Predictive Accuracy of Calf Circumference Measurements to Detect Decreased Skeletal Muscle Mass and European Society for Clinical Nutrition and Metabolism-Defined Malnutrition in Hospitalized Older Patients

Ann Nutr Metab. 2017;71(1-2):10-15. doi: 10.1159/000478707. Epub 2017 Jun 24.

Abstract

Background/aims: The ability to readily diagnose sarcopenia and malnutrition in a clinical setting is essential. This study is aimed at clarifying the calf circumference (CC) cut-off values for decreased skeletal muscle mass (SMM), according to the Asian Work Group for Sarcopenia's criteria definition of sarcopenia, and those for European Society for Clinical Nutrition and Metabolism-defined malnutrition, in hospitalized Japanese patients.

Methods: The study involved 1,164 patients aged ≥65 years. Predictive CC cut-off values were determined using receiver operating curve (ROC) analyses. The predictive validity of the cut-off values was confirmed against in-hospital mortality.

Results: There were 654 females and 510 males (mean age, 83.5 ± 8.2 years). Decreased SMM and malnutrition were observed in 80.4 and 32.8% of all patients, respectively. ROC analyses identified CCs of ≤29 cm (female, area under the curve [AUC] 0.791) and ≤30 cm (male, AUC 0.832) as cut-off values for decreased SMM, and CCs of ≤26 cm (female, AUC 0.798) and ≤28 cm (male, AUC 0.837) for malnutrition. CC cut-off values for SMM and malnutrition were independently correlated with in-hospital mortality.

Conclusions: The study determined appropriate cut-off values for CC to identify decreased SMM and malnutrition according to the relevant guidelines.

Keywords: Calf circumference; Hospitalized patients; Malnutrition; Mortality; Sarcopenia.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anthropometry
  • Body Mass Index
  • Cross-Sectional Studies
  • Europe
  • Female
  • Hospital Mortality
  • Hospitalization
  • Humans
  • Male
  • Malnutrition / diagnosis*
  • Malnutrition / etiology
  • Muscle, Skeletal / anatomy & histology*
  • Organ Size
  • Retrospective Studies
  • Sarcopenia / complications
  • Sarcopenia / diagnosis*