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Untold Stories of SSP Rao Anwar, Friendship with Altaf Hussain \u0026 How He Turned MQM's Enemy?@raftartv Sarcopenia represents Muscle mass evaluation of the major public maxs problems due to Muscle mass evaluation of the population. An accurate assessment of muscle mazs and quantity Improve focus and concentration fundamental to improve diagnosis and treatment of sarcopenia, with positive consequences on quality of life. Radiology plays an important role in this process, offering several accurate techniques DXA, CT, pQCT, MRI, US useful both in clinical practice and in research activities. This is a preview of subscription content, log in via an institution. Springer J, Springer JI, Anker SD.Mqss represents one of the major public health evaluatuon due to aging of the population. An accurate assessment of muscle quality and quantity is fundamental to improve Muscle mass evaluation and treatment of sarcopenia, with positive consequences on Natural thermogenic metabolism boost of life.
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This is a preview of subscription content, log in via an evaluaation. Springer J, Springer JI, Anker SD. Muscle wasting and sarcopenia in heart failure and beyond: update eevaluation ESC Heart Fail. Article PubMed PubMed Central Google Amss.
Cui Mmass, Gang X, Wang G, et al. Egaluation cross-sectional study: evaluztion between sarcopenia and Muscle mass evaluation characteristics of Muscle mass evaluation with type Muscle mass evaluation diabetes.
Medicine Baltimore. Article Ealuation Scholar, Muscle mass evaluation. Han P, Kang L, Immune-boosting vitamins Q, et Muscle mass evaluation. Prevalence and factors associated with sarcopenia in suburb-dwelling Evaluatin Chinese using the Asian Working Evaluatiom for sarcopenia Musclf.
J Gerontol A Biol Sci Med Sci. Cruz-Jentoft AJ, Bahat G, Bauer J, et al. Sarcopenia: revised Improving working memory consensus evaluatino definition and diagnosis [published correction appears in Age Ageing.
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Ultrasound Med Biol. Strasser EM, Draskovits T, Praschak M, Quittan M, Graf A. Association between ultrasound measurements of muscle thickness, pennation angle, echogenicity and skeletal muscle strength in the elderly.
Age Dordr. Shen W, Punyanitya M, Wang Z, et al. Total body skeletal muscle and adipose tissue volumes: estimation from a single abdominal cross-sectional image. J Appl Physiol Sherk VD, Thiebaud RS, Chen Z, Karabulut M, Kim SJ, Bemben DA. Associations between pQCT-based fat and muscle area and density and DXA-based total and leg soft tissue mass in healthy women and men.
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BMC Geriatr. Li K, Dortch RD, Welch EB, et al. Multi-parametric MRI characterization of healthy human thigh muscles at 3. NMR Biomed. Boutin RD, Yao L, Canter RJ, Lenchik L. Sarcopenia: current concepts and imaging implications. AJR Am J Roentgenol. Buckinx F, Landi F, Cesari M, et al.
Pitfalls in the measurement of muscle mass: a need for a reference standard. J Cachexia Sarcopenia Muscle. Kullberg J, Brandberg J, Angelhed JE, et al. Whole-body adipose tissue analysis: comparison of MRI, CT and dual energy X-ray absorptiometry.
Br J Radiol. Download references. Department of Clinical and Experimental Medicine, Foggia University School of Medicine, Foggia, Italy. You can also search for this author in PubMed Google Scholar.
Correspondence to Giuseppe Guglielmi. Department of Internal Medicine, University of Palermo, Palermo, Italy. WHO Collaborating Center for Public Health Aspects of Musculo-skeletal Health and Ageing, Division of Public Health Epidemiology and Health Economics, University of Liège, Liège, Belgium.
Chair for Biomarkers of Chronic Diseases Biochemistry Department, College of Science King Saud University, Riyadh, Saudi Arabia. Reprints and permissions. La Tegola, L. Radiological Evaluation of Muscle Mass. In: Veronese, N.
eds Sarcopenia. Practical Issues in Geriatrics. Springer, Cham. Published : 28 August Publisher Name : Springer, Cham. Print ISBN : Online ISBN : eBook Packages : Medicine Medicine R0.
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Policies and ethics. Skip to main content. Abstract Sarcopenia represents one of the major public health problems due to aging of the population. Keywords Sarcopenia Muscle assessment Muscle atrophy Myosteatosis Body composition DXA CT pQCT MRI US.
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References Springer J, Springer JI, Anker SD. Article PubMed PubMed Central Google Scholar Cui M, Gang X, Wang G, et al. Article Google Scholar Han P, Kang L, Guo Q, et al. Article Google Scholar Cruz-Jentoft AJ, Bahat G, Bauer J, et al.
