DOI: https://doi.org/10.14710/jbtr.v1i1.12115

Diagnostic accuracy of calf circumference for decreased muscle mass in older adults with sarcopenia

Faculty of Medicine, Universitas Diponegoro, Indonesia

Received: 21 Aug 2022; Revised: 15 Mar 2022; Accepted: 27 Mar 2022; Available online: 28 Apr 2022; Published: 28 Apr 2022.
Open Access Copyright (c) 2022 Journal of Biomedicine and Translational Research
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Abstract

Background: Increasing number of the older adults population results in increasing sarcopenia, a geriatric problem that may lead to poor quality of life, susceptibility to disease, malnutrition, and even death. Muscle mass is an important sarcopenia parameter that can be measured by Bioelectrical Impedance Analysis (BIA). Detection of decreased muscle mass can be done by measuring calf circumference, it is expected to provide an early diagnose of sarcopenia so that early intervention can be given and improve the quality of life of the older adults.

Objective: To analyze the diagnostic accuracy of calf circumference for decreased muscle mass in older adults to provide simple way in diagnosing sarcopenia.

Methods: This study involved 126 older adults, consisted of 57 men and 69 women aged 60-80 years in the community who met the inclusion criteria. Criteria of sarcopenia were defined based on the Asian Working Group for Sarcopenia (AWGS) Consensus, consisted of three components; muscle mass, handgrip strength, and walking speed. This study analyze the diagnostic accuracy of calf circumference for decreased muscle mass measured by single- frequency BIA and calf circumference was measured using a measuring tape. The analysis was carried out according to the receiver operating characteristic (ROC) curve to determine the cut-off point along with the sensitivity (Se) and specificity (Sp) values, positive and negative predictive values (PPV and NPV) of calf circumference as an indicator for low muscle mass.

Results: Optimal cut-off point of calf circumference to indicate low muscle mass is 32.9 cm in women (Se 80.8%, Sp 79.1%, PPV 75.9%, NPV 87.5%) and 33.5 cm in men (Se 78.6%, Sp 74.4%, PPV 50%, NPV 91.4%). PPV in men is lower than women. This is due to a lower prevalence of decreased muscle mass in men than women. There were 49 participants with the calf circumference below cut-off point and 40 (31.7%) of the 126 participants had sarcopenia.

Conclusion: Calf circumference has a diagnostic accuracy to find decreased muscle mass in  sarcopenia.

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Keywords: sarcopenia; elderly; calf circumference; muscle mass

