相位角筛查 "肌肉疏松症 "的诊断准确性和临界值：系统回顾与元分析》。

IF 4.2 2区医学 Q2 GERIATRICS & GERONTOLOGY

Journal of the American Medical Directors Association Pub Date : 2024-09-23 DOI:10.1016/j.jamda.2024.105283

Jian Zhang MM , Ning Wang MD , Jiatian Li PhD, MD , Yilun Wang PhD, MD , Yongbing Xiao PhD, MD , Tingting Sha PhD

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引用次数: 0

摘要

目的：相位角（Phase angle，PhA）会随着年龄的增长而减小，是肌肉功能的可靠标记，因此是肌肉疏松症的潜在筛查指标。然而，对相位角检测肌少症的可靠性和有效性的研究结果并不一致。这项荟萃分析旨在评估 PhA 筛查肌少症的准确性和临界值，并研究潜在的混杂因素：设计：这是一项荟萃分析：截至2023年9月18日，共检索了PubMed、Embase和Cochrane图书馆，纳入了18项研究（6184名参与者），报告了PhA筛查肌少症的诊断准确性：采用随机效应模型估算了筛选肌少症的汇总准确率（即计算的曲线下面积值 [AUC]）和临界值区间。进行元回归分析以确定异质性的来源：AUC值为0.81。汇总灵敏度和特异度分别为 80% 和 70%。计算得出的用于筛查肌少症的 PhA 临界值的 95% CI 介于 4.54° 和 5.25°之间。元回归分析结果显示，种族、体重指数（BMI）、健康状况和诊断标准是影响肌少症筛查诊断准确性的主要因素（P 值均小于 0.01）：PhA可作为一种强有力的肌少症筛查工具，推荐的临界值在4.54°和5.25°之间。种族、体重指数、健康状况和诊断标准会影响 PhA 在肌少症筛查中的效果。

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The Diagnostic Accuracy and Cutoff Value of Phase Angle for Screening Sarcopenia: A Systematic Review and Meta-Analysis

Objectives

Phase angle (PhA) declines with age and is a reliable marker for muscle function, making it a potential screening indicator for sarcopenia. However, studies examined the reliability and validity of PhA for detecting sarcopenia, yielding inconsistent results. This meta-analysis aimed to evaluate the accuracy and cutoff value of PhA for screening sarcopenia and examine the potential confounding factors.

Design

This is a meta-analysis.

Setting and Participants

PubMed, Embase, and Cochrane Library were searched up to September 18, 2023. Eighteen studies (6184 participants) were included reporting the diagnostic accuracy of PhA for screening sarcopenia.

Methods

Pooled accuracy [ie, the computed area under the curve value (AUC)] and cutoff value interval for screening sarcopenia were estimated using a random-effects model. Meta-regression analyses were conducted to identify sources of heterogeneity.

Results

The AUC value was 0.81. Pooled sensitivity and specificity were 80% and 70%. The calculated 95% CI of the cutoff value of PhA for screening sarcopenia falls between 4.54° and 5.25°. The results of meta-regression analyses showed that ethnicity, body mass index (BMI), health status, and diagnostic criteria were the main factors affecting the diagnostic accuracy for screening sarcopenia (with all P values < 0.01).

Conclusion and Implications

PhA may serve as a robust screening tool for sarcopenia, and the recommended cutoff interval falls between 4.54° and 5.25°. Ethnicity, BMI, health status, and diagnostic criteria can affect PhA's efficacy in sarcopenia screening.

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来源期刊

Journal of the American Medical Directors Association 医学-老年医学

CiteScore

11.10

自引率

6.60%

发文量

472

审稿时长

44 days

期刊介绍： JAMDA, the official journal of AMDA - The Society for Post-Acute and Long-Term Care Medicine, is a leading peer-reviewed publication that offers practical information and research geared towards healthcare professionals in the post-acute and long-term care fields. It is also a valuable resource for policy-makers, organizational leaders, educators, and advocates. The journal provides essential information for various healthcare professionals such as medical directors, attending physicians, nurses, consultant pharmacists, geriatric psychiatrists, nurse practitioners, physician assistants, physical and occupational therapists, social workers, and others involved in providing, overseeing, and promoting quality