Department of Physical Therapy, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-Ku, Niigata City, 950-3198, Japan.
Department of Geriatric Medicine, National Center for Geriatrics and Gerontology, 7-430 Morioka, Obu, Aichi, 474-8511, Japan; Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan.
Arch Gerontol Geriatr. 2021 Mar-Apr;93:104290. doi: 10.1016/j.archger.2020.104290. Epub 2020 Nov 3.
The Asia Working Group for Sarcopenia 2019 (AWGS) recommended using the calf circumference (CC) cut-off values to facilitate the case-finding of sarcopenia. However, the validity of the proposed cut-offs has not been examined in older patients with stroke. This study investigated the validity of the AWGS-recommended CC cut-off values for identifying sarcopenia among older patients with stroke.
This cross-sectional study enrolled consecutive patients with stroke, aged 65 years and older, admitted to a convalescent rehabilitation ward. Sarcopenia was diagnosed based on the AWGS 2019 criteria. We drew a receiving operating characteristic curve to assess the ability of CC to predict sarcopenia diagnosis. Subsequently, we estimated the sensitivity, specificity, accuracy, F-value, and Matthews correlation coefficient (MCC) of the considered cut-off values.
We enrolled 256 patients (43 % women) (mean age, 76.6 ± 7.5 years). The prevalence of sarcopenia was 63.7 %. Among men who presented with CC < 34 cm (the AWGS-recommended cut-off value), sensitivity and specificity were 85 % and 66 %, respectively. Concurrently, estimates of accuracy, F-value, and MCC were the highest at cut-off value <34 cm. Among women, at <33 cm of the AWGS-recommended cut-off value, the sensitivity and specificity were 91 % and 28 %, respectively. At cut-off value <32 cm, sensitivity was maintained at 80 %, while specificity increased to 56 %; suggesting that this cut-off value might be a useful indicator for the case-finding of sarcopenia.
The AWGS-recommended CC cut-off values are valid. The predictive characteristics of sarcopenia differed among men and women with stroke.
亚洲肌少症工作组（AWGS）2019 年建议使用小腿围（CC）截断值来促进肌少症的病例发现。然而，这些建议的截断值在老年卒中患者中的有效性尚未得到检验。本研究旨在探讨 AWGS 推荐的 CC 截断值在识别老年卒中患者肌少症中的有效性。
本横断面研究纳入了连续入住康复病房的年龄在 65 岁及以上的卒中患者。根据 AWGS 2019 标准诊断肌少症。我们绘制了接收者操作特征曲线来评估 CC 识别肌少症诊断的能力。随后，我们估计了考虑的截断值的敏感性、特异性、准确性、F 值和马修斯相关系数（MCC）。
我们共纳入了 256 名患者（43%为女性）（平均年龄 76.6±7.5 岁）。肌少症的患病率为 63.7%。在男性中，CC<34cm（AWGS 推荐的截断值）时，敏感性和特异性分别为 85%和 66%。同时，<34cm 时的准确性、F 值和 MCC 估计值最高。在女性中，在 AWGS 推荐的截断值<33cm 时，敏感性和特异性分别为 91%和 28%。当截断值<32cm 时，敏感性保持在 80%，而特异性增加到 56%，表明该截断值可能是肌少症病例发现的有用指标。
AWGS 推荐的 CC 截断值是有效的。卒中男性和女性肌少症的预测特征不同。
