R Matsuzawa, K Nagai, K Takahashi, T Mori, M Onishi, S Tsuji, K Hashimoto, K Tamaki, Y Wada, H Kusunoki, Y Nagasawa, K Shinmura
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引用次数: 0
Abstract
Objectives: To compare the discriminative capabilities for the manifestation of sarcopenia or physical frailty between serum creatinine- and cystatin C-derived indices among community-dwelling older adults.
Design: Cross-sectional study.
Setting: Primary Care and Community.
Participants: We utilized a subset of data from the Frail Elderly in the Sasayama-Tamba Area (FESTA) study, which was initiated in 2015 to gather comprehensive information on various health-related parameters among community-dwelling older individuals (age ≥65 years).
Measurements: Five serum creatinine-cystatin C based indices including the Sarcopenia Index, the serum creatinine/cystatin C ratio, the disparity between serum cystatin-C-based and creatinine-based estimated GFR, the total body muscle mass index (TBMM), and the prediction equation for skeletal muscle mass index (pSMI) were employed. Sarcopenia and physical frailty were identified based on the Asian Working Group for Sarcopenia criteria and the revised Japanese version of the Cardiovascular Health Study criteria, respectively. The receiver operating characteristic (ROC) and logistic regression analyses were performed to assess the discriminative abilities of these tools.
Results: In the analysis of 954 participants, 52 (5.5%) were identified with sarcopenia and 35 (3.7%) with physical frailty. Regarding sarcopenia discrimination, TBMM and pSMI both exhibited area under the curve (AUC) values exceeding 0.8 for both men and women. Concerning the identification of physical frailty, AUC values ranged from 0.61 to 0.77 for males and 0.50 to 0.69 for females. In the multivariate logistic regression analyses, only TBMM and pSMI consistently displayed associations with sarcopenia, irrespective of sex (P<0.001, respectively). On the other hand, no consistent associations were observed between the indices and physical frailty.
Conclusions: This study provides a robust association of a serum creatinine- and cystatin C-derived indices, especially TBMM and pSMI, with sarcopenia among community-dwelling older adults. Conversely, the application of these indices for the screening of physical frailty has its constraints, necessitating further investigation.
目的比较血清肌酐和胱抑素 C 衍生指数对社区老年人肌少症或身体虚弱表现的鉴别能力：设计：横断面研究：参与者我们利用了筱山-丹波地区体弱老年人（FESTA）研究的数据子集，该研究于2015年启动，旨在收集社区老年人（年龄≥65岁）各种健康相关参数的综合信息：采用了五种基于血清肌酐-胱抑素 C 的指数，包括肌少症指数、血清肌酐/胱抑素 C 比率、基于血清胱抑素 C 和肌酐的估计 GFR 之间的差异、全身肌肉质量指数（TBMM）和骨骼肌质量指数预测方程（pSMI）。沙细胞减少症和体质虚弱分别根据亚洲沙细胞减少症工作组标准和日本修订版心血管健康研究标准进行鉴定。通过接收器操作特征（ROC）和逻辑回归分析来评估这些工具的鉴别能力：结果：在对 954 名参与者的分析中，有 52 人（5.5%）被确定为肌肉疏松症患者，35 人（3.7%）被确定为身体虚弱。关于肌肉疏松症的判别，TBMM 和 pSMI 的曲线下面积（AUC）值均超过 0.8（男性和女性）。在体质虚弱的识别方面，男性的 AUC 值介于 0.61 到 0.77 之间，女性介于 0.50 到 0.69 之间。在多变量逻辑回归分析中，只有 TBMM 和 pSMI 与肌肉疏松症持续相关，与性别无关（PC 结论：本研究提供了血清肌酐和胱抑素 C 衍生指数（尤其是 TBMM 和 pSMI）与社区老年人肌少症的密切联系。相反，将这些指数用于身体虚弱筛查有其局限性，需要进一步研究。
期刊介绍：
The Journal of Frailty & Aging is a peer-reviewed international journal aimed at presenting articles that are related to research in the area of aging and age-related (sub)clinical conditions. In particular, the journal publishes high-quality papers describing and discussing social, biological, and clinical features underlying the onset and development of frailty in older persons. The Journal of Frailty & Aging is composed by five different sections: - Biology of frailty and aging In this section, the journal presents reports from preclinical studies and experiences focused at identifying, describing, and understanding the subclinical pathophysiological mechanisms at the basis of frailty and aging. - Physical frailty and age-related body composition modifications Studies exploring the physical and functional components of frailty are contained in this section. Moreover, since body composition plays a major role in determining physical frailty and, at the same time, represents the most evident feature of the aging process, special attention is given to studies focused on sarcopenia and obesity at older age. - Neurosciences of frailty and aging The section presents results from studies exploring the cognitive and neurological aspects of frailty and age-related conditions. In particular, papers on neurodegenerative conditions of advanced age are welcomed. - Frailty and aging in clinical practice and public health This journal’s section is devoted at presenting studies on clinical issues of frailty and age-related conditions. This multidisciplinary section particularly welcomes reports from clinicians coming from different backgrounds and specialties dealing with the heterogeneous clinical manifestations of advanced age. Moreover, this part of the journal also contains reports on frailty- and age-related social and public health issues. - Clinical trials and therapeutics This final section contains all the manuscripts presenting data on (pharmacological and non-pharmacological) interventions aimed at preventing, delaying, or treating frailty and age-related conditions.The Journal of Frailty & Aging is a quarterly publication of original papers, review articles, case reports, controversies, letters to the Editor, and book reviews. Manuscripts will be evaluated by the editorial staff and, if suitable, by expert reviewers assigned by the editors. The journal particularly welcomes papers by researchers from different backgrounds and specialities who may want to share their views and experiences on the common themes of frailty and aging.The abstracting and indexing of the Journal of Frailty & Aging is covered by MEDLINE (approval by the National Library of Medicine in February 2016).
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