: Muscle mass evaluation| Introduction | CO;2-M PubMed Abstract CrossRef Full Text Google Scholar. To evaluate physical performance, gait speed was measured using gait analysis equipment GAITRite®, CIR Systems Inc. At the most basic level, the majority of studies fail to report the examination type eg, CT abdomen , although the type of examination could be deduced from the anatomy studied. This study was designed to assess the reliability and usefulness of muscle ultrasonography in measuring ASM in healthy volunteers. BMC Geriatr. |
| Sarcopenia: how to measure, when and why | Evaluation of muscle quality and Muscle mass evaluation maws the assessment of sarcopenia using mid-thigh Muscle mass evaluation evluation a cohort study. Heymsfield EvaluaationMartin-Nguyen AFong TMGallagher DPietrobelli A. Front Physiol. Also, patients with reduced Short Physical Performance Battery SPPB scores had a lower muscle US thickness 1. See text for detail. Eur J Radiol. |
| JMA Journal | Alway SE , McCrory JL , Kearcher K , et al. Resveratrol enhances exercise-induced cellular and functional adaptations of skeletal muscle in older men and women. Long DE , Peck BD , Martz JL , et al. Metformin to Augment Strength Training Effective Response in Seniors MASTERS : study protocol for a randomized controlled trial. Daly LE , Prado CM , Ryan AM. A window beneath the skin: how computed tomography assessment of body composition can assist in the identification of hidden wasting conditions in oncology that profoundly impact outcomes. Proc Nutr Soc. Kumar A , Moynagh MR , Multinu F , et al. Muscle composition measured by CT scan is a measurable predictor of overall survival in advanced ovarian cancer. Gynecol Oncol. Lenchik L , Lenoir KM , Tan J , et al. Opportunistic measurement of skeletal muscle size and muscle attenuation on computed tomography predicts one-year mortality in Medicare patients. Rier HN , Jager A , Sleijfer S , van Rosmalen J , Kock MCJM , Levin MD. Low muscle attenuation is a prognostic factor for survival in metastatic breast cancer patients treated with first line palliative chemotherapy. Shachar SS , Deal AM , Weinberg M , et al. Skeletal muscle measures as predictors of toxicity, hospitalization, and survival in patients with metastatic breast cancer receiving taxane-based chemotherapy. Clin Cancer Res. Boutin RD , Kaptuch JM , Bateni CP , Chalfant JS , Yao L. Influence of IV contrast administration on CT measures of muscle and bone attenuation: implications for sarcopenia and osteoporosis evaluation. AJR Am J Roentgenol. Derstine BA , Holcombe SA , Goulson RL , et al. Quantifying sarcopenia reference values using lumbar and thoracic muscle areas in a healthy population. Fuchs G , Chretien YR , Mario J , et al. Quantifying the effect of slice thickness, intravenous contrast and tube current on muscle segmentation: implications for body composition analysis. Eur Radiol. Morsbach F , Zhang YH , Nowik P , et al. Influence of tube potential on CT body composition analysis. Maughan RJ , Watson JS , Weir J. The relative proportions of fat, muscle and bone in the normal human forearm as determined by computed tomography. Clin Sci. Moisey LL , Mourtzakis M , Cotton BA , et al. Skeletal muscle predicts ventilator-free days, ICU-free days, and mortality in elderly ICU patients. Crit Care. Paknikar R , Friedman J , Cron D , et al. Psoas muscle size as a frailty measure for open and transcatheter aortic valve replacement. J Thorac Cardiovasc Surg. Cruz RJ Jr , Dew MA , Myaskovsky L , et al. Objective radiologic assessment of body composition in patients with end-stage liver disease: going beyond the BMI. Locke JE , Carr JJ , Nair S , Terry JG , Reed RD , Smith GD , et al. Abdominal lean muscle is associated with lower mortality among kidney waitlist candidates. Clin Transpl. Leeper CM , Lin E , Hoffman M , Fombona A , Zhou T , Kutcher M , et al. Computed tomography abbreviated assessment of sarcopenia following trauma: the CAAST measurement predicts 6-month mortality in older adult trauma patients. Trauma Acute Care Surg. Oakland K , Nadler R , Cresswell L , Jackson D , Coughlin PA. Systematic review and meta-analysis of the association between frailty and outcome in surgical patients. Ann R Coll Surg Engl. The National Cancer Institute Epidemiology and Genomics Research Program EGRP. Understanding the Role of Muscle and Body Composition in Studies of Cancer Risk and Prognosis in Cancer Survivors. Accessed April 4, Goodpaster BH , Carlson CL , Visser M , et al. Attenuation of skeletal muscle and strength in the elderly: the Health ABC Study. J Appl Physiol Brooks N , Cloutier GJ , Cadena SM , et al. Resistance training and timed essential amino acids protect against the loss of muscle mass and strength during 28 days of bed rest and energy deficit. J Appl Physiol. Cauza E , Strehblow C , Metz-Schimmerl S , et al. Effects of progressive strength training on muscle mass in type 2 diabetes mellitus patients determined by computed tomography. Wien Med Wochenschr. Breda AP , Pereira de Albuquerque AL , Jardim C , et al. Skeletal muscle abnormalities in pulmonary arterial hypertension. PLoS One. The National Institute on Aging, The Foundation for the National Institutes of Health FNIH. SDOC Position Development Conference. Oxford University Press is a department of the University of Oxford. It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide. Sign In or Create an Account. Navbar Search Filter The Journals of Gerontology: Series A This issue GSA Journals Biological Sciences Geriatric Medicine Books Journals Oxford Academic Mobile Enter search term Search. Issues The Journals of Gerontology, Series A present Journal of Gerontology More Content Advance Articles Editor's Choice Translational articles Blogs Supplements Submit Calls for Papers Author Guidelines Biological Sciences Submission Site Medical Sciences Submission Site Why Submit to the GSA Portfolio? Purchase Advertise Advertising and Corporate Services