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首页> 外文期刊>Journal of Cachexia, Sarcopenia and Muscle >When a reference value makes all the difference
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When a reference value makes all the difference

机译：当参考值使一切不同时

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Dear Editor,;I read with great interest the article by Webber and Barr on the age- and gender-dependent values of skeletal muscle mass in healthy children and adolescents [1]. The authors open a field of scientific dispute that is often underrepresented if not totally neglected. The validity of any method of measurement depends not only on the appropriate choice of a certain method according to the question to be studied. In fact, the interpretation of the results depends just as much on the existence of adequate standards and reference values to which our measurements can be compared.;Age and gender are fundamental factors influencing probably all biological measurements and should be taken into account for correct interpretation of clinical data. Webber and Barr provide reference values for normal ranges of skeletal muscle tissue mass in children and adolescents separately for females and males. Moreover, they confirm the high reproducibility of dual X-ray absorptiometry (DXA) to detect differences in muscle tissue mass as low as a few hundred grams. For this rather sophisticated method of assessing body composition, interpretation according to age and gender seems well appreciated. By contrast, it is surprising that the most global measure of body composition, namely body mass index (BMI), is commonly applied to patients and populations irrespective of age.;There is increasing evidence that in older populations the association of body composition with mortality is substantially shifted as compared to middle-aged populations [2–4]. According to the World Health Organisation, the “optimum BMI” ranges from 18.5 to 25?kg/m2. It may be another point of discussion what the “optimum” refers to and whether these margins are still applicable, as the nadir of the mortality curves in recent epidemiological observations is around or even above 25?kg/m2 [4]. The discussion on the accuracy of BMI as a predictor of disease and/or mortality is ongoing [5]. Clearly, the simplicity of the method may be weighed against the limitations of the data obtained. A first step would be to address different age groups for reference values of BMI, just as presented by Webber and Barr for DXA.
机译：亲爱的编辑：我对Webber和Barr在健康儿童和青少年中骨骼肌质量的年龄和性别依赖性值[1]感兴趣。作者开辟了一个科学争端领域，即使没有被完全忽视，它也常常被低估。测量的任何方法的有效性根据待研究的问题不仅取决于一定的方法的合适的选择。实际上，结果的解释同样也取决于是否存在可以与我们的测量结果进行比较的适当标准和参考值。年龄和性别是可能影响所有生物学测量结果的基本因素，应将其考虑在内以进行正确的解释临床数据。 Webber和Barr分别为女性和男性提供儿童和青少年骨骼肌组织质量正常范围的参考值。而且，他们证实了双X射线吸收法（DXA）的高再现性，可检测到数百克的肌肉组织质量差异。对于这种相当复杂的评估身体成分的方法，根据年龄和性别进行的解释似乎受到赞赏。相比之下，令人惊讶的是，最全面的身体成分测量方法，即体重指数（BMI），无论年龄大小，都普遍应用于患者和人群。越来越多的证据表明，在老年人口中，身体成分与死亡率之间的关系相较于中年人口[2–4]发生了很大变化。根据世界卫生组织，“最佳BMI”范围为18.5至25？kg / m2。这可能是另一个讨论点，“最佳”是指什么以及这些裕度是否仍然适用，因为最近流行病学观察的死亡率曲线的最低点约为25？kg / m2甚至更高[4]。关于BMI作为疾病和/或死亡率预测指标的准确性的讨论正在进行中[5]。显然，可以将方法的简便性与获得的数据的限制进行权衡。第一步将是针对不同年龄组的BMI参考值，正如Webber和Barr针对DXA提出的那样。

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