EWGSOP共识在上海市70～79岁社区老年女性肌肉衰减症研究中的应用

发布时间：2018-11-17 13:20

【摘要】：目的:将欧洲老年人肌肉衰减症工作组(EWGSOP)提出的肌肉质量、肌肉力量和身体活动能力三维度综合评定法应用于上海市70~79岁社区老年女性肌肉衰减症的筛检研究中,以了解其检测方法及代表性指标是否适用于中国老年人群。方法:以上海市22位健康老年女性作为研究对象(老年组),另以10位青年女性作为参照对象(青年组),分别采用3D人体扫描法、生物电阻抗(BIA)法和双能X射线(DEXA)法,在获取四肢围度的同时,以相对骨骼肌质量指数(RASM)和骨骼肌指数(SMI)这两项国际通用指标对肌肉质量进行考量;采用握力计、Contrex等动训练仪对上、下肢肌肉力量进行测评;采用10 m步速、功能性伸展测试(FRT)、计时起立行走(TUG)、Berg平衡量表(BBS)、躯体简易功能量表(SPPB)等测试评定身体活动能力,最后参照EWGSOP共识就肌肉衰减症的检出率进行初步判定。结果:(1)老年组上臂围度和上肢脂肪量均较青年组显著上升(P0.01),而上、下肢肌肉质量均未见显著变化(P0.05);(2)BIA法和DEXA法检测结果显示,老年组RASM值均显著高于青年组(P0.05),SMI值均显著低于青年组(P0.01);(3)老年组握力、相对握力、下肢三关节伸肌和屈肌的各项肌肉力量指标均显著低于青年组(P0.01),其中相对握力同下肢肌力多数指标间相关性较为显著;(4)老年组身体活动能力较青年组呈现显著衰退趋势(P0.05),且除握力和步速间存在显著相关关系外,上肢肌力指标同其他身体活动能力指标间均未见显著相关关系;(5)经RASM指标评估肌肉质量维度时,BIA法和DEXA法所得检出率均为0,而经SMI指标评估肌肉质量维度时,相应的检出率分别为63.6%和45.4%。结论:本研究中EWGSOP共识应用于筛检肌肉衰减症时存在指标依赖性,建议在EWGSOP共识首推的"RASM+握力+步速"模式基础上,适当引入"SMI+相对握力+TUG/SPPB/Berg"模式进行综合判定,以避免对EWGSOP共识的简单照搬。
[Abstract]:Objective: to apply the three-dimension comprehensive evaluation method of muscle mass, muscle strength and physical activity proposed by the European working Group on Muscular Attenuations of the elderly (EWGSOP) to the screening study of senile women's muscular attenuation in 7079-year-old community in Shanghai. To find out whether the test method and representative index are suitable for Chinese elderly population. Methods: a total of 22 healthy elderly women in Shanghai were selected as the study subjects (elderly group) and 10 young women as control subjects (youth group). Bioelectric impedance (BIA) method and dual-energy X-ray (DEXA) method were used to measure the muscle quality by using the relative skeletal muscle mass index (RASM) and the skeletal muscle index (SMI), which were used to measure the limb circumference at the same time as the relative skeletal muscle mass index (RASM) and the skeletal muscle index (SMI). The muscle strength of upper and lower limbs was measured by grip force meter and Contrex isokinetic training instrument. The body activity was evaluated by 10 m step speed, functional stretching test, (FRT), standing up and walking (TUG), Berg balance scale, (BBS), somatic mini-function scale, (SPPB), etc. Finally, according to the EWGSOP consensus, the detection rate of muscle attenuation was preliminarily determined. Results: (1) the upper arm circumference and upper limb fat content in the elderly group were significantly higher than those in the young group (P0.01), but the muscle mass of the upper and lower limbs had no significant change (P0.05). (2) the results of BIA and DEXA showed that the RASM value of the old group was significantly higher than that of the young group (P0.05), SMI value was significantly lower than that of the young group (P0.01); (3) grip strength, relative grip strength, muscle strength index of extensor muscle and flexor muscle of lower extremity in the elderly group were significantly lower than those in the young group (P0.01), and the correlation between relative grip strength and most indexes of lower limb muscle strength was significant. (4) the physical activity of the elderly group showed a significant decline trend compared with the young group (P0.05), and there was no significant correlation between the upper limb muscle strength index and other physical activity indicators except for the significant correlation between grip strength and walking speed. (5) when the muscle quality dimension was evaluated by RASM, the detection rates of BIA and DEXA were both 0, while those of SMI were 63.6% and 45.4%, respectively. Conclusion: in this study, the application of EWGSOP consensus in the screening of muscle attenuation has index dependence. It is suggested that the "SMI relative grip strength TUG/SPPB/Berg" model should be introduced on the basis of the "RASM grip step speed" model recommended by the EWGSOP consensus. To avoid a simple copy of the EWGSOP consensus.
【作者单位】：浙江工业大学体育科学研究所;上海体育学院运动科学学院;美国俄勒冈州立大学;
【基金】：中国博士后科学基金项目(2012T50430&2011M500805) 浙江省体育局科研项目(2013[334]-22)
【分类号】：R685

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