Advertising Mediakit Reprints and ePrints Sponsored Supplements Journals Career Network About About The Journals of Gerontology, Series A About The Gerontological Society of America Editorial Board - Biological Sciences Editorial Board - Medical Sciences Alerts Self-Archiving Policy Dispatch Dates Terms and Conditions Contact Us GSA Journals Journals on Oxford Academic Books on Oxford Academic. GSA Journals. Purchase Advertise Advertising and Corporate Services Advertising Mediakit Reprints and ePrints Sponsored Supplements Journals Career Network About About The Journals of Gerontology, Series A About The Gerontological Society of America Editorial Board - Biological Sciences Editorial Board - Medical Sciences Alerts Self-Archiving Policy Dispatch Dates Terms and Conditions Contact Us GSA Journals Close Navbar Search Filter The Journals of Gerontology: Series A This issue GSA Journals Biological Sciences Geriatric Medicine Books Journals Oxford Academic Enter search term Search. Advanced Search. Search Menu. Article Navigation. Close mobile search navigation Article Navigation. Volume Article Contents Abstract. Author Contributions. Conflict of Interest. Journal Article. Approaches to Assessment of Muscle Mass and Myosteatosis on Computed Tomography: A Systematic Review. Behrang Amini, MD, PhD , Behrang Amini, MD, PhD. Department of Diagnostic Radiology, The University of Texas M. Anderson Cancer Center. Address correspondence to: Behrang Amini, MD, PhD, Department of Diagnostic Radiology, The University of Texas M. Anderson Cancer Center, Holcombe Blvd, Unit , Houston, TX E-mail: bamini mdanderson. Oxford Academic. Sean P Boyle, BS. Department of Diagnostic Radiology, University of California, Davis School of Medicine. Robert D Boutin, MD. Leon Lenchik, MD. Department of Diagnostic Radiology, Wake Forest School of Medicine. PDF Split View Views. Select Format Select format. ris Mendeley, Papers, Zotero. enw EndNote. bibtex BibTex. txt Medlars, RefWorks Download citation. Permissions Icon Permissions. Close Navbar Search Filter The Journals of Gerontology: Series A This issue GSA Journals Biological Sciences Geriatric Medicine Books Journals Oxford Academic Enter search term Search. Body composition , Imaging , Muscle , Sarcopenia. Figure 1. Open in new tab Download slide. Figure 2. Table 1. Muscle Mass Assessment. Anatomic Landmarks. Main Muscle Mass Measurement. Sarcopenia Cut Points Used. Male c. Muscle Thresholding Used. Threshold Range HU. Open in new tab. Table 2. Article CAS PubMed Google Scholar. Beaudart C, McCloskey E, Bruyere O, et al. Sarcopenia in daily practice: assessment and management. BMC Geriatr. Li K, Dortch RD, Welch EB, et al. Multi-parametric MRI characterization of healthy human thigh muscles at 3. NMR Biomed. Boutin RD, Yao L, Canter RJ, Lenchik L. Sarcopenia: current concepts and imaging implications. AJR Am J Roentgenol. Buckinx F, Landi F, Cesari M, et al. Pitfalls in the measurement of muscle mass: a need for a reference standard. J Cachexia Sarcopenia Muscle. Kullberg J, Brandberg J, Angelhed JE, et al. Whole-body adipose tissue analysis: comparison of MRI, CT and dual energy X-ray absorptiometry. Br J Radiol. Download references. Department of Clinical and Experimental Medicine, Foggia University School of Medicine, Foggia, Italy. You can also search for this author in PubMed Google Scholar. Correspondence to Giuseppe Guglielmi. Department of Internal Medicine, University of Palermo, Palermo, Italy. WHO Collaborating Center for Public Health Aspects of Musculo-skeletal Health and Ageing, Division of Public Health Epidemiology and Health Economics, University of Liège, Liège, Belgium. Chair for Biomarkers of Chronic Diseases Biochemistry Department, College of Science King Saud University, Riyadh, Saudi Arabia. Reprints and permissions. La Tegola, L. Radiological Evaluation of Muscle Mass. In: Veronese, N. eds Sarcopenia. Practical Issues in Geriatrics. Springer, Cham. Published : 28 August Publisher Name : Springer, Cham. Print ISBN : Online ISBN : eBook Packages : Medicine Medicine R0. Anyone you share the following link with will be able to read this content:. Sorry, a shareable link is not currently available for this article. Provided by the Springer Nature SharedIt content-sharing initiative. Policies and ethics. Skip to main content. Abstract Sarcopenia represents one of the major public health problems due to aging of the population. Competing interests: The authors have declared that no competing interests exist. Sarcopenia is a skeletal muscle disorder characterized by progressive and generalized loss of muscle mass and strength and reduced functional physical performance [ 1 ]. This could be related to the increased risk of falls, frailty, and mortality. Recently, sarcopenia has been recognized as an independent disease condition with a dedicated International Classification of Disease code and not just an age-related decline in muscle mass [ 2 ]. The European Working Group on Sarcopenia in Older People EWGSOP and the Asian Working Group for Sarcopenia AWGS recommended that the diagnosis of sarcopenia should be based on the combination of muscle mass, muscle strength, and physical performance [ 3 , 4 ]. Therefore, measurement of muscle mass is an important part of sarcopenia diagnosis. Muscle mass has been measured by several techniques, including dual-energy X-ray absorptiometry DEXA , bioelectrical impedance analysis BIA , computer tomography CT , and magnetic resonance imaging MRI. MRI and CT are considered the gold standards for the assessment of muscle mass because of their high accuracy. However, these techniques are not commonly used in clinical practice because of their high cost. In contrast, the DEXA and BIA techniques are widely used for the assessment of muscle mass because they are relatively inexpensive and easy to use. Recently, ultrasound has been widely used as an effective neuroimaging tool for assessing the peripheral nerves and