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基于亚洲肌肉减少症工作组专家共识的4种筛查工具对中国老年人肌肉减少症的诊断价值

Diagnostic value of four screening tools based on consensus of Asian Working Group for Sarcopenia in the elderly in China with sarcopenia

    摘要
  • 摘要:
    目的 探讨基于亚洲肌肉减少症工作组专家共识(AWGS)的4种筛查工具简易五项问卷(SARC-F)、SARC-Calf问卷、小腿围(CC)、石井评分(Ishii评分)对中国老年人肌肉减少症(肌少症)的诊断价值。
    方法 计算机检索Web of Science、PubMed、EMBase、CNKI、WanFang Data数据库，搜集有关肌少症筛查工具准确性的诊断性试验, 检索时限为建库至2023年4月。由2名研究者独立筛选文献、提取资料并交叉核对，并评价纳入研究的质量。采用Meta-disc 1.4和Stata 17.0软件进行Meta分析。
    结果 共纳入18个研究，涉及4种筛查工具。基于AWGS诊断标准，在中国老年人中SARC-F、SARC-Calf、CC、Ishii评分的灵敏度分别为19%、58%、82%、92%, 特异度为93%、84%、72%、71%, 曲线下面积(AUC)为0.76、0.77、0.85、0.88, SARC-F、SARC-Calf、CC应用于女性的灵敏度比男性高，特异度比男性低, Ishii评分与之相反。SARC-F、Ishii评分在养老机构和住院患者中具有更高的灵敏度，分别为39%、95%。SARC-Calf在社区居民中具有更高特异度(87%)。CC在社区居民中具有更高的灵敏度、特异度，分别为84%、76%。
    结论 SARC-F、Ishii评分更适合在养老机构和住院患者中筛查肌少症, CC更适合在社区居民中筛查肌少症, SARC-F、SARC-Calf可作为排除肌少症患者的工具。SARC-F、SARC-Calf、CC在女性中的应用价值较男性高, Ishii评分与之相反。

     

    Abstract:
    Objective To explore the diagnostic value of four screening tools Simple Five-item Questionnaire (SARC-F), SARC-Calf Questionnaire, calf circumference (CC), Ishii score based on the expert consensus of Asian Working Group for Sarcopenia (AWGS) in the elderly in China with sarcopenia.
    Methods Web of Science, PubMed, EMBase, CNKI, WanFang Data databases were searched by computer. Diagnostic tests on the accuracy of sarcopenia screening tools were collected from the establishment of database until April 2023. Two researchers independently screened the literature, extracted and cross-checked the data, and evaluated the quality of the included studies. Meta-analysis was performed by using Meta-disc 1.4 and Stata 17.0 software.
    Results A total of 18 studies were included, involving four screening tools. Based on AWGS diagnostic criteria, the sensitivity of SARC-F, SARC-Calf, CC and Ishii score in Chinese elderly was 19%, 58%, 82% and 92%, and the specificity was 93%, 84%, 72% and 71%, respectively. The area under the curve (AUC) was 0.76, 0.77, 0.85 and 0.88, respectively. The sensitivities of SARC-F, SARC-Calf and CC in females were higher than that of males, but the specificities were lower than that of males, and Ishii score was the opposite. The sensitivities of SARC-F and Ishii score in nursing institutions and inpatients were higher, which were 39% and 95%, respectively. SARC-Calf had a higher specificity among community residents (87%). CC had higher sensitivity and specificity among community residents, which were 84% and 76%, respectively.
    Conclusion SARC-F and Ishii score are more suitable for screening sarcopenia in elderly care institutions and hospitalized patients, CC is more suitable for screening sarcopenia in community residents, and SARC-F and SARC-Calf can be used as tools to exclude patients with sarcopenia. The application value of SARC-F, SARC-Calf and CC in females is higher than that in males, and the Ishii score is opposite.

     

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