摘要
目的 系统梳理并比较筛选适宜的社区老年人群肌少症筛查工具.方法 在PubMed、Web of Science、中国知网、万方和维普数据库检索已发表的关于肌少症筛查工具准确性的文献,检索时间从各数据库建立至2022年12月,由2名研究者独立进行文献筛选和资料提取,并对纳人文献的偏倚风险进行评估.应用Stata 16.0和R 4.4.2软件进行Meta分析及网状Meta分析.结果 共纳入22篇文献,样本量共10 969例,涉及8种筛查工具,分别是简易五项评分问卷(SARC-F)、小腿围(CC)、简易五项评分问卷联合小腿围(SARC-CALF)、迷你肌少症风险评估问卷(MSRA-7、MSRA-5)、简易五项评分问卷联合年龄和BMI(SARC-F+EBM)、Ishii评分和指环测试.Meta分析结果显示,SARC-CALF、CC、SARC-F、MSRA-5和MSRA-7拟合受试者工作特征(SROC)曲线下面积(AUC)从高到低依次为 0.86(95％CI:0.82～0.88)、0.85(95％CI:0.81～0.89)、0.80(95％CI:0.76～0.83)、0.77(95％CI:0.73～0.81)和 0.67(95％CI:0.63～0.71),其中 SARC-CALF、CC 和 SARC-F 三者准确性相对较好,SARC-CALF准确性最优.网状Meta分析结果显示在AWGS 1、EWGSOP 1、EWGSOP 2、IWGS和SCWD 5种肌少症诊断标准下,SARC-CALF诊断比值比(DOR)、优势指数(SI)均高于SARC-F,在AWGS 1诊断标准下,SARC-CALF的DOR和SI均高于CC和SARC-F.结论 推荐可探索尝试将SARC-CALF作为社区老年人的肌少症筛查工具,并结合干预与风险预测评估其应用的综合效果.
Abstract
Objective To systematically assess the available screening tools and to identify the most appropriate tool for screening sarcopenia in the community-dwelling elderly.Methods PubMed,Web of Science,CNKI,Wanfang Data,and VIP databases were searched to collect studies on the diagnostic accuracy of sarcopenia screening tools from database establishment to December 2022.Literature screening,data extraction,and risk bias evaluation were conducted by two researchers independently.Meta-analysis and network meta-analysis were performed using Stata 16.0 and R 4.4.2 software.Results A total of 22 studies comprising 10 969 participants were included.Eight screening tools were identified,including SARC-F(strength,assistance walking,rise from a chair,climb stairs and falls),CC(calf circumference),SARC-CALF(a combination of SARC-F with calf circumference),Mini Sarcopenia Risk Assessment questionnaire(MSRA-7,MSRA-5),SARC-F+EBM(SARC-F combined with age and BMI),Ishii test,and the finger ring test.The meta-analysis revealed that the area under the summary receiver operating characteristic curve(AUC)was 0.86 in SARC-CALF(95％CI:0.82,0.88),0.85 in CC(95％CI:0.81,0.89),0.80 in SARC-F(95％CI:0.76,0.83),0.77 in MSRA-5(95％CI:0.73,0.81),and 0.67 in MSRA-7(95％CI:0.63,0.71),respectively.SARC-CALF,CC,and SARC-F showed relatively high accuracy,with SARC-CALF boasting the highest accuracy.The network meta-analysis revealed that SARC-CALF yielded higher diagnostic odds ratios(DOR)and superiority indices(SI)compared with SARC-F using the golden diagnostic criteria of AWGS 1,EWGSOP 1,EWGSOP 2,IWGS,and SCWD.Specifically,under the AWGS 1 criteria,both DOR and SI of SARC-CALF were found to surpass those of SARC-F and CC.Conclusion SARC-CALF should be advocated as the preferred screening tool for sarcopenia screening in the community-dwelling elderly.Further researches combined with risk prediction and interventions is needed to validate the comprehensive effectiveness of SARC-CALF.
维普
万方数据