muscles. Muscle ultrasound can evaluate muscle thickness, cross-sectional area, muscle architecture, and muscle echo-intensity EI. Therefore, muscle ultrasound may have the potential to evaluate both muscle quantity and quality. Although several studies have reported the possibility of muscle mass measurement using muscle ultrasound [ 5 — 9 ], it is still not approved as a neuroimaging tool for assessing muscle mass according to the EWGOP and AWGS recommendations [ 3 , 4 ]. In addition, whether muscle EI is valuable for assessing muscle mass and further investigating sarcopenia is rarely reported. This study aimed to investigate whether muscle ultrasound can be used as an effective tool for estimating ASM in terms of muscle quantity and quality. Since muscle mass begins to decline in middle-aged, and decreases gradually with age [ 10 ], we explored whether muscle ultrasonography could be used as a screening tool for sarcopenia in middle-aged and older individuals. Healthy volunteers aged 41—80 years were prospectively recruited between October and December We excluded participants with any objectively detected muscle weakness at the time of the study, any neurological disorder or musculoskeletal disease that could have caused muscle weakness within recent 3 months, or gait disturbance or muscle weakness as a sequela of a previous neurological disorder or musculoskeletal disease. Thus, the entire dataset of our study was randomly divided into a model development group training set and a validation group testing set. The ASM prediction equation using ultrasound parameters was then deduced from the model development group, and the accuracy of deducing the ASM equation was verified in the cross-validation group. Written informed consent was obtained from all participants prior to inclusion. This study was approved by the Institutional Review Board of Korea at the University Anam Hospital No. We collected demographic and clinical information on the participants, including their age, sex, height, weight, and body mass index BMI. To evaluate muscle strength, the handgrip strength of the dominant hand was measured using hand-held dynamometry Jamar hand dynamometry, TEC Inc. To evaluate physical performance, gait speed was measured using gait analysis equipment GAITRite®, CIR Systems Inc. To measure muscle mass, body composition analysis was performed via BIA methods using InBody InBody Co. LTD, Seoul, Korea. The InBody machine had a total of 30 impedance measurements at six different frequencies 1 kHz, 5 kHz, 50 kHz, kHz, kHz, and kHz for five body segments right and left arms, right and left legs, and trunk. Body composition was estimated according to the developed prediction equations using tissue conductivity variables in combination with other covariates such as sex, weight, and height. In addition, the participants were instructed not to eat or exercise for at least three hours before the test and to maintain normal fluid intake the day before the test. Body composition data, including ASM data, were collected. Since muscle mass correlates with body size, muscle mass-adjusted body size is required to identify the optimal cut-off point for sarcopenia. The EWGSOP and AWGS consensus have proposed the cutoff point of sarcopenia using ASM normalized with the squared height [ 3 , 4 ]. Muscle ultrasound was performed using a diagnostic ultrasound device Aplio i, Canon Medical Systems, Tochigi, Japan with an MHz linear probe and B-mode scanning, which was set with Gain 78, a penetrance depth of 3. In this study, two representative muscles from the upper and lower extremities that are easy to assess using ultrasound were selected. Thus, the biceps brachii BB and triceps brachii TB in the upper extremity and the rectus femoris RF and biceps femoris BF in the extremity were chosen for study. MT and EI of these muscles were measured on the dominant hand side. The probe was placed perpendicular to the skin at minimal pressure to ensure accurate measurements. All participants were asked to be fully relaxed while lying in a supine position for the examination of the BB, TB, and RF muscles and in a prone position for the BF muscle. MT was measured in the short-axis view at the maximal vertical distance from the superficial to deep fascia layers. For the BB and TB muscles, the probe was placed between the acromion and cubital crease and scanned along the BB muscle to identify the thickest point of the BB muscle. Subsequently, the probe was laterally rotated 90° to identify the thickest point of the TB muscle. In addition, the probe was placed at the midpoint between the anterior superior iliac spine and the superior border of the patella for the RF muscle, and at the midpoint between the ischial tuberosity and fibular head for the BF muscle, followed by scanning along the RF and BF muscles to identify the thickest point of each muscle. To measure EI, regions of interest were drawn at each muscle that included maximum muscle tissue without the bone or surrounding fascia. The EI in the region of interest of each muscle was measured thrice and averaged for analysis. Fig 1 shows the methods used to measure ultrasonography parameters in each muscle. Muscle thickness and echo intensity of the four selected muscles biceps brachii, triceps brachii, rectus femoris, and biceps femoris muscles on the dominant hand side using a muscle ultrasound. The muscle thickness was measured in the short-axis view at the maximal vertical distance from the superficial to deep fascia layers. To measure echo intensity, regions of interest were drawn at each muscle that included maximum muscle tissue without bone or surrounding fascia. Descriptive summaries are presented as frequencies and proportions for categorical variables and means and standard deviations for continuous variables. To develop an ASM prediction equation, a multiple linear regression analysis was performed in the model development group, and a paired t-test was performed to