 3 米步行测试确定步态速度，并使用 Jamar 手持式测力计评估握力。研究人员完成了问卷调查，详细说明跌倒和骨折史。使用 EWGSOP、IWGS 和 FNIH 相关定义，该队列中肌少症的患病率分别为 3.3%、8.3% 和 2.0%； 24.8% 的人患有行动障碍综合征。患有活动障碍的个体报告的跌倒次数（去年和 45 岁以来）明显高于没有活动障碍的个体（p<0.01），但在该组中没有观察到骨折率增加（p=0.96）。 IWGS 定义的肌少症患者报告去年跌倒率和骨折发生率显着较高（去年跌倒率：OR 2.51 CI 1.09, 5.81 p=0.03；骨折 OR 2.50 CI 1.05, 5.92 p=0.04），但应用 EWGSOP 定义时并未发现这些显着关联。 IWGS 对肌肉减少症的定义似乎是识别存在普遍不良肌肉骨骼事件风险的个体的有效方法。
Sarcopenia is common in later life and may be associated with adverse health outcomes such as disability, falls and fracture. There is no consensus definition for its diagnosis although diagnostic algorithms have been proposedby the European Working Group for Sarcopenia in Older People (EWGSOP), the International Working Group on Sarcopenia (IWGS) and the Foundation for the National Institutes of Health Sarcopenia Project (FNIH). More recently, Binkley and colleagues devised a score-based system for the diagnosis of “dysmobility syndrome” in an attempt to combine adverse musculoskeletal phenotypes, including sarcopenia and osteoporosis, in order to identify older individuals at particular risk. We applied these criteria to participants from the Hertfordshire Cohort Study (HCS) to define their prevalence in an unselected cohort of UK community dwelling older adults and assess their relationships with previous falls and fracture. Body composition and areal bone mineral density (BMD) were measured using dual-energy X-ray absorptiometry (DXA), gait speed was determined by a 3-metre walk test and grip strength was assessed with a Jamar hand-held dynamometer. Researcher-administered questionnaires were completed detailing falls and fracture history. The prevalence of sarcopenia in this cohort was 3.3%, 8.3% and 2.0% using the EWGSOP, IWGS and related-definition of FNIH respectively; 24.8% of individuals had dysmobility syndrome. Individuals with dysmobility reported significantly higher number of falls (last year and since the age of 45 years) (p<0.01) than those without it, but no increased fracture rate was observed in this group (p=0.96). Those with sarcopenia as defined by the IWGS reported significantly higher falls in the last year and prevalent fractures (falls in the last year: OR 2.51 CI 1.09, 5.81 p=0.03; fractures OR 2.50 CI 1.05, 5.92 p=0.04) but these significant associations were not seen when the EWGSOP definition was applied. The IWGS definition of sarcopenia appears to be an effective means of identifying individuals at risk of prevalent adverse musculoskeletal events.