文章摘要
王光辉,蔡文玮,沈晓君,张倩,李晨奕.欧洲肌少症共识在上海部分社区老年人群肌少症筛查中的应用[J].中国临床保健杂志,2020,23(3):325-330.
欧洲肌少症共识在上海部分社区老年人群肌少症筛查中的应用
The application of EWGSOP2 consensus in the screening for sarcopenia in the elderly in Shanghai communities
投稿时间:2020-04-07  
DOI:10.3969/J.issn.1672-6790.2020.03.010
中文关键词: 衰弱  患病率  肌肉骨骼生理现象  诊疗准则  危险因素  肌少症  老年人
英文关键词: Frailty  Prevalence  Musculoskeletal physiological phenomena  Practice guideline  Risk factors  Sarcopenia  Aged 〖FL
基金项目:
作者单位E-mail
王光辉 上海交通大学医学院附属第九人民医院老年病科,上海200011 13564084838@139.com 
蔡文玮 上海交通大学医学院附属第九人民医院老年病科,上海200011 13564084838@139.com 
沈晓君 上海市黄浦区老西门街道社区卫生服务中心 13564084838@139.com 
张倩 上海交通大学医学院附属第九人民医院老年病科,上海200011 13564084838@139.com 
李晨奕 上海交通大学医学院附属第九人民医院老年病科,上海200011 13564084838@139.com 
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中文摘要:
      目的 评价欧洲肌少症工作组修订的欧洲肌少症共识(EWGSOP2)在社区老年人肌少症筛查中的准确性,并调查上海社区医院老年人肌少症患病率及其相关危险因素。方法 采取现况调查的方法,在社区医院门诊对515例老年人收集一般资料、慢性病史、生活方式,进行人体学指标测量,使用EWGSOP2共识推荐的FACS评估流程进行肌少症的筛查和评估。使用单因素和与多因素logistic回归分析筛选肌少症发病的相关危险因素,使用ROC曲线评价简易五项评分问卷(SARC-F)的准确性。结果 上海市社区医院老年人肌少症患病率为17.9%,男性19.5%,女性17.0%,严重肌少症总体患病率4.3%,不同性别患病率差异无统计学意义(P=0.478)。肌少症组年龄、职业史、文化程度、营养状况、体育活动情况、日常生活活动能力、吸烟等级、体质指数、腹型肥胖人数占比、糖尿病和骨质疏松症患病率与非肌少症组存在差异(P<0.05)。多因素logistic回归分析显示年龄、日常生活能力功能障碍、低体质量,吸烟和糖尿病为肌少症的独立危险因素(P<0.05);体力劳动职业史、高体育活动等级、超重和肥胖为肌少症的独立保护因素(P<0.05)。肌少症组SARC-F高风险例数和各项目评分高分人数比例均高于非肌少症组,SARC-F评分ROC曲线下面积(AUC)为0.774,95%CI:0.713~0.834,P<0.001,以3分为截点时约登指数最大。结论 上海市社区老年人肌少症患病率较高,年龄、日常生活能力功能障碍、低体质量、吸烟和糖尿病是肌少症的危险因素。
英文摘要:
      Objective To assess the application of EWGSOP2 consensus in the screening for sarcopenia and toinvestigate the prevalence of sarcopenia and the associated risk factors in the elderly in community hospitals in Shanghai.Methods A total of 515 community dweling residents in community hospitals were assessed by using the FACS algorithm recommended by the EWGSOP2 consensus,and their general information,medical history,life style and anthropometric measurements were collected.Univariate and multivariate logistic regression were used to analyze the risk factors of sarcopenia,and the ROC curves were used to evaluate the accuracy of the SARC-F score.Results The prevalence of sarcopenia was 17.9% in the elderly,the prevalences of the male and female were 19.5% and 17.0%,and there was no statistical difference between different genders (P=0.478),the overall prevalence of severe sarcopenia was 4.3%.Univariate factor analusis showed that there were significant differences between the sarcopenia group and non-sarcopenia group in age,employment history,level of education,nutrition status,physical activity levels,activities of daily living,grade of smoking,BMI,proportion of abdominal obesity and prevalence of diabetes mellitus and osteoporosis(P<0.05).Logistic regression analysis indicated that experience in manual labor,higher physical activity levels,overweight and obesity were independent protective factors of sarcopenia(P<0.05)while age increasing,ADL dependence,underweight,smoking and diabetes mellitus were independent risk factors of sarcopenia(P<0.05).The proportion of high scores of each item and SARC-F positive in sarcopenia group were higher than those in non-sarcopenia group.The area under the curve of ROC (AUC) for SARC-F score was 0.774,the 95% CI was from 0.713 to 0.834,P<0.001;Score of 3 was the cut-off point when the Youden's index reached the highest.Conclusion The prevalence of sarcopenia in the elderly in shanghai communities is higher and age increasing,ADL dependence,underweight,smoking and diabetes mellitus were risk factors of sarcopenia.
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