investigate the agreement between the measured and estimated ASM. In addition, the Bland—Altman plot was used to compare the BIA-measured and estimated ASM. The prediction equation of ASM derived from the model development group was applied to the cross-validation group. A paired t-test and two-way random-effect intraclass correlation coefficient ICC were used to test the agreement between the measured and estimated ASM in the cross-validation group. In addition, a multivariate logistic regression model was used to identify the potential risk factors for sarcopenia. Statistical comparisons between the normal and low ASM groups were performed using independent t-tests for continuous variables. The discriminative power of each parameter was assessed using the receiver operating characteristic curve and area under the curve AUC. All statistical analyses were performed using SPSS This study included healthy volunteers 91 men, women , of which two were excluded: one with inadequate data and another with a history of poliomyelitis. Thus, participants 91 men and women were finally enrolled in this study. Descriptive clinical data and ultrasound parameters for each group are summarized in Table 1. ASM was positively correlated with height, weight, BMI, and hand grip strength and negatively correlated with age. In addition, ASM was correlated with muscle thickness but negatively correlated with muscle EI. The results of the correlation analysis are summarized in Table 2. Multiple linear regression was performed in the model development group to develop an equation for estimating the ASM using muscle ultrasound parameters. In the men group, weight, height, MT of the BF muscle, and the ratio of EI to MT of the BB muscle were predictors of ASM Table 3 and S1 Table. The multiple linear regression model produced the following equation for estimated ASM in men:. In the women group, weight, height, MT of the RF muscle, and the ratio of EI to MT in the BB muscle were predictors of ASM Table 4 and S2 Table. The multiple linear regression model produced the following equation for estimated ASM in women:. BIA, bioelectrical impedance analysis; ASM, appendicular skeletal muscle mass. The developed ASM prediction equation was applied in the cross-validation group. The mean value of estimated ASM did not differ significantly from that of measured ASM in either men A low ASM index is essential for diagnosing sarcopenia. Among the study population, eight men and 13 women met the low ASM index criteria and were classified into the low ASM group. The low ASM group was older than the normal ASM group in men; however, no difference in age was observed between the two groups in women. Both men and women in the low ASM group exhibited weaker handgrip strength. Additionally, the low ASM group had a lower MT of the BB, TB, and RF muscles in men and the BB and TB muscles in women. However, there were no significant differences in the EI of any muscle between the two groups, except for the BF muscle in men. The clinical characteristics of the normal and low ASM groups are summarized in Table 6. Multivariate logistic regression analysis was performed to identify potential risk factors for sarcopenia Table 7. In the men group, the EI to MT ratio of the RF muscle odds ratio [OR] 3. The EI to MT ratio of the RF and BF muscles for predicting the risk of low ASM had AUC of 0. Using these cut-off values, a sensitivity of In addition, the AUC of the combination of these two variables for predicting the risk of low ASM was 0. In the women group, the MT of the BB muscle OR 0. The MT of BB muscle for predicting the risk of low ASM had an AUC of 0. Using this cut-off value, a sensitivity of This study deduced ultrasound-driven estimation equations of the ASM using a multiple linear regression model. |
Muscle mass evaluation -
J Cachexia Sarcopenia Muscle[Internet]. Cut-off points to identify sarcopenia according to European Working Group on Sarcopenia in Older People EWGSOP definition.
Although the results demonstrate that CC has a good ability to predict muscle mass decrease, the different cutoff points available in the literature - 31 cm to 35 cm in women 27 27 Roland Y, Lauwers-Cances V, Cournot M, Nourhashémi F, Reynish W, Rivière D, et al.
Considering the possibility of applying calf circumference as a low cost and affordable care technology for evaluation of muscle mass in the elderly, especially in primary care services, the overall objective of this study was to validate calf circumference as a mass evaluation technology in the elderly.
As specific objectives, the study sought to verify the prevalence of decreased muscle mass according to DEXA and CC, as well as to analyze the predictive capacity of calf circumference in identifying muscle mass and to identify cutoff points in the elderly population.
This research is nested in a matrix study, "Validation of Anthropometric Indicators for Assessment of the Nutritional Status of Elderly", approved by the Research Ethics Committee of the Federal University of Goiás. The elderly respondents signed the Informed Consent Term, confirming the consent participate in the study.
In order to evaluate the proposed objectives, a secondary analysis of data from the main research was carried out. The main objective of this study was to analyze the health and nutrition conditions of elderly users of the Primary Health Care System SUS of Goiânia.
In the matrix study, elderly individuals were randomly selected, with probabilistic and proportional sampling to the nine sanitary districts of the city of Goiânia. This sample is representative of the elderly users of Primary Care in this municipality 32 32 Pagotto V, Silveira EA.
Applicability and agreement of different diagnostic criteria for sarcopenia estimation in the elderly. For the present study, a sub-sample of elderly subjects was randomly selected. They performed the DEXA exam, recommended as a reference in estimating muscle mass in the elderly.
