Abstract
We aimed to determine the most appropriate sarcopenia screening method for Asian populations. We retrospectively studied the physiological differences between the sexes in healthy individuals and prospectively compared using skeletal muscle mass versus handgrip strength (HS) to screen for sarcopenia in a community-based population. Skeletal muscle mass was determined using dual-energy X-ray absorptiometry. Of 5881 healthy individuals recruited, 101 were from urban populations and 349 from a community-based population. The sexes were comparable in total lean muscle mass declines after peaking around 20 years of age. An age-dependent decline in total fat mass was found only among men;a persistent increase in total fat mass was observed only among women. The prevalence of low skeletal muscle mass significantly increased with age in both sexes only when applying the weight-adjusted skeletal muscle index (wSMI); it was significant only among men when applying the height-adjusted skeletal muscle index (hSMI). Using HS resulted in a much higher prevalence of sarcopenia in both sexes. A significant age-dependent increase in fat mass in women showed that the most appropriate adjustment method is wSMI for women and hSMI for men. Nevertheless, a primary HS survey is recommended for both sexes in Asian populations.
Highlights
Sarcopenia is an aging process related to losses in muscle mass and function; it is accompanied by reduced physical capabilities, deteriorated quality of life, and even early death
The physiological change in mean (SD) total lean mass (TLM) was similar in women (35.02 [4.58] kg at 20 years of age), a significant difference, compared to men, was noted in total fat mass (TFM)
Instead of showing a constant decline in TFM starting at an early age, women showed a continuous increase in TFM from 20 to 70+ years of age, where the peak, 21.69 (6.19) kg, occurred
Summary
Sarcopenia is an aging process related to losses in muscle mass and function; it is accompanied by reduced physical capabilities, deteriorated quality of life, and even early death Does it increase national medical costs, it is considered one of the most important public health issues in geriatric care [1,2,3]. Normalization of the cut-off value for the ASMI in a young referent is commonly performed using either a weight-adjusted skeletal muscle index (wSMI), described by Janssen et al [9,10], or a height-adjusted skeletal muscle index (hSMI), described by Baumgartner et al [11] These two adjustment methods can provide different results for the prevalence of sarcopenia, even when applied to the same population. The 2019 revised European Working Group on Sarcopenia has changed the primary screening tool to HS from ASMI [14]; whether this rule fits well in Asian populations remains unclear
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