中老年人骨骼肌減少症盛行率與相關危險因子之流行病學調查

Epidemiological Survey of the Prevalence and Associated Risk Factors of Sarcopenia in Middle-Aged and Old People

郭卜瑄(Pu-Hsian Guo) ； 孫子傑(Zai-Jie Sun) ； 歐玲君(Ling-Jun Ou) ； 張尹凡(Yin-Fan Chang) ； 張秦松(Chin-Song Chang) ； 張家銘(Chia-Ming Chang) ； 官大紳(Da-Shen Guan) ； 林瑞模(Ruey-Mo Lin) ； 吳至行(Chih-Hsing Wu)

《台灣老年醫學暨老年學雜誌》 8卷1期 (2013/02) Pp. 28-46

https://doi.org/10.29461/TGG.201302_8(1).0003

摘要

目的：了解中台灣地區40歲以上中老年人骨骼肌減少症之盛行率以及探討可能之相關危險因子。方法：針對雲林縣斗六市與古坑鄉分層隨機抽樣1,200位四十歲以上中老年人進行橫斷式調查。以自填或經由訪員詢問完成問卷，內容包涵基本資料、吸菸、飲酒、茹素習慣及健康相關資料（如骨折史、慢性疾病等）等；每位受檢者皆測量身體質量指數並使用生物電阻抗分析儀測量體脂率及骨骼肌量。以骨骼肌量低於年輕參考族群肌肉量的兩個標準差，為骨骼肌減少症判定標準。結果：本研究共取得1,191位（男性520位、女性671位）受測者之完整資料，平均年齡59.5±11.4歲。骨骼肌減少症盛行率於全體、男性、女性分別為3.0%、4.6%、1.8%；若以65歲以上老年人來看，骨骼肌減少症之盛行率於全體、男性、女性分別為5.3%、8.6%、1.5%。以單變項分析發現年齡與骨骼肌減少症呈正相關，男性、身體質量指數與骨骼肌減少症呈現負相關。經邏輯斯複迴歸分析全體個案發現性別（OR: 0.109, 95%CI: 0.033-0.353）、年齡（OR: 1.068, 95%CI:1.027-1.111）、身體質量指數（OR: 0.355, 95%CI: 0.268-0.472）和體脂率（OR:1.156, 95%CI: 1.087-1.230）為骨骼肌減少症的獨立危險因子。結論：社區40歲以上中老年人之骨骼肌減少症盛行率於不同性別與年齡層約介於1.8%－8.6%之間。老年男性、年齡越高、較低的身體質量指數和較高體脂率易出現骨骼肌減少症。建議針對高危險個案早期篩檢，適時介入，以預防骨骼肌減少症與後續衍伸的健康問題。

關鍵字

骨骼肌量 ； 體脂率 ； 老化 ； 身體質量指數 ； 身體活動量

並列摘要

Objectives: This cross-sectional study was designed to evaluate the prevalence and associated risk factors of pre-sarcopenia and sarcopenia in community-dwelling subjects aged 40 years old and over in central Taiwan.Method: Stratified random sampling was performed on 1,200 subjects aged 40 and over were stratified random sampled from Douliou/Gukeng, Yunlin County in 2010. Subjects were asked to complete, either by themselves or with the assistance of trained interviewers, a structured questionnaires that included basic personal data, special habits (smoking, drinking, vegetarian) and health related information (fracture history, chronic disease, etc). Body mass index (BMI) and body composition (percent body fat and skeletal muscle mass) were measured using bioimpedance analysis. Sarcopenia was defined statistically as a reduction in muscle mass of two standard deviations or more below the normal means for young people.Results: A total of 1,191 subjects (M/F=520/671, mean age=59.5±11.4 year-old) with completed data were collated for final analysis. The prevalences of sarcopenia in total, males and females were respectively 3.0%, 4.6% and 1.8%. For subjects aged 65 and over, the prevalences of sarcopenia in total, males and females read respectively 5.3%, 8.6% and 1.5%. Results of univariate analysis found age, gender, and BMI significantly correlated with sarcopenia. Multiple logistic regression analysis identified sex (OR: 0.109, 95%CI: 0.033-0.353), age (OR: 1.068, 95%CI: 1.027-1.111), BMI (OR: 0.355, 95%CI: 0.268-0.472) and percent body fat (OR: 1.156, 95%CI: 1.087-1.230) as independent risk factors for sarcopenia.Conclusions: The prevalence of sarcopenia ranges from 1.8% to 8.6% across different gender and age in the 1191 subjects. Those who are older, male and with a lower BMI and a higher percent body fat are at higher risk of developing sarcopenia. Provision of early screening and timely intervention for the high risk groups is recommended to prevent sarcopenia and subsequent health hazards.

並列關鍵字

skeletal muscle mass ； percent body fat ； aging ； BMI ； physical activity