The circumference of the calf was also evaluated, as well as other anthropometric measures and the application of a standardized and pre-tested questionnaire. The data were collected in a clinic specialized in diagnostic imaging, between July and August , by a team previously trained.
It should be noted that data from the period were analyzed because it is a broad population-based study whose results, already analyzed, together with the continuous updating of the literature on the different diagnostic methods of muscle mass, led us to evaluate the circumference of the calf as a method for evaluation of muscle mass in the elderly, emphasizing its application in nursing practice.
The clinic in question was selected considering the cost of the examination, methodological quality in performing the DEXA exam, location and adequate space to accommodate the elderly at all stages of data collection.
To this end, the research objectives were first communicated and clarified by telephone to the elderly, and, agreeing to participate, they were also advised about the care in the standardized preparation for DEXA: absolute fasting of at least 4 hours before the test; do not consume alcohol or foods containing caffeine in the 24 hours before the test; not exercise within the 12 hours prior to the test; urinate 30 minutes before the test; nor to use diuretics within 24 hours of the test 13 13 Bruyère O, Beaudart C, Reginster J, Buckinx F, Schoene, Hirani D, et al.
The elderly were transported from their homes to the site of the research in a safe vehicle, accompanied by one of the researchers.
The muscular mass was obtained by means of DEXA, using Lunar DPX-MD PLUS, software version 7. Muscle mass was defined by the Appendicular Muscle Mass MMA , which is estimated by the sum of the fat-free mass of the arms and legs.
The decrease in muscle mass was defined by the Appendicular Muscle Mass Index IMMA , ratio between MMA and height squared 3 3 Cruz-Jentoft AJ, Baeyens JP, Bauer JM, Boirie Y, Cederholm T, Landi F, et al.
The cutoff point for low muscle mass was 7. Calf circumference CC was measured with inelastic tape with the elderly in the upright position, feet 20 cm apart, at the maximum circumference in the plane perpendicular to the longitudinal line of the calf 33 33 Lohman TG, Roche AF, Martorel R.
Anthropometrics standartization reference manual. Champaign: Human Kinetics Books; The measurement was performed in a standardized way 33 33 Lohman TG, Roche AF, Martorel R. The researcher who collected these measurements was duly trained according to the technique of Habicht 34 34 Habicht JP.
Estandarizacion de métodos epidemiológicos cuantitativos sobre el terreno. Bol Oficina Sanit Panam [Internet]. to calculate the technical error of the measurement in order to achieve appropriate accuracy and accuracy for the quality of scientific research data.
The Receiver Operating Characteristic ROC curve was used to analyze the sensitivity and specificity variation of different CC values in relation to the low muscle mass diagnostic criteria by DEXA 35 35 Schisterman EF, Faraggi D, Reiser B, Trevisan M.
Statistical inference for the area under the receiver operating characteristic curve in the presence of random measurement error. An area under the ROC curve above 0. Subsequently, the cutoff points for calf circumference were identified, with respective values and confidence intervals of sensitivity, specificity and accuracy.
Values indicated through the ROC curve are cut-off points that should promote a more adequate balance between sensitivity and specificity. A total of elderly individuals, The mean MII was 7. The prevalence of decreased muscle mass was higher in men Mean values of BMI, WC and CC were lower in elderly with low muscle mass, with statistically significant differences.
The sensitivity and specificity of the CC cut-off points available in the literature are described in Table 2. The prevalence of muscle mass decreased according to this cutoff point in women was Among men, the two cutoff points, both 33 cm and 34 cm, presented a median accuracy, but the 34 cm showed a better balance between sensitivity and specificity The prevalence of muscle mass decreased according to this cutoff point in men was The prevalence according to the other cutoffs analyzed is different, since it has a lower accuracy to identify the decreased muscle mass in the elderly.
As for the best cut points obtained by the ROC curve, it can be seen in Table 3 , in men and women, that the best values were However, because they are fractional values, the cut points 34 cm in men and 33 cm in women were those that presented better sensitivity, specificity and accuracy Table 3.
The prevalence of decreased muscle mass according to DEXA was high, which is consistent with studies that also used DEXA performed in the United States 14 14 Baumgartner RN, Koehler KM, Gallagher D, Romero L, Heymsfield SB, Ross RR, et al. Prevalence of sarcopenia and sarcopenic obesity in Korean adults: the korean sarcopenic obesity study.
Int J Obes[Internet]. and China 37 37 Chen LK, Liu LK, Woo J, Assantachai P, Auyeung TW, Bahyah KS, et al. Sarcopenia in Asia: consensus report of the Asian Working Group for Sarcopenia. J Am Med Dir Assoc [Internet].
Studies in Brazil found a prevalence of Osteoporos Int [Internet]. and 3. Revision study 4 4 Kim H, Hirano H, Edahiro A, Ohara Y, Watanabe Y, Kojima N, et al. identified that the mean cutoff points for muscle mass through DEXA vary from 5.
These discrepancies found in the prevalence of decreased muscle mass can be attributed to the different diagnostic criteria proposed for its estimation.
The most common cut-off point in the literature was that proposed by Baumgartner et al 14 14 Baumgartner RN, Koehler KM, Gallagher D, Romero L, Heymsfield SB, Ross RR, et al.
