Department of Nutrition and Dysphagia Rehabilitation, Tamana Regional Health Medical Center, Kumamoto, Japan.
Ann Nutr Metab. 2017;71(1-2):10-15. doi: 10.1159/000478707. Epub 2017 Jun 24.
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.
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.
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.
The study determined appropriate cut-off values for CC to identify decreased SMM and malnutrition according to the relevant guidelines.
背景/目的：能够在临床环境中快速诊断肌少症和营养不良至关重要。本研究旨在根据亚洲肌少症工作组的肌少症定义标准和欧洲临床营养与代谢学会定义的营养不良标准，明确用于诊断日本住院患者骨骼肌量减少的小腿围（CC）截断值。
本研究纳入了 1164 名年龄≥65 岁的患者。使用受试者工作特征曲线（ROC）分析确定预测性 CC 截断值。通过与住院死亡率的相关性验证这些截断值的预测有效性。
所有患者中分别有 654 名女性和 510 名男性（平均年龄为 83.5±8.2 岁）。分别有 80.4%和 32.8%的患者存在骨骼肌量减少和营养不良。ROC 分析确定 CC≤29cm（女性，曲线下面积[AUC]0.791）和 CC≤30cm（男性，AUC 0.832）为骨骼肌量减少的截断值，CC≤26cm（女性，AUC 0.798）和 CC≤28cm（男性，AUC 0.837）为营养不良的截断值。CC 用于骨骼肌量减少和营养不良的截断值与住院死亡率独立相关。
本研究根据相关指南确定了适当的 CC 截断值，以识别骨骼肌量减少和营养不良。
