Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital and School of Medicine, National Defense Medical Center, Taipei, Taiwan 11490, Republic of China.
Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital and School of Medicine, National Defense Medical Center, Taipei, Taiwan 11490, Republic of China.
Age Ageing. 2022 Feb 2;51(2). doi: 10.1093/ageing/afab239.
Recommendations in current guidelines on the use of calf circumference (CC) as a diagnostic measure in sarcopenia is conflicting. In this study, we incorporated CC into conventional models of sarcopenia and compared their predictive scores on mortality.
To clarify the predictive capacity of CC-added models of sarcopenia on and establish the correlation of CC with mortality risk.
DESIGN, SETTING AND SUBJECTS: From the National Health and Nutrition Examination Survey 1999-2002, 2,532 participants aged 50-85 and comprising 51.7% male were included.
Our definitions contained four sarcopenic components, low CC (C), low muscle strength (S), low muscle mass (M) and low gait speed (G). Cox proportional hazard models and the receiver-operator characteristic curves for all-cause, cardiovascular (CV) and cancer mortality were conducted to compare the different sarcopenia definitions.
For all-cause mortality, the hazard ratio (HR) of C + S + M + G was 15.062, which was substantially higher than the conventional definition S + M + G (HR = 6.433). Other CC-added definitions such as C + M (HR = 2.260), C + G (HR = 4.978), C + S + M (HR = 5.761) also revealed higher HR than their without-CC counterparts. Similar patterns were observed in CV mortality, for instance, HR of C + S + M + G was 31.812 comparing to the conventional definition S + M + G (HR = 18.434). Concerning accuracy in predicting mortality, the area under the curve (AUC) of CC + S + G + M (AUC = 0.702) and C + S + G (AUC = 0.708) were higher than the conventional definition S + G + M (AUC = 0.697). A significant correlation was found between CC and each of the three conventional components of sarcopenia.
CC-added definitions of sarcopenia correlated with higher all-cause and CV mortality risks. CC is potentially a simple but valuable screening tool for sarcopenia that could improve diagnostic accuracy when used with other parameters.
目前关于使用小腿围（CC）作为肌少症诊断指标的指南推荐存在矛盾。在这项研究中，我们将 CC 纳入传统的肌少症模型，并比较了它们对死亡率的预测评分。
阐明 CC 增加的肌少症模型对死亡率的预测能力，并确定 CC 与死亡率风险的相关性。
设计、地点和受试者：本研究纳入了 1999-2002 年全国健康与营养调查（NHANES）中年龄在 50-85 岁、男性占 51.7%的 2532 名参与者。
我们的定义包含四个肌少症成分，即低 CC（C）、低肌肉力量（S）、低肌肉量（M）和低步态速度（G）。使用 Cox 比例风险模型和受试者工作特征曲线（ROC）比较了全因、心血管（CV）和癌症死亡率的不同肌少症定义。
在全因死亡率方面，C+S+M+G 的风险比（HR）为 15.062，明显高于传统定义 S+M+G（HR=6.433）。其他 CC 增加的定义，如 C+M（HR=2.260）、C+G（HR=4.978）、C+S+M（HR=5.761），其 HR 也高于无 CC 对应的定义。在 CV 死亡率方面也观察到了类似的模式，例如，C+S+M+G 的 HR 为 31.812，明显高于传统定义 S+M+G（HR=18.434）。在预测死亡率的准确性方面，CC+S+G+M（AUC=0.702）和 C+S+G（AUC=0.708）的曲线下面积（AUC）高于传统定义 S+G+M（AUC=0.697）。CC 与肌少症的三个传统成分均呈显著相关。
CC 增加的肌少症定义与全因和 CV 死亡率风险增加相关。CC 可能是一种简单但有价值的肌少症筛查工具，与其他参数结合使用时可提高诊断准确性。