Although more recent studies have shown cutoff points for CP with better sensitivity and specificity 28 28 Kawakami R, Murakami H, Sanada K, Tanaka N, Sawada SS, Tabata I, et al. and Mexico 22 22 Velazquez-Alva MC, Irigoyen Camacho ME, Lazarevich I, Delgadillo Velazquez J, Acosta Dominguez P, Zepeda Zepeda MA.
that assessed the prevalence of sarcopenia using the cutoff point of 31 cm of CC for estimation of decreased muscle mass, whose sensitivity in the present study was low.
In the study with Mexican elderly women, the prevalence of sarcopenia using IMME as measured by DEXA and CC was, respectively, In the Netherlands 20 20 Bastiaanse LP, Hilgenkamp TIM, Achteld MA, Avenhuis HM. It should be emphasized that men and women were included, and the cut-off point of 31 cm had been established for women 27 27 Roland Y, Lauwers-Cances V, Cournot M, Nourhashémi F, Reynish W, Rivière D, et al.
Therefore, the results may not represent the actual prevalence in men. In the present study, the 33 cm cutoff point for females and 34 cm for males has a greater capacity to predict decreased muscle mass. The first study to analyze the predictive capacity of CC was performed in French women 27 27 Roland Y, Lauwers-Cances V, Cournot M, Nourhashémi F, Reynish W, Rivière D, et al.
and the suggested cutoff point was 31 cm, whose sensitivity More recent studies have been conducted with men and women in Turkey 31 31 Bahat G, Tufan A, Tufan F, Kilic C, Akpinar TS, Kose M, et al. and Brazil 30 30 Barbosa-Silva TG, Bielemann RM, Gonzalez MC, Menezes ANB.
In these studies, the elderly were also analyzed in the community and the reference method used was DEXA 28 28 Kawakami R, Murakami H, Sanada K, Tanaka N, Sawada SS, Tabata I, et al. In these three studies, cut-off points in men and women presented close values 33 cm to 34 cm.
In spite of the amplitude of the variations in these studies and in the present investigation, the proximity of the cut points found indicates that there is good accuracy in identifying the decreased muscle mass, except for the 31 cm point, which presented low sensitivity Diagnostic tests with high specificity can avoid unnecessary interventions and bring less physical, financial and emotional repercussions due to an incorrect diagnosis of sarcopenia 35 35 Schisterman EF, Faraggi D, Reiser B, Trevisan M.
On the other hand, the low sensitivity of the CP cutoff point may make it an inadequate tool for the screening of sarcopenia in the elderly. Thus, the use of CP with a cutoff point of The possibility of identifying elderly patients with reduced muscle mass through CP is reinforced by studies that have evaluated their ability to predict mortality 23 23 Pérez-Zepeda MU, Gutiérrez-Robledo LM.
and disability 24 24 Tsai AC, Lai MC, Chang TL. The effectiveness of BMI, calf circumference and mid-arm circumference in predicting subsequent mortality risk in elderly Taiwanese.
Br J Nutr[Internet]. and need for care 26 26 Hsu WC, Tsai AC, Wang JY. In Taiwan, the decrease in CP 26 26 Hsu WC, Tsai AC, Wang JY. increased the risk of death in men by 1.
Although studies 23 23 Pérez-Zepeda MU, Gutiérrez-Robledo LM. have shown that decreased CP increases the likelihood of decreased muscle mass, a study with elderly in Mexico 24 24 Tsai AC, Lai MC, Chang TL. Other studies 14 14 Baumgartner RN, Koehler KM, Gallagher D, Romero L, Heymsfield SB, Ross RR, et al.
Development of a simple screening test for sarcopenia in older adults. have also developed proposals with SC to track sarcopenia, but the measure is dependent on other variables. One of them, carried out in Japan 39 39 Ishii S, Tanaka T, Shibasaki K, Ouchi Y, Kikutani T, Higashiguchi T, et al.
From a clinical practice point of view, this may not be an easy way to assess sarcopenia in developing country contexts, as the dynamometer is not usually available.
On the other hand, SC can be used in clinical practice and in primary care settings by different health professionals, requiring only a tape measure and training for this verification. Considering the adverse health outcomes of the elderly, this evaluation can be included in the routine evaluation of the elderly in primary care and, once changed, both the nurse and other health professionals can intervene or propose a more accurate evaluation of the body composition.
Despite their contributions, one of the limitations of this study is the cutoff point used for the definition of decreased muscle mass according to DEXA. It is a value obtained from a young American population 14 14 Baumgartner RN, Koehler KM, Gallagher D, Romero L, Heymsfield SB, Ross RR, et al.
that does not have the same standard of living nor the health conditions of the Brazilian population. However, the studies presented here 27 27 Roland Y, Lauwers-Cances V, Cournot M, Nourhashémi F, Reynish W, Rivière D, et al.
that analyzed the predictive capacity of CP and proposed cut-off points also used this parameter, which facilitates comparisons of results.
One possible limitation refers to errors inherent in anthropometric measures, since body changes related to aging, such as increased body fat deposition 40 and loss of skin elasticity, render these measures vulnerable to errors.
To avoid this kind of bias, the following precautions were taken: single anthropometrist, training, standardization and analysis of interobserver technical error.
