Department of Emergency, The Affiliated Baoan Hospital of Southern Medical University, People's Hospital of Baoan Shenzhen, Shenzhen, China.
Department of Nursing, Chinese Academy of Medical Sciences, Peking Union Medical College, Peking Union Medical College Hospital (Dongdan Campus), Beijing, 100730, China.
Eur Geriatr Med. 2022 Jun;13(3):597-609. doi: 10.1007/s41999-021-00603-3. Epub 2022 Jan 10.
Low calf circumference is an important indicator of malnutrition and has been widely studied, especially among older adults. However, data on the association between low calf circumference and mortality have been inconsistent. This systematic review was aimed to quantify this association.
The internet databases (PubMed, Embase, ScienceDirect and Cochrane Library databases) were systematically searched from inception to November 01, 2021 for studies investigating the association between low calf circumference and mortality. A random effects model was adopted to pool the relevant data.
Low calf circumference was associated with a higher risk of mortality than normal calf circumference, with a pooled HR of 2.42 (95% CI 1.97-2.97, I = 74.3%). In addition, this association between low calf circumference and morality was still statistically significant in the subgroup analysis across different settings, including hospitals (pooled HR = 2.63, 95% CI 1.93-3.58), nursing homes (pooled HR = 2.49, 95% CI 1.76-3.54), and communities (pooled HR = 2.22, 95% CI 1.60-3.07). Other subgroup analyses based on different cutoffs of calf circumference showed that, compared to individual with normal calf circumference, participants with low calf circumference had an increased risk of mortality (pooled HR = 2.66, 95% CI 2.06-3.43) when using the Asian Working Group for Sarcopenia (AWGS) criterion (≤ 34 cm for males and ≤ 33 cm for females). Similar results were found when the Mini Nutritional Assessment (MNA) criterion (≤ 31 cm) was used, with a pooled HR of 2.11 (95% CI 1.59-2.81).
Calf circumference, which is simple and convenient to measure, could be used to stratify the high-risk group, as low calf circumference was significantly associated with mortality among patients. Interventions, including exercise and nutrition programs, could be conducted promptly once low calf circumference is detected.
小腿围小是营养不良的一个重要指标，已得到广泛研究，尤其是在老年人中。然而，小腿围小与死亡率之间的关系的数据一直不一致。本系统综述旨在量化这种关联。
从数据库建立到 2021 年 11 月 01 日，系统地检索了互联网数据库（PubMed、Embase、ScienceDirect 和 Cochrane Library 数据库），以调查小腿围小与死亡率之间的关联。采用随机效应模型汇总相关数据。
小腿围小与死亡率升高相关，风险比（HR）为 2.42（95%置信区间 1.97-2.97，I=74.3%）。此外，在不同环境（医院、养老院和社区）的亚组分析中，这种小腿围小与死亡率之间的关联仍然具有统计学意义。在医院中，小腿围小的 HR 为 2.63（95%置信区间 1.93-3.58）；在养老院中，HR 为 2.49（95%置信区间 1.76-3.54）；在社区中，HR 为 2.22（95%置信区间 1.60-3.07）。基于不同的小腿围截断值的其他亚组分析表明，与小腿围正常的个体相比，使用亚洲肌少症工作组（AWGS）标准（男性≤34cm，女性≤33cm）时，小腿围小的参与者死亡风险增加（HR=2.66，95%置信区间 2.06-3.43）。当使用 Mini Nutritional Assessment（MNA）标准（≤31cm）时，也得到了类似的结果，HR 为 2.11（95%置信区间 1.59-2.81）。
小腿围简便易行，可用于分层高危人群，因为小腿围小与患者死亡率显著相关。一旦发现小腿围小，可立即进行包括运动和营养计划在内的干预措施。
