| Objective: Sarcopenia is a comprehensive degenerative disorder characterized by a decline in skeletal muscle mass,muscle strength and physical performance with age which mainly occurs in the elderly population.The occurrence of sarcopenia will affect the daily activities of the elderly,leading to an increase in the hospitalization rate and risk of death among the elderly.With the advancement of the aging society in our country,the number of patients with sarcopenia has increased year by year due to the surge in the elderly population,which has affected the quality of life of the elderly and also brought enormous medical expenditure pressure to the society.Effective diagnosis can help people discover the occurrence of sarcopenia in time,but there is no diagnostic standard for the occurrence of sarcopenia in the elderly in China.The screening methods of the four international organizations have established a criteria which have not yet included the subjects of the elderly in China’s mainland.The applicability of the elderly population in China has been questioned.Moreover,the cut-off values of the existing diagnostic indicators are mostly based on the norm reference method,and the correlation between the indicators is not considered.Based on the international consensus that the usual gait speed(UGS)less than 0.8m/s was defined as mobility impairment,the study determines the grip strength cutpoints based on the correlation between muscle strength and physical performance,and then determines the cutpoints of muscle mass based on the cutpoints of the grip strength.It is intended to provide a basis for the diagnosis of sarcopenia in the elderly in China.Methods: A total of 12981(male,5031;female,7950)subjects over 60 years old who reside in Beijing,Changchun and Jurong were selected in a pooled cross-sectional data.Their anthropometrics,body composition,muscle strength and function,dietary intake,physical activity and diseases history were obtained by the physical measurements or questionnaire interviews.With the UGS values less than0.8 m/s as a functional decline,the classification and regression tree analysis(CART)was used to determine the cutpoints of the HGS loss.The cut-off value of muscle mass attenuation is determined by the grip force cutpoints.The cutpoints were also evaluated by predicting slow UGS and weak HGS based on HGS and ALM categories in a logistic regression model including the covariates such as anthropometrics,dietary intake,physical activity and chronic diseases.Results: Three categories of HGS for male and female,respectively: > 34.0 kg or21.4 kg,strong;26.6-34.0 kg or 16.5-21.4 kg,medium;<26.6 kg or 16.5 kg,weakness.Compared with the strong HGS group,the odds ratios for mobility impariment were4.50(95%CI:3.13-6.47)and 1.93(95%CI:1.37-2.71)in male,and3.22(95%CI:2.37-4.36)and 1.81(95%CI:1.38-2.36)in female,respectively.Three categories of ALM for male and female,respectively: > 18.54 or 15.04 kg,high;16.52-18.54 kg or 12.54-15.04 kg,medium;< 16.52 kg/12.54 kg,low.Compared with the high ALM group,the odds ratios for weak were 9.09(95% CI: 5.99-13.81)and2.20(95% CI: 1.71-2.84)in male,and 4.48(95% CI: 3.45-5.83)and 1.73(95% CI:1.39-2.15)in female,respectively.Conclusion: The diagnostic cutpoints of HGS were 26.6 kg and 16.5 kg for predicting muscle weakness in male and female.Compared with the HGS cutpoints were suggested by FNIH,the cutpoints was 0.6 kg higher in male and 0.5 kg higher in female.The diagnostic cutpoints of ALM were 16.52 kg and 12.54 kg for predicting muscle loss in male and female.Compared with the HGS cutpoints were suggested by FNIH,the cutpoints was 3.23 kg lower in male and 2.48 kg lower in female.The diagnostic cutpoints of this study results the prevalence of sarcopenia has a decrease in both male and female. |
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