Other care refers to the spectrum of the subjects, a fundamental condition for validation studies, that is, the tests were performed in a population that uses Primary Care, a population that proposes to apply the anthropometric measures later. In nursing clinical practice, this measure can be performed during the physical examination of the elderly at different levels of health services, directing the clinical judgment and increasing the probability of a correct diagnostic decision and adoption of preventive measures, considering that in some situations the nurse diagnoses or establishes associations using taxonomies, from a subjective perception of the decrease of muscular mass.
This study validated and identified calf circumferential cutoff points for decreased muscle mass using DEXA as a reference. In the studied population, the cutoff points of 33 cm in females and 34 cm in males presented better predictive capacity of decreased muscle mass.
In addition, the estimated prevalence of decreased muscle mass, according to these cutoff points, was similar to that identified by DEXA, which demonstrates the good accuracy of CP.
The evaluation of calf circumference can therefore be a useful technology in the clinical practice of nurses in both the identification and follow-up of muscle mass reduction, in the follow-up of body losses and in the early identification of sarcopenia.
Thus, it is recommended to use it in clinical practice contexts in primary care using the values of 33 cm in women and 34 cm in men for screening of decreased muscle mass.
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Português Español. Open menu. table of contents « previous current next ». Abstract Resumo English Resumo Spanish Resumo Portuguese. Text EN Text English Texto Portuguese. PDF Download PDF English Download PDF Portuguese. ABSTRACT Objective: To validate calf circumference as a technology for assessing muscle mass in the elderly.
Method: Cross-sectional study with elderly people from Goiânia, Goiás, Brazil. Results: The most accurate cut-off points for detecting decreased muscle mass in the elderly were 34 cm for men sensitivity: Conclusion: CC can be used as a measure for early identification of muscle mass decrease in routine evaluations of the elderly in primary care.
RESUMEN Objetivo: Validar la circunferencia de la pantorrilla como tecnología de evaluación de masa muscular en mayores. Método: Estudio transversal con mayores de Goiânia, Goiás, Brasil. Conclusión: La CP puede ser utilizada como medida para identificación precoz de disminución de masa muscular en evaluaciones de rutina de mayores en la atención primaria.
RESUMO Objetivo: Validar a circunferência da panturrilha como tecnologia de avaliação de massa muscular em idosos.
Método: Estudo transversal com idosos de Goiânia, Goiás, Brasil. Conclusão: A CP pode ser utilizada como medida para identificação precoce de diminuição de massa muscular em avaliações de rotina de idosos na atenção primária. METHOD Ethical aspects This research is nested in a matrix study, "Validation of Anthropometric Indicators for Assessment of the Nutritional Status of Elderly", approved by the Research Ethics Committee of the Federal University of Goiás.
Kind of study In order to evaluate the proposed objectives, a secondary analysis of data from the main research was carried out. Study scenario and data source In the matrix study, elderly individuals were randomly selected, with probabilistic and proportional sampling to the nine sanitary districts of the city of Goiânia.
Collection and organization of data The data were collected in a clinic specialized in diagnostic imaging, between July and August , by a team previously trained.
RESULTS A total of elderly individuals, Table 1 Description of the sample and prevalence of Decreased Muscle Mass measured by Dual Energy X-Ray Absortometry DEXA according to sex, age range and anthropometric variables, Goiânia, Goiás, Brazil.
National Council of Scientific and Technological Development CNPq. Rosenberg HM. Cruz-Jentoft AJ, Baeyens JP, Bauer JM, Boirie Y, Cederholm T, Landi F, et al. Kim H, Hirano H, Edahiro A, Ohara Y, Watanabe Y, Kojima N, et al.
Diz JB, Leopoldino AA, Moreira BS, Henschke N, Dias RC, Pereira LS, et al. Beaudart C, Zaaria M, Pasleau F, Reginster JY, Bruyère O. Costa AGS, Oliveira ARS, Alves FEC, Chaves DBR, Moreira RP, Araujo TL.
However, even after adjusting for these variables, the muscle indicators remained moderately correlated with body size. Therefore, the use of muscle indicators as part of the sarcopenia diagnosis criteria may have biased the diagnosed sarcopenia from the true sarcopenia.
Furthermore, the residual correlation between adjusted muscle indicators and body size may interfere with the appropriate assessment of muscle loss. Further research on muscle mass assessment is necessary to establish a clear definition of sarcopenia.
This article is based on the study, which received the Medical Research Encouragement Prize of The Japan Medical Association in Because this is not a research of human beings, approval from the institutional review board is not required.
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Sarcopenia is assessed Muscle mass evaluation several methods, Muscle mass evaluation dual energy X-ray absorptiometry DEXAwhich provide a height-adjusted skeletal evauation index H-SMI. A SMI Mhscle standard evaluatkon below the young adult reference dvaluation 1 Musscle combined with low Muscle mass evaluation Strengthening skins barrier function or performance is used to identify sarcopenia. As height declines with age, H-SMI may underestimate low skeletal muscle mass in the older population. Our study aims to evaluate an alternative SMI and to examine its relationship to grip strength in a group of Australian women. Women from two cohorts were analysed. The relationship between leg length-adjusted SMI LL-SMI to grip strength and anthropometric variables to skeletal muscle mass by DEXA were examined by linear regression analysis.
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