肌少症的評估與診斷

The Evaluation and Diagnosis of Sarcopenia

10.6317/LTC.20.115

韓德生(Der-Sheng Han)

肌少症 ； 診斷標準 ； 肌肉重 ； 握力 ； 步速 ； sarcopenia ； diagnostic criteria ； muscle mass ； grip strength ； gait speed

長期照護雜誌

20卷2期（2016 / 09 / 01）

115 - 124

繁體中文

肌少症是因老化造成肌肉質量減少與肌肉功能下降的新興老年症候群，會增加失能、依賴、跌倒甚至死亡的機會。目前國際間已有普遍接受的診斷共識，可提供國內研究及與國際研究的比較。依據2014年亞洲肌少症工作小組共識，其診斷標準包括：肌肉質量減少（若以雙能量X光測量，男性為小於7.0kg/m^2，女性為小於5.4kg/m^2；若以生物阻抗分析儀測量，男性為小於7.0kg/m^2，女性為小於5.7kg/m^2）、握力下降（男性小於26公斤，女性小於18公斤）、步速降低（小於0.8m/s）。國內研究顯示男性肌少症的比率介於4.0～23.6%之間，女性為0.4-18.6%。良好的診斷標準須能反應疾病所造成之罹病率與致死率，未來有賴長期追蹤的世代研究回答此課題。

Sarcopenia is a geriatric syndrome, which related with muscle mass and muscle function decline during ageing. It will increase the risk of disability, dependence, fall, and death. There are diagnostic consensuses for sarcopenia to facilitate the comparison between studies. According to, the cutoff values for low muscle mass are 7.0 kg/m^2 for male and 5.4 kg/m^2 for female when employing DXA for evaluation; 7.0 kg/m^2 for male and 5.7 kg/m^2 for female when employing BIA. Low grip strength is defined as less than 26kg for male and 18kg for female. Low gait speed is defined as slower than 0.8 m/s. The prevalence in Taiwan is 4.0-23.6% for male, and 0.4-18.6% for female. Good diagnostic criteria should reflect morbidity and mortality. Future longitudinal cohort study can fulfill this aim.

