中国骨质疏松杂志

OSTA指数和小腿围筛查老年肌少症价值分析

Screening value of OSTA index and calf circumference for sarcopenia in elderly individuals

DOI：10.3969/j.issn.1006-7108.2026.02.002

英文关键词:OSTA index calf circumference sarcopenia

基金项目:江苏省卫生健康发展研究中心重点课题（JSHD2022011）

作者	单位
刘晔欧阳晓俊* 奚玲陈吉海陆冰	南京医科大学附属老年医院（江苏省老年病医院）老年医学科,江苏南京 210024

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中文摘要:

目的探讨亚洲人骨质疏松自我筛查工具（osteoporosis self-assessment tool for Asians，OSTA）和小腿围对老年肌少症的筛查价值。方法采用横断面研究，纳入2021年1月至2023年12月在南京医科大学附属老年医院（江苏省老年病医院）老年医学科长期随访管理的60～99岁患者950例，收集其一般临床资料，计算OSTA指数，评估肌少症。采用独立样本的非参数检验、受试者工作特征曲线、总符合率和Kappa值进行统计分析。结果（1）本研究对象肌少症患病率：男性为35.50 %，女性为33.86 %。80～99岁组肌少症比例显著高于60～79岁组（P＜0.001），且OSTA指数、小腿围、四肢骨骼肌指数、握力、步速均更低（P＜0.001）；（2）OSTA高风险组肌少症患病率：男性为81.18 %，女性为53.95 %。小腿围低于界值组患病率：男性为64.20 %，女性为55.77 %；（3）60～79岁组OSTA指数的AUC高于小腿围（男性：0.929 vs 0.885；女性：0.863 vs 0.856），在80～99岁组中优势更明显（男性：0.906 vs 0.816；女性：0.839 vs 0.816）。小腿围最佳筛查阈值：男性为33.5 cm，女性为32.5 cm。80～99岁组中小腿围的AUC低于60～79岁组（男性：0.816 vs 0.885；女性：0.816 vs 0.856）；（4）各组OSTA指数的肌少症筛查总符合率（77.78 %～85.88 %）及Kappa值（0.460～0.648）均高于小腿围（72.22 %～84.18 %，Kappa=0.378～0.597）。（5）两者联合筛查时，串联法符合率提升至82.05 %～91.53 %（Kappa= 0.524～0.734），并联法敏感度达0.952～0.982。结论 OSTA指数对高龄老年肌少症筛查效能优于小腿围，两者联合使用可进一步提升符合率。

英文摘要:

Objective To investigate the screening value of the Osteoporosis Self-Assessment Tool for Asians (OSTA) and calf circumference (CC) for sarcopenia in elderly individuals. Methods A cross-sectional study was conducted, enrolling 950 patients aged from 60 to 99 years old under long-term follow-up at the Geriatrics Department of our hospital from January 2021 to December 2023. General clinical data were collected, the OSTA index was calculated, and sarcopenia was assessed. Statistical analyses included independent non-parametric tests, receiver operating characteristic (ROC) curves, overall agreement rates, and Kappa values. Results (1) The prevalence of sarcopenia in this study was 35.50 % in males and 33.86 % in females. The 80-99 age group had a significantly higher sarcopenia rate than the 60-79 age group (P<0.001), with lower OSTA index, CC, appendicular skeletal muscle mass index (ASMI), grip strength, and gait speed (P<0.001). (2) In the OSTA high-risk group, sarcopenia prevalence was 81.18 % in males and 53.95 % in females, respectively. In the low CC group, it was 64.20 % in males and 55.77 % in females, respectively. (3) In the 60-79 age group, the area under the curve (AUC) of OSTA was higher than that of CC (males: 0.929 vs 0.885; females: 0.863 vs 0.856), with a more pronounced advantage in the 80-99 age group (males: 0.906 vs 0.816; females: 0.839 vs 0.816). The optimal CC cutoff values were 33.5 cm for males and 32.5 cm for females, respectively. The AUC of CC in the 80-99 age group was lower than in the 60-79 group (males: 0.816 vs 0.885; females: 0.816 vs 0.856). (4) OSTA index showed higher overall agreement (77.78 %-85.88 %) and Kappa values (0.460-0.648) than CC (72.22 %-84.18 %, Kappa 0.378-0.597). (5) When combined, serial testing improved agreement to 82.05 %-91.53 % (Kappa 0.524-0.734), while parallel testing achieved a sensitivity of 0.952-0.982. Conclusion The OSTA index demonstrates superior screening efficacy for sarcopenia in the elderly compared to CC. Their combined use further enhances diagnostic accuracy.

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