Clinical and research interest in sarcopenia has burgeoned internationally, Asia included. The Asian Working Group for Sarcopenia (AWGS) 2014 consensus defined sarcopenia as "age-related loss of muscle mass, plus low muscle strength, and/or low physical performance" and specified cutoffs for each diagnostic component; research in Asia consequently flourished, prompting this update. AWGS 2019 retains the previous definition of sarcopenia but revises the diagnostic algorithm, protocols, and some criteria: low muscle strength is defined as handgrip strength <28 kg for men and <18 kg for women; criteria for low physical performance are 6-m walk <1.0 m/s, Short Physical Performance Battery score ≤9, or 5-time chair stand test ≥12 seconds. AWGS 2019 retains the original cutoffs for height-adjusted muscle mass: dual-energy X-ray absorptiometry, <7.0 kg/m2 in men and <5.4 kg/m2 in women; and bioimpedance, <7.0 kg/m2 in men and <5.7 kg/m2 in women. In addition, the AWGS 2019 update proposes separate algorithms for community vs hospital settings, which both begin by screening either calf circumference (<34 cm in men, <33 cm in women), SARC-F (≥4), or SARC-CalF (≥11), to facilitate earlier identification of people at risk for sarcopenia. Although skeletal muscle strength and mass are both still considered fundamental to a definitive clinical diagnosis, AWGS 2019 also introduces "possible sarcopenia," defined by either low muscle strength or low physical performance only, specifically for use in primary health care or community-based health promotion, to enable earlier lifestyle interventions. Although defining sarcopenia by body mass index-adjusted muscle mass instead of height-adjusted muscle mass may predict adverse outcomes better, more evidence is needed before changing current recommendations. Lifestyle interventions, especially exercise and nutritional supplementation, prevail as mainstays of treatment. Further research is needed to investigate potential long-term benefits of lifestyle interventions, nutritional supplements, or pharmacotherapy for sarcopenia in Asians.

中文翻译：

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亚洲肌肉减少症工作组：2019 年肌肉减少症诊断和治疗共识更新


国际上（包括亚洲）对肌少症的临床和研究兴趣日益浓厚。亚洲肌肉减少症工作组 (AWGS) 2014 年共识将肌肉减少症定义为“与年龄相关的肌肉质量损失，加上肌肉力量低下和/或身体机能低下”，并为每个诊断部分指定了界限；亚洲的研究因此蓬勃发展，促进了这一更新。 AWGS 2019保留了之前对肌少症的定义，但修改了诊断算法、方案和一些标准：低肌力定义为男性握力<28 kg，女性握力<18 kg；低身体表现的标准是 6 米步行 <1.0 m/s、短期身体表现电池得分 ≤9，或 5 次椅子站立测试 ≥12 秒。 AWGS 2019 保留了身高调整肌肉质量的原始截止值：双能 X 射线吸收测定法，男性 <7.0 kg/m2，女性 <5.4 kg/m2；生物阻抗，男性为<7.0 kg/m2，女性为<5.7 kg/m2。此外，AWGS 2019 更新提出了针对社区与医院环境的单独算法，这两种算法都首先筛查小腿围（男性 <34 厘米，女性 <33 厘米）、SARC-F (≥4) 或 SARC-CalF (≥11)，以利于及早识别有肌肉减少症风险的人。尽管骨骼肌力量和质量仍然被认为是明确临床诊断的基础，但 AWGS 2019 还引入了“可能的肌肉减少症”，仅由肌肉力量低下或身体机能低下定义，专门用于初级卫生保健或社区健康促进，以实现早期生活方式干预。 尽管通过体重指数调整的肌肉量而不是身高调整的肌肉量来定义肌肉减少症可能会更好地预测不良后果，但在改变当前的建议之前还需要更多的证据。生活方式干预，特别是运动和营养补充，是治疗的支柱。需要进一步研究来调查生活方式干预、营养补充剂或药物治疗对亚洲人肌肉减少症的潜在长期益处。