Abstract：
OBJECTIVE: To investigate the accuracy of the SARC-F questionnaire to identify sarcopenia in patients with Parkinson\'s disease (PD).
METHODS: We prospectively recruited patients with PD who had a score of 3 or lower on the Hoehn and Yahr (H&Y) scale. Appendicular skeletal muscle mass (ASM), hand grip strength, and the SARC-F were used to assess sarcopenia. The cutoffs for the ASM index and hand grip strength to diagnose sarcopenia were based on the Asian Working Group for Sarcopenia 2019 consensus. A score ≥4 on the SARC-F was considered at risk for sarcopenia.
RESULTS: A total of 365 patients with PD were included (mean age, 71.1 years; men, 53.2 %), and 73 (20.0 %) were diagnosed with sarcopenia. The area under the receiver operating characteristic curve of the SARC-F was 0.702 (95 % confidence interval, 0.634-0.770). Using the recommended cutoff score of ≥4, the SARC-F showed a sensitivity of 38.4 %, specificity of 85.6 %, positive predictive value (PPV) of 40.0 %, and negative predictive value (NPV) of 84.7 %. The Youden\'s index was the highest at a cutoff score of ≥2, in which the SARC-F showed a sensitivity of 67.1 %, specificity of 65.4 %, PPV of 32.7 %, and NPV of 88.8 %. These predictive values were similar to those obtained using a cutoff score of ≥2.5 or 3 on the H&Y scale.
CONCLUSIONS: The application of the SARC-F to the mild-to moderate PD population is not appropriate as a first-step screening tool to diagnose sarcopenia. Given the comparable predictive values of the SARC-F and H&Y scale, this questionnaire may be considered only for ruling out sarcopenia in patients with similar disease severity.
METHODS: We prospectively recruited patients with PD who had a score of 3 or lower on the Hoehn and Yahr (H&Y) scale. Appendicular skeletal muscle mass (ASM), hand grip strength, and the SARC-F were used to assess sarcopenia. The cutoffs for the ASM index and hand grip strength to diagnose sarcopenia were based on the Asian Working Group for Sarcopenia 2019 consensus. A score ≥4 on the SARC-F was considered at risk for sarcopenia.
RESULTS: A total of 365 patients with PD were included (mean age, 71.1 years; men, 53.2 %), and 73 (20.0 %) were diagnosed with sarcopenia. The area under the receiver operating characteristic curve of the SARC-F was 0.702 (95 % confidence interval, 0.634-0.770). Using the recommended cutoff score of ≥4, the SARC-F showed a sensitivity of 38.4 %, specificity of 85.6 %, positive predictive value (PPV) of 40.0 %, and negative predictive value (NPV) of 84.7 %. The Youden\'s index was the highest at a cutoff score of ≥2, in which the SARC-F showed a sensitivity of 67.1 %, specificity of 65.4 %, PPV of 32.7 %, and NPV of 88.8 %. These predictive values were similar to those obtained using a cutoff score of ≥2.5 or 3 on the H&Y scale.
CONCLUSIONS: The application of the SARC-F to the mild-to moderate PD population is not appropriate as a first-step screening tool to diagnose sarcopenia. Given the comparable predictive values of the SARC-F and H&Y scale, this questionnaire may be considered only for ruling out sarcopenia in patients with similar disease severity.
摘要：
目的：探讨SARC-F问卷对帕金森病（PD）患者肌肉减少症的诊断准确性。
方法：我们前瞻性招募了在Hoehn和Yahr（H&Y）量表上评分为3分或更低的PD患者。阑尾骨骼肌质量（ASM），手握力,和SARC-F用于评估肌肉减少症。诊断肌肉减少症的ASM指数和手握力的截止值基于亚洲肌肉减少症工作组2019共识。SARC-F评分≥4被认为有患肌少症的风险。
结果：共纳入365例PD患者（平均年龄，71.1岁；男性，53.2%），73例(20.0%)被诊断为肌肉减少症。SARC-F的接收器工作特征曲线下面积为0.702（95％置信区间，0.634-0.770）。使用推荐的分界点≥4，SARC-F显示出38.4%的灵敏度，特异性为85.6%，阳性预测值（PPV）为40.0%，阴性预测值（NPV）为84.7%。Youden指数在截止分数≥2时最高，其中SARC-F显示出67.1％的敏感性，特异性为65.4%，PPV为32.7%，净现值为88.8%。这些预测值与在H&Y量表上使用≥2.5或3的截止分数获得的预测值相似。
结论：将SARC-F应用于轻度至中度PD人群并不适合作为诊断肌肉减少症的第一步筛查工具。鉴于SARC-F和H&Y量表的可比较预测值，本问卷仅可用于排除严重程度相似的肌少症患者.
方法：我们前瞻性招募了在Hoehn和Yahr（H&Y）量表上评分为3分或更低的PD患者。阑尾骨骼肌质量（ASM），手握力,和SARC-F用于评估肌肉减少症。诊断肌肉减少症的ASM指数和手握力的截止值基于亚洲肌肉减少症工作组2019共识。SARC-F评分≥4被认为有患肌少症的风险。
结果：共纳入365例PD患者（平均年龄，71.1岁；男性，53.2%），73例(20.0%)被诊断为肌肉减少症。SARC-F的接收器工作特征曲线下面积为0.702（95％置信区间，0.634-0.770）。使用推荐的分界点≥4，SARC-F显示出38.4%的灵敏度，特异性为85.6%，阳性预测值（PPV）为40.0%，阴性预测值（NPV）为84.7%。Youden指数在截止分数≥2时最高，其中SARC-F显示出67.1％的敏感性，特异性为65.4%，PPV为32.7%，净现值为88.8%。这些预测值与在H&Y量表上使用≥2.5或3的截止分数获得的预测值相似。
结论：将SARC-F应用于轻度至中度PD人群并不适合作为诊断肌肉减少症的第一步筛查工具。鉴于SARC-F和H&Y量表的可比较预测值，本问卷仅可用于排除严重程度相似的肌少症患者.
