Objective To compare the application effect of five screening tools for sarcopenia in maintenance hemodialysis (MHD) patients. Methods A survey was conducted in 340 patients who received MHD treatment in blood purification centre of Qingdao municipal hospital by convenience sampling from October 2020 to April 2021. Strength, assistance with walking, rise from a chair, climb stairs and falls (SARC-F) questionnaire, SARC-F combined with calf circumference (SARC-CalF) questionnaire, SARC-F adding elderly and body mass index information (SARC-F+EBM) questionnaire, mini sarcopenia risk assessment-7 items (MSRA-7) questionnaire, mini sarcopenia risk assessment-5 items (MSRA-5) questionnaire were used for screening. Receiver operating characteristic curve was drawn and the area under the curve (AUC) was calculated using SPSS 22.0 and MedCalc 19.6 software. The optimal cut-off value of five screening tools were determined according to the Yoden index. The performance indicators of five screening tools at the original cut-off value and the optimal cut-off value were calculated respectively. Results Eighty-four (24.71%) MHD patients were diagnosed as sarcopenia. AUC of five screening tools in MHD patients ranged from 0.759 to 0.872. The AUC of SARC-CalF questionnaire was larger than that of SARC-F questionnaire (Z2.506, P0.012), SARC-F+EBM questionnaire (Z3.451, P0.001), MSRA-7 questionnaire (Z2.841, P0.005), MSRA-5 questionnaire (Z2.248, P0.025). Furthermore, its sensitivity (78.57%) and specificity (89.84%) were high with the optimal cut-off value being 11 points. Conclusion SARC-CalF questionnaire has the highest accuracy of all screening tools and has high sensitivity and specificity at the optimal cut-off value, so it is more suitable for being used to screening the risk of sarcopenia in MHD patients than the other four screening tools.
[1] Cruz-Jentoft AJ, Sayer AA. Sarcopenia[J]. Lancet, 2019,393(10191):2636-2646.
[2] Shu X, Lin T, Wang H, et al. Diagnosis, prevalence, and mortality of sarcopenia in dialysis patients: a systematic review and meta-analysis[J]. J Cachexia Sarcopeni, 2022,13(1):145-158.
[3] 李兰, 温贤秀, 夏琪, 等. 维持性血液透析患者肌少症患病率的meta分析[J]. 现代预防医学, 2021,48(22):4214-4218.
[4] Lin Y, Liou H, Wang C, et al. Impact of sarcopenia and its diagnostic criteria on hospitalization and mortality in chronic hemodialysis patients: a 3-year longitudinal study[J]. J Formos Med Assoc, 2020,119(7):1219-1229.
[5] Hayashi H, Izumiya Y, Hayashi O, et al. Dynapenia is an independent predictor of cardio-cerebrovascular events in patients undergoing hemodialysis[J]. Heart Vessels, 2022,37(6):1066-1074.
[6] Ferreira MF, Bohlke M, Pauletto MB, et al. Sarcopenia diagnosis using different criteria as a predictor of early mortality in patients undergoing hemodialysis[J]. Nutrition, 2022,95:111542.
[7] 黎梦丽, 刘闵敬, 周思美, 等. 上臂围和小腿围在社区老年肌少症患者筛查诊断中的应用[J]. 中国康复理论与实践, 2021,27(08):982-992.
[8] Bahat G, Erdogan T, Ilhan B. SARC-F and other screening tests for sarcopenia[J]. Curr Opin Clin Nutr, 2022,25(1):37-42.
[9] 谢长清. 脑卒中急性期并发深静脉血栓形成不同风险评估工具的比较研究[D]. 苏州大学, 2020.
[10] 何莉, 陈林, 张颖君, 等. 亚洲地区维持性血液透析患者肌少症患病率及影响因素的Meta分析[J]. 中国血液净化, 2021,20(07):455-459.
[11] Malmstrom TK, Morley JE. SARC-F: a simple questionnaire to rapidly diagnose sarcopenia[J]. J Am Med Dir Assoc, 2013,14(8):531-532.
[12] 王晓英. 老年肌少症问卷的汉化及运动疗法对肌少症治疗效果的meta分析[D]. 河北医科大学, 2018.
[13] Barbosa-Silva TG, Menezes AM, Bielemann RM, et al. Enhancing SARC-F: improving sarcopenia screening in the clinical practice[J]. J Am Med Dir Assoc, 2016,17(12):1136-1141.
[14] Kurita N, Wakita T, Kamitani T, et al. SARC-F validation and SARC-F+EBM derivation in musculoskeletal disease: the SPSS-OK study[J]. J Nutr Health Aging, 2019,23(8):732-738.