1. Bahat, G.,Saka, B.,Tufan, F.,Akin, S.,Sivrikaya, S.,Yucel, N.,Karan, M. A.(2010).Prevalence of sarcopenia and its association with functional and nutritional status among male residents in a nursing home in Turkey.The Aging Male,13(3),211-214.
2. Baumgartner, R. N.,Koehler, K. M.,Gallagher, D.,Romero, L.,Heymshield, S. B.,Ross, R. R.,Lindeman, R. D.(1998).Epidemiology of sarcopenia among the elderly in New Mexico.American Journal of Epidemiology,147(8),755-763.
3. Chen, L. K.,Liu, L. K.,Woo, J.,Assantachai, P.,Auyeung, T. W.,Bahyah, K. S.,Arai, H.(2014).Sarcopenia in Asia: Consensus report of the Asian Working Group for Sarcopenia.Journal of the American Medical Directors Association,15(2),95-101.
4. Chien, M. Y.,Huang, T. Y.,Wu, Y. T.(2008).Prevalence of sarcopenia estimated using a bioelectrical impedance analysis prediction equation in community-dwelling elderly people in Taiwan.Journal of the American Geriatrics Society,56(9),1710-1715.
5. Cruz-Jentoft, A. J.,Baeyens, J. P.,Bauer, J. M.,Boirie, Y.,Cederholm, T.,Landi, F.,Zamboni, M.(2010).Sarcopenia: European consensus on definition and diagnosis.Age and Ageing,39(4),412-423.
6. Cruz-Jentoft, A. J.,Landi, F.,Topinková, E.,Michel, J. P.(2010).Understanding sarcopenia as a geriatric syndrome.Current Opinion in Clinical Nutrition & Metabolic Care,13(1),1-7.
7. Delmonico, M. J.,Harris, T. B.,Lee, J. S.,Visser, M.,Nevitt, M.,Kritchevsky, S. B.,Newman, A. B.(2007).Alternative definitions of sarcopenia, lower extremity performance, and functional impairment with aging in older men and women.Journal of the American Geriatrics Society,55(5),769-774.
8. Fielding, R. A.,Vellas, B.,Evans, W. J.,Bhasin, S.,Morley, J. E.,Newman, A. B.,Zamboni, M.(2011).Sarcopenia: An undiagnosed condition in older adults. Current consensus definition: Prevalence, etiology, and consequences. International working group on sarcopenia.Journal of the American Medical Directors Association,12(4),249-256.
9. Fried, L. P.,Tangen, C. M.,Walston, J.,Newman, A. B.,Hirsch, C.,Gottdiener, J.,McBurnie, M. A.(2001).Frailty in older adults.The Journals of Gerontology Series A: Biological Sciences and Medical Sciences,56(3),M146-M157.
10. Han, D. S.,Chang, K. V.,Li, C. M.,Lin, Y. H.,Kao, T. W.,Tsai, K. S.,Yang, W. S.(2016).Skeletal muscle mass adjusted by height correlated better with muscular functions than that adjusted by body weight in defining sarcopenia.Scientific Report,6(19457)
11. Han, D. S.,Chen, Y. M.,Lin, S. Y.,Chang, H. H.,Huang, D. M.,Chi, Y. C.,Yang, W. S.(2011).Serum myostatin levels and grip strength in normal subjects and patients on maintenance hemodialysis.Clinical Endocrinology,75(6),857-863.
12. Heimbürger, O.,Qureshi, A. R.,Blaner, W. S.,Berglund, L.,Stenvinkel, P.(2000).Hand-grip muscle strength, lean body mass, and plasma proteins as markers of nutritional status in patients with chronic renal failure close to start of dialysis therapy.American Journal of Kidney Diseases,36(6),1213-1225.
13. Janssen, I.,Heymsfield, S. B.,Ross, R.(2002).Low relative skeletal muscle mass (sarcopenia) in older persons is associated with functional impairment and physical disability.Journal of the American Geriatrics Society,50(5),889-896.
14. Kamel, H. K.(2003).Sarcopenia and aging.Nutrition Reviews,61(5),157-167.
15. Kamel, H. K.,Maas, D.,Duthie, E. H. Jr.(2002).Role of hormones in the pathogenesis and management of sarcopenia.Drugs and Aging,19(11),865-877.
16. Kuyumcu, M. E.,Halil, M.,Kara, Ö,Ç uni, B.,Çağlayan, G.,Güven, S.,Ö zçakar, L.(2016).Ultrasonographic evaluation of the calf muscle mass and architecture in elderly patients with and without sarcopenia.Archives of Gerontology and Geriatrics,65,218-224.
17. Lauretani, F.,Russo, C. R.,Bandinelli, S.,Bartali, B.,Cavazzini, C.,Di Iorio, A.,Ferrucci, L.(2003).Age-associated changes in skeletal muscles and their effect on mobility: An operational diagnosis of sarcopenia.Journal of Applied Physiology,95(5),1851-1860.
18. Lee, W. J.,Liu, L. K.,Peng, L. N.,Lin, M. H.,Chen, L. K.(2013).Comparisons of sarcopenia defined by IWGS and EWGSOP criteria among older people: Results from the I-Lan longitudinal aging study.Journal of the American Medical Directors Association,14(7),528.e1-528.e7.
19. Mathiowetz, V.,Kashman, N.,Volland, G.,Weber, K.,Dowe, M.,Rogers, S.(1985).Grip and pinch strength: Normative data for adults.Archives of Physical Medicine and Rehabilitation,66(2),69-74.
20. Melton, L. J. r.,Khosla, S.,Riggs, B. L.(2000).Epidemiology of sarcopenia.Journal of the American Geriatrics Society,48(6),625-630.
21. Meng, N. H.,Li, C. I.,Liu, C. S.,Lin, C. H.,Lin, W. Y.,Chang, C. K.,Lin, C. C.(2015).Comparison of height- and weight-adjusted sarcopenia in a Taiwanese metropolitan older population.Geriatrics & Gerontology International,15(1),45-53.
22. Morley, J. E.,Baumgartner, R. N.,Roubenoff, R.,Mayer, J.,Nair, K. S.(2001).Sarcopenia.Journal of Laboratory and Clinical Medicine,137,231-243.
23. Patil, R.,Uusi-Rasi, K.,Pasanen, M.,Kannus, P.,Karinkanta, S.,Sievänen, H.(2013).Sarcopenia and osteopenia among 70-80-year-old home-dwelling finnish women: Prevalence and association with functional performance.Osteoporosis International,24(3),787-796.
24. Rosenberg, I. H.(1997).Sarcopenia: Origins and clinical relevance.Journal of Nutrition,127,990S-991S.
25. Shephard, R. J.,Montelpare, W.,Plyley, M.,McCracken, D.,Goode, R. C.(1991).Handgrip dynamometry, Cybex measurements and lean mass as markers of the ageing of muscle function.British Journal of Sports Medicine,25(4),204-208.
26. Strasser, E. M.,Draskovits, T.,Praschak, M.,Quittan, M.,Graf, A.(2013).Association between ultrasound measurements of muscle thickness, pennation angle, echogenicity and skeletal muscle strength in the elderly.Age,35(6),2377-2388.
27. Wen, X.,Wang, M.,Jiang, C. M.,Zhang, Y. M.(2011).Are current definitions of sarcopenia applicable for older Chinese adults?.The Journal of Nutrition, Health & Aging,15(10),847-851.
28. Wu, C. H.,Chen, K. T.,Hou, M. T.,Chang, Y. F.,Chang, C. S.,Liu, P. Y.,Chen, C. Y.(2014).Prevalence and associated factors of sarcopenia and severe sarcopenia in older Taiwanese living in rural community: The Tianliao old people study 04.Geriatrics & Gerontology International,14,69-75.

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