Pol Grootswagers, Alice Ricco, Paul Hulshof, Lisette de Groot
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引用次数: 0
Abstract
Introduction: Sarcopenia, a progressive age-related loss of skeletal muscle mass and function, poses significant health risks in older adults. Phase angle (PhA), derived from bioimpedance analysis, has been proposed as an indicator of muscle quality and physical functioning. This study investigates the association between PhA and physical function, and its potential utility in case-finding phase of sarcopenia assessment based on EWGSOP2 functional cut-offs.
Methods: This cross-sectional observational study used baseline data from two clinical trials involving Dutch older adults (≥65 years, n=228) at risk of malnutrition or frailty. PhA was measured using multi-frequency bioimpedance vector analysis. Physical functioning was assessed through handgrip strength, knee extension strength, chair rise test, and gait speed (4m and 400-m/6-min walk tests). Associations were evaluated using linear mixed models adjusted for age, gender, height, and lean body mass. Receiver-operating characteristic (ROC) analyses identified PhA thresholds for low performance based on EWGSOP2 cut-offs.
Results: PhA was significantly associated with all performance outcomes in crude models. After adjustment, each unit increase in PhA was associated with a 43.5 ± 8.4 N increase in knee extension strength (P < 0.0001), a 1.5 ± 0.4 s reduction in chair rise time (P = 0.0004), and a 0.14 ± 0.02 m/s increase in gait speed (P < 0.0001). Associations with handgrip strength became non-significant after full adjustment. A PhA threshold of 5.4° showed high sensitivity (0.96) for detecting low physical performance via the chair rise test. However, misclassification rates exceeded 25 %.
Conclusions: PhA is associated with physical function, particularly lower-body performance measures, but without muscle mass assessment, it cannot support a complete diagnosis of sarcopenia. It may be valuable as a case-finding tool in older adults at risk.
骨骼肌减少症是一种与年龄相关的骨骼肌质量和功能的进行性丧失，对老年人的健康构成重大风险。相位角（PhA）源于生物阻抗分析，已被提出作为肌肉质量和身体功能的指标。本研究探讨了PhA与身体功能之间的关系，以及其在基于EWGSOP2功能切断的肌少症病例评估阶段的潜在应用。方法：这项横断面观察性研究使用了两项临床试验的基线数据，涉及荷兰老年人（≥65岁，n=228），有营养不良或虚弱的风险。PhA采用多频生物阻抗矢量分析测定。通过握力、膝关节伸展力、椅子起身测试和步态速度（4米和400米/6分钟步行测试）评估身体功能。使用调整了年龄、性别、身高和瘦体重的线性混合模型评估相关性。接收机工作特征（ROC）分析确定了基于EWGSOP2截止值的低性能PhA阈值。结果：PhA与粗模型的所有表现结果显著相关。调整后，PhA每增加一个单位，膝关节伸展强度增加43.5±8.4 N (P < 0.0001)，起立时间减少1.5±0.4 s (P = 0.0004)，步态速度增加0.14±0.02 m/s （P < 0.0001）。完全调整后，与握力的关联变得不显著。PhA阈值为5.4°，表明通过椅子上升测试检测低物理性能具有很高的灵敏度（0.96）。然而，误分类率超过25%。结论：PhA与身体功能有关，特别是下半身运动指标，但没有肌肉质量评估，它不能支持肌肉减少症的完整诊断。对于处于危险中的老年人，它可能是一种有价值的病例发现工具。
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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