ふくらはぎ周囲長によりサルコペニアをスクリーニングする際のカットオフ値は、年齢や肥満の有無によらず、男性は35cm、女性は33cm程度が妥当であることが、日本人対象の研究から明らかになった。早稲田大学スポーツ科学学術院の川上諒子氏らが、同大学の同窓生を対象とする「WASEDA'S Health Study」のデータを解析した結果であり、「Geriatrics & Gerontology International」10月号に論文が掲載された。
Early intervention in sarcopenia requires a simple screening method
Sarcopenia, a state where muscle mass and muscle strength decrease, increases the risk of falling, fractures and death, not only in QOL.Although the rate of illness rises with aging, it can be prevented and improved by exercise and nutritional intervention.Therefore, the point is to find it early by screening.
Sarcopenia's diagnosis is performed by the DXA method (double energy X -ray absorbing measurement method), and the measurement of the walking speed is performed.However, it should be the subject of sarcopenia's screening, not only by specific disease -affected persons, but all the elderly, so it can be done in a shorter time to avoid the risk of cost and time and the risk of radiation exposure.A way of judging is required.
As one of the simple screening methods, in 2019, the Asian Sarcopenia Working Group (Asian Working Group for Sarcopenia; AWGS) first measured the calf peripheral, and if it falls below the reference value, the grip strength and chair standing test, etc.A diagnostic criteria for the site to determine in more detail was announced.The judge of the calf under the diagnostic standard is said to be "less than 34 cm for men and less than 33 cm for women".
However, the effects of age and obesity are unknown, and it is not clear whether it is a diagnosis of the DXA method or the Biological Impedance Law (BIA method) used for measuring skeletal muscle mass, and it is also a value correlated.It has not been verified whether it can be applied to Japanese people.Mr. Kawakami's research aimed at clarifying these points.
Analyze the data of the long -term observation research "WASEDA'S HEALTH STUDY" for Waseda graduates
This study shows the Waseda Alumni's Sports, EXERCISE, Daily Activity, Sedential Phillines and Health Study, which has long been observed for lifestyles such as exercise and meals for graduates at Waseda University.(Health promotion research for Waseda University Alumni)] was used.
The analysis was to be 1,239 of the calf permanent, who was over 40 years old, among those who underwent a health survey from March 2015 to January 2020, and the DXA and BIA methods were measured.。The characteristics of gender are as follows.
There are 827 men, age 57 ± 10 years old, BMI23.8 ± 3.0kg/m2, body fat percentage 20.4 ± 4.7 %, 37 calf surroundings.6 ± 2.It is 6cm, and the skeletal muscle mass index (SMI. SMI. The value of excluding limb muscle mass with the square of height) is 7 in the DXA method..9 ± 0.8kg/m2, 8kg, 8 in the BIA method.3 ± 0.It was 9kg/m2.In addition, the grip strength used in the diagnostic criteria for sarcopenia is 37..9 ± 5.It was 8kg.
There are 412 women, age 52 ± 9 years old, BMI21.4 ± 2.9kg/m2, body fat percentage 27.2 ± 5.1 %, the calf periphery is 34.4 ± 2.It is 2cm, SMI is 6 in the DXA method.1 ± 0.7kg/m2, 6 in the BIA method.4 ± 0.6kg/m2, grip strength 24.5 ± 3.It was 7kg.
Comparison between sarcopenia and non -salmon
According to AWGS's Sarcopenia diagnostic standard, the SMI judgment standard by the DXA method is male 7.Less than 0kg/m2, for women 5.If it is less than 4kg/m2, the BIA method is 7 in the same order..0kg/m2 less than 5, 5.It is less than 7kg/m2.
If this standard is applied to this analysis subject, the rate of illness in sarcopenia is 8 men in the DXA method..6 %, 12 women.9 %, in the BIA method 4 in the same order.1 %, 6.It was calculated as 6 %.
Comparing the Sarcopenia groups determined by the DXA method and the non -salmon penias, both men and women have a significantly lower BMI, calf surrounding director, SMI, and grip strength.On the other hand, there was no significant difference between ages and body fat percentage.Each figure is as follows.
Men are BMI20 in the order of sarcopenia groups and non -saltarcopenia groups..7 ± 1.7 vs 24.1 ± 2.9kg/m2, calf periphery 34.5 ± 1.7 vs 37.8 ± 2.5cm, SMI6.6 ± 0.3 vs 8.1 ± 0.7kg/m2, grip strength 32.1 ± 6.0 vs 38.4 ± 5.5kg (both p <0.001）。年齢59±12 vs 57 ± 10歳（ｐ＝0.114), body fat percentage 21.3 ± 4.6 vs 20.3 ± 4.7 % (p = 0.069).
Women are BMI18.7 ± 1.5 vs 21.8 ± 2.8kg/m2, calf periphery 32.1 ± 1.8 vs 34.7 ± 2.0cm, SMI5.1 ± 0.2 vs 6.2 ± 0.6kg/m2, grip strength 22.6 ± 3.6 vs 24.8 ± 3.6kg (both P <0.001).Age 51 ± 7 vs 52 ± 9 years old (p = 0.174), body fat percentage 26.8 ± 4.5 vs 27.3 ± 5.2 % (p = 0.534).
Relationship between the calf surroundings and sarcopenia
Next, we examined the relationship between the calf surrounding director and SMI.As a result, the SMI measured by the DXA method is a male R = 0..78, female R = 0.76, the SMI measured by the BIA method is a male R = 0.81, female R = 0.It was 73, all of which had a strong legal correlation.
The relationship with grip strength is male R = 0..33, female R = 0.It was 31 and was a weak legal correlation.
Next, using the ROC analysis to examine the prediction of sarcopenia by the calf, AUC0 for men's DXA law..88, the same for diagnosis by the BIA method.93, 0 in the same order for women.84, 0.It was 89, and high prediction was confirmed.
The cut -off value of the calf that is ideal for screening is 35 for diagnosis by the DXA method of men..8cm (sensitivity 81.7 %, specificity 80.4 %), 35 for diagnosis by the BIA method.4cm (sensitivity 91.2 %, specificity 83.5 %), 33 in the same order for women.5cm (sensitivity 84.9 %, specificity 72.4 %), 32.7cm (sensitivity 81.5 %, specificity 83.The value of 6 %) was calculated.
Sub -group analysis was performed to confirm the effects of age and obesity.Regarding the age of the age of 60, for obesity, the body fat percentage under the DXA method is 25 % or more, and more than 30 % for women are defined as obesity.As a result, all groups have a significant correlation between the calf surroundings and SMI.It turned out that the cut -off value of the screening was almost equivalent to the above values.
Based on the above results, the authors conclude that "the calf can be a simple salon marker for sarcopenia diagnosis, regardless of obesity or age."
Literature information
The title of the original title is "Cut -OFFS for CALCUMFERENCE AS A SCREENING TOOL FOR LOW LOW MUSCLE MASS: WASEDA'S HEALTH STUDY".[GERIATR GERONTOL INT. 2020 Oct;20(10):943-950〕原文はこちら（John Wiley & Sons）
この記事のURLとタイトルをコピーする