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Section: Original Research Articles
Language : EN
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  1. Darmojo RB, Moelyanto RD, Abdulrochim IP, Nasution I, Rachman K, Rahmatullah P, et al. Buku Ajar Boedhi-Darmojo Geriatri Ilmu Kesehatan Usia Lanjut. Vol. 5, Badan Penerbit Fakultas Kedokteran Universitas Indonesia; 2015. 7–79
  2. Chen L, Liu L, Woo J, Shahrul K, Chou M, Chen L, et al. Sarcopenia in Asia : Consensus Report of the Asian Working Group for Sarcopenia. J Am Med Dr Assoc. 2014;15:95–101. https://doi.org/10.1016/j.jamda.2013.11.025
  3. Walston JD. Sarcopenia in older adults. Curr Oppinion Rheumatol. 2012;24(6):623–7. https://dx.doi.org/10.1097%2FBOR.0b013e328358d59b
  4. Stein LK, Wiramihardja S, Kulsum ID. Muscle Mass and Quality of Life of Elderly People in Panti Tresna Werdha in Bandung Faculty of Medicine Padjadjaran University- Hasan Sadikin Hospital Department of Public Health Faculty of Medicine Padjadjaran University- Hasan Sadikin Hospital Department. J Med Heal. 2018;2(1):637–45
  5. Defi IR, Nugraha GI, Setiabudiawan B. Prevalensi Sarkopenia pada Lansia di Komunitas ( Community Dwelling ) berdasarkan Dua Nilai Cut-off Parameter Diagnosis Sarcopenia Prevalence In Community-Dwelling Elderly based on Two Cut-off Points Diagnosis Parameters. 2014;48(38). https://doi.org/10.15395/mkb.v48n3.417
  6. Cruz-Jentoft AJ, Baeyens JP, Bauer JM, Boirie Y, Cederholm T, Landy F, et al. Sarcopenia : European consensus on definition and diagnosis Report of the European Working Group on Sarcopenia in Older People. Age and Ageing British Geriatrics Society 2010. 412–23. https://doi.org/10.1093/ageing/afq034
  7. Rolland Y, Lauwers-cances V, Cournot M. Sarcopenia, Calf Circumference, and Physical Function of Elderly Women: A Cross-Sectional Study. J Am Geriatr Soc. 2003;51(8):1120–4. https://doi.org/10.1046/j.1532-5415.2003.51362.x
  8. Cashin K, Oot L. Guide to Anthropometry: A Practical Tool for Program Planners, Managers, and Implementers. Food Nutr Tech Assist III Proj (FANTA)/ FHI 360. 2018;120–200
  9. Dhillon RJS, Hasni S. Pathogenesis and Management of Sarcopenia. Clin Geriatr Med. 2017;33(3):17–26. https://doi.org/10.1016/j.cger.2016.08.002
  10. Vasold KL, Parks AC, Phelan DML, Pontifex MB, Pivarnik JM. Reliability and validity of commercially available low-cost bioelectrical impedance analysis. Int J Sport Nutr Exerc Metab. 2019;29(4):406–10. https://doi.org/10.1123/ijsnem.2018-0283
  11. Chen LK, Woo J, Assantachai P, Auyeung TW, Chou MY, Iijima K, et al. Asian Working Group for Sarcopenia: 2019 Consensus Update on Sarcopenia Diagnosis and Treatment. J Am Med Dir Assoc. 2020;21(3):300-307. https://doi.org/10.1016/j.jamda.2019.12.012
  12. Statistik BP. Profil Lansia Provinsi Jawa Tengah 2018. Badan Pus Stat Provinsi Jawa Teng. 2018;xiv + 82
  13. Sari NR, Maylasari I, Dewi FWR, Putrianti R, Nugroho SW, Wilson H. Statistik Penduduk Lanjut Usia 2020. Subdirektorat Stat Pendidik dan Kesejaht Sos. 2020;
  14. Callahan DM, Miller MS, Sweeny AP, Tourville TW, Slauterbeck JR, Savage PD, et al. Muscle disuse alters skeletal muscle contractile function at the molecular and cellular levels in older adult humans in a sex-specific manner. J Physiol. 2014;592(20):4555–73. https://doi.org/10.1113/jphysiol.2014.279034
  15. Rosa-Caldwell ME, Greene NP. Muscle metabolism and atrophy: let’s talk about sex. Biol Sex Differ. 2019;10(43):1–14. https://doi.org/10.1186/s13293-019-0257-3
  16. Shafiee G, Keshtkar A, Soltani A, Ahadi Z, Larijani B, Heshmat R. Prevalence of sarcopenia in the world : a systematic review and meta-analysis of general population studies. J Diabetes Metab Disord. 2017;16(21):1–10. https://doi.org/10.1186/s40200-017-0302-x
  17. Vianna LC, Oliveira RB, Araújo CGS. Age-related decline in handgrip strength differs according to gender. J Strength Cond Res. 2007;21(4):1310–4. https://doi.org/10.1519/r-23156.1
  18. Asai C, Akao K, Adachi T, Iwatsu K, Fukuyama A, Ikeda M, et al. Maximal calf circumference reflects calf muscle mass measured using magnetic resonance imaging. Arch Gerontol Geriatr. 2019; 83 (April):175–8. https://doi.org/10.1016/j.archger.2019.04.012
  19. Kawakami R, Miyachi M, Sawada SS, Torii S, Midorikawa T, Tanisawa K, et al. Cut-offs for calf circumference as a screening tool for low muscle mass: WASEDA’S Health Study. Geriatr Gerontol Int. 2020;20(10):943–50. https://doi.org/10.1111/ggi.14025
  20. Woo J, Leung J, Morley JE. Defining sarcopenia in terms of incident adverse outcomes. J Am Med Dir Assoc. 2015;16(3):247–52. https://doi.org/10.1016/j.jamda.2014.11.013
  21. Kirchengast S, Huber J. Gender and age differences in lean soft tissue mass and sarcopenia among healthy elderly. Anthropol Anzeiger. 2009;67(2):139–51. https://doi.org/10.1127/0003-5548/2009/0018
  22. Kawakami R, Murakami H, Sanada K, Tanaka N, Sawada SS, Tabata I, et al. Calf circumference as a surrogate marker of muscle mass for diagnosing sarcopenia in Japanese men and women. Geriatr Gerontol Int. 2014;1–8. https://doi.org/10.1111/ggi.12377
  23. Mienche M, Setiati S, Setyohadi B, Kurniawan J, Laksmi PW, Ariane A, et al. Diagnostic Performance of Calf Circumference, Thigh Circumference, and SARC-F Questionnaire to Identify Sarcopenia in Elderly Compared to Asian Working Group for Sarcopenia’s Diagnostic Standard. Acta Med Indones. 2019;51(2):117–27. PMID: 31383826
  24. Kim S, Kim M, Lee Y, Kim B, Yoon TY, Won CW. Calf Circumference as a Simple Screening Marker for Diagnosing Sarcopenia in Older Korean Adults : the Korean Frailty and Aging Cohort Study ( KFACS ). J Korean Med Sci. 2018;33(20):1–10. https://dx.doi.org/10.3346%2Fjkms.2018.33.e151
  25. Laksmi PW, Mitayani SH, Setyohadi B, Muhadi, Ariane A, Tirtarahardja G. Diagnostic Merit of Using the Calf Circumference to Estimate the Muscle Mass as a Component of Sarcopenia in Elderly Outpatients. J Nat Sci Biol Med. 2019;10:126–30. https://doi.org/10.4103/jnsbm.JNSBM_42_19
  26. Akobeng AK. Understanding diagnostic tests 1: Sensitivity, specificity and predictive values. Acta Paediatr Int J Paediatr. 2007;96(3):338–41. https://doi.org/10.1111/j.1651-2227.2006.00180.x
  27. Bartol T. Thoughtful use of diagnostic testing: Making practical sense of sensitivity, specificity, and predictive value. Nurse Pract. 2015;40(8):10–2. https://doi.org/10.1097/01.npr.0000470366.64804.35

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