Abstract
BackgroundThis study was conducted to determine the prevalence of a low appendicular skeletal muscle index (ASMI) using three cut-off points (mean ASMI-2SD of a gender-specific young reference group (aged 18–39 years), mean ASMI-1SD of a gender-specific young reference group, and the lower 20 percentile value of a gender-specific older group (aged ≥ 65 years)) in Korean older people and the relationship between ASMI and subjective health-related quality of life.MethodsThis study utilized data acquired during the Korean National Health and Nutrition Examination Survey (KNHANES) from 2008–2011. Dual-energy X-ray absorptiometry body compositional data was obtained from a subsample of 6538 subjects (men 2804, women 3734) aged 18–39 and 4413 subjects (men 1872, women 2541) aged 65 years and older. The three definitions of low appendicular skeletal muscle and the EQ-5D-3 L-Korean descriptive system were applied to Korean older people.ResultsFor the ASMI cutoff points used, in men, the three cutoff points were ASMI 2SD (6.09 kg/m2), ASMI 20 (6.48 kg/m2), and ASMI 1SD (6.95 kg/m2). In women, ASMI 2SD (4.38 kg/m2) was the lowest, followed by ASMI 1SD (4.96 kg/m2) and ASMI 20 (5.33 kg/m2). Proportions of older subjects with a low ASMI using the three cutoff points were 9.7% (ASMI 2SD) and 40.9% (ASMI 1SD) in men, and 0.7% (ASMI 2SD) and 7.4% (ASMI 1SD) in women. By multivariate ordinal logistic regression analysis, men with a low ASMI had significantly high odd ratios for the three domains of mobility (p < 0.001), self-care (p = 0.005), and usual activities (p = 0.004) among the five domains of the EQ-5D and EQ-5D index (p = 0.010).ConclusionsThe ASMI 2SD cut-off points for older Koreans, 6.09 kg/m2 for men and 4.38 kg/m2 for women, resulted in low prevalences of a low ASM, that is, 9.7% for men and 0.7% for women, and showed low clinical usefulness due to very low determined prevalence in women. Hence, we suggest that the cut-off point of the lowest 20% of Korean older people (men: 6.48 kg/m2, women; 5.33 kg/m2) be used for older Koreans.
Highlights
This study was conducted to determine the prevalence of a low appendicular skeletal muscle index (ASMI) using three cut-off points (mean ASMI-2SD of a gender-specific young reference group, mean ASMI-1SD of a gender-specific young reference group, and the lower 20 percentile value of a gender-specific older group) in Korean older people and the relationship between ASMI and subjective health-related quality of life
Subjects This study was based on data obtained from the 2008– 2011 Korean National Health and Nutrition Examination Survey IV and V (KNHANES), a nationally-representative survey conducted by the Korean Ministry of Health and Welfare
Low ASMI groups were defined as subjects whose ASMIs were lower than the following three cutoff points: ASMI 2SD - the value of the lowest 2.28% of the gender-specific young reference group, ASMI 1SD - the value of the lowest 15.87% of the gender-specific young reference group, and ASMI 20 - the value of lowest 20% of the gender-specific old age study group
Summary
Subjects This study was based on data obtained from the 2008– 2011 Korean National Health and Nutrition Examination Survey IV and V (KNHANES), a nationally-representative survey conducted by the Korean Ministry of Health and Welfare. Test results were treated as missing value in participants with implanted radio-opaque material (e.g., a prosthetic device, implant or other radio-opaque object) that could affect DXA results [12] After excluding those without a whole body DXA scan (aged 18–39 years: 123 men and 214 women, aged 65–97 years: 105 men and 143 women), 6538 subjects (aged 18–39 years: 2,804 men, 3,743 women; the young reference group) and 4413 subjects (aged 65–97 years: 1872 men, 2541 women; the main analysis group) were included in the final analysis. Factors associated with ADL or IADL in previous studies, status of obesity using BMI, smoking, AUDIT-K, chronic illness, and numbers of chronic disease, were considered additional independent variables. Statistical analyses Statistical analyses were conducted using the complex sample procedure because the KNHANES data set was selected using a representative, stratified, and clustered
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