[15] Rossi AP, Micciolo R, Rubele S, et al. Assessing the risk of sarcopenia in the elderly: the Mini Sarcopenia Risk Assessment (MSRA) questionnaire[J]. J Nutr Health Aging, 2017,21(6):743-749.
[16] Yang M, Hu X, Xie L, et al. Validation of the Chinese version of the Mini Sarcopenia Risk Assessment questionnaire in community-dwelling older adults[J]. Medicine, 2018,97(37):e12426.
[17] Chen L, Woo J, Assantachai P, et al. Asian Working Group for sarcopenia: 2019 consensus update on sarcopenia diagnosis and treatment[J]. J Am Med Dir Assoc, 2020,21(3):300-307.
[18] 刘娟, 丁清清, 周白瑜, 等. 中国老年人肌少症诊疗专家共识(2021)[J]. 中华老年医学杂志, 2021,40(08):943-952.
[19] 秦姣, 刘文霞, 苏佳欣, 等. 维持性血液透析患者肌少症及肌少性肥胖的相关因素[J]. 肾脏病与透析肾移植杂志, 2021,30(02):113-118.
[20] Ding Y, Chang L, Zhang H, et al. Predictive value of phase angle in sarcopenia in patients on maintenance hemodialysis[J]. Nutrition, 2022,94:111527.
[21] Ida S, Kojima Y, Hamaoka S, et al. Validity of Japanese version of SARC-F questionnaire in patients with chronic liver disease[J]. J Gastroen Hepatol, 2018,34(5):947-953.
[22] Ishida Y, Maeda K, Nonogaki T, et al. SARC-F as a screening tool for sarcopenia and possible sarcopenia proposed by AWGS 2019 in hospitalized older adults[J]. J Nutr Health Aging, 2020,24(10):1053-1060.
[23] Voelker SN, Michalopoulos N, Maier AB, et al. Reliability and concurrent validity of the SARC-F and its modified versions: a systematic review and meta-analysis[J]. J Am Med Dir Assoc, 2021,22(9):1864-1876.
[24] 陆金玲, 许勤, 陈丽, 等. 5种肌肉减少症筛查工具在胃癌患者术前营养评定中的应用比较[J]. 中华护理杂志, 2021,56(09):1299-1304.
[25] Wu TY, Liaw CK, Chen FC, et al. Sarcopenia screened with SARC-F questionnaire is associated with quality of life and 4-year mortality[J]. J Am Med Dir Assoc, 2016,17(12):1129-1135.
[26] Hanai T, Hiraoka A, Shiraki M, et al. Utility of the SARC-F questionnaire for sarcopenia screening in patients with chronic liver disease: a multicenter cross-sectional study in Japan[J]. J Clin Med, 2021,10(15):3448.
[27] 葛凤, 刘民辉, 鲁永锦, 等. FRAIL-NH量表和Tilburg衰弱量表对养老机构老年人衰弱评估比较[J]. 中国护理管理, 2019,19(04):513-517.
[28] Fu X, Tian Z, Thapa S, et al. Comparing SARC-F with SARC-CalF for screening sarcopenia in advanced cancer patients[J]. Clin Nutr, 2020,39(11):3337-3345.
[29] Mo Y, Zhong J, Dong X, et al. Comparison of three screening methods for sarcopenia in community-dwelling older persons[J]. J Am Med Dir Assoc, 2021,22(4):746-750.
[30] Nishioka S, Yamanouchi A, Matsushita T, et al. Validity of calf circumference for estimating skeletal muscle mass for Asian patients after stroke[J]. Nutrition, 2021,82:111028.
[31] Duarte PM, Ribeiro HS, Almeida LS, et al. SARC-F and SARC-CalF are associated with sarcopenia traits in hemodialysis patients[J]. Nutr Clin Pract, 2022.
[32] Lim WS, Chew J, Lim JP, et al. Letter to the editor: case for validated instead of standard cut-offs for SARC-CalF[J]. J Nutr Health Aging, 2019,23(4):393-395.
[33] 杜晓菊, 张海林, 尹丽霞, 等. 小腿围在评估维持性血液透析患者骨骼肌质量下降中的效果研究[J]. 中华护理杂志, 2021,56(08):1187-1193.
[34] 薛晓燕, 秦泰然, 武琪, 等. 三种肌少症评估工具筛查社区老年人肌少症效果比较[J]. 护理学杂志, 2021,36(20):10-14.
