Endocrinology and Nutrition Department, Clinical Universitary Hospital of Valladolid, 47003 Valladolid, Spain.
Investigation Centre Endocrinology and Nutrition, Faculty of Medicine, University of Valladolid, 47003 Valladolid, Spain.
Nutrients. 2024 May 21;16(11):1552. doi: 10.3390/nu16111552.
A nationwide, prospective, multicenter, cohort study (the Disease-Related caloric-protein malnutrition EChOgraphy (DRECO) study) was designed to assess the usefulness of ultrasound of the rectus femoris for detecting sarcopenia in hospitalized patients at risk of malnutrition and to define cut-off values of ultrasound measures.
Patients at risk of malnutrition according to the Malnutrition Universal Screening Tool (MUST) underwent handgrip dynamometry, bioelectrical impedance analysis (BIA), a Timed Up and Go (TUG) test, and rectus femoris ultrasound studies. European Working Group on Sarcopenia in Older People (EWGSOP2) criteria were used to define categories of sarcopenia (at risk, probable, confirmed, severe). Receiver operating characteristic (ROC) and area under the curve (AUC) analyses were used to determine the optimal diagnostic sensitivity, specificity, and predictive values of cut-off points of the ultrasound measures for the detection of risk of sarcopenia and probable, confirmed, and severe sarcopenia.
A total of 1000 subjects were included and 991 of them (58.9% men, mean age 58.5 years) were evaluated. Risk of sarcopenia was detected in 9.6% patients, probable sarcopenia in 14%, confirmed sarcopenia in 9.7%, and severe sarcopenia in 3.9%, with significant differences in the distribution of groups between men and women ( < 0.0001). The cross-sectional area (CSA) of the rectus femoris showed a significantly positive correlation with body cell mass of BIA and handgrip strength, and a significant negative correlation with TUG. Cut-off values were similar within each category of sarcopenia, ranging between 2.40 cm and 3.66 cm for CSA, 32.57 mm and 40.21 mm for the -axis, and 7.85 mm and 10.4 mm for the -axis. In general, these cut-off values showed high sensitivities, particularly for the categories of confirmed and severe sarcopenia, with male patients also showing better sensitivities than women.
Sarcopenia in hospitalized patients at risk of malnutrition was high. Cut-off values for the better sensitivities and specificities of ultrasound measures of the rectus femoris are established. The use of ultrasound of the rectus femoris could be used for the prediction of sarcopenia and be useful to integrate nutritional study into real clinical practice.
一项全国性、前瞻性、多中心队列研究（疾病相关能量-蛋白质营养不良超声研究（DRECO））旨在评估股直肌超声检测营养不良风险住院患者肌少症的有用性，并确定超声测量的截断值。
根据营养不良普遍筛查工具（MUST），对有营养不良风险的患者进行握力测试、生物电阻抗分析（BIA）、计时起立行走测试（TUG）和股直肌超声研究。采用欧洲老年人肌少症工作组（EWGSOP2）标准定义肌少症类别（有风险、可能、确诊、严重）。采用受试者工作特征（ROC）和曲线下面积（AUC）分析确定超声测量截断值检测肌少症风险和可能、确诊和严重肌少症的最佳诊断灵敏度、特异性和预测值。
共纳入 1000 例患者，其中 991 例（58.9%为男性，平均年龄 58.5 岁）进行了评估。9.6%的患者存在肌少症风险，14%的患者存在可能的肌少症，9.7%的患者存在确诊的肌少症，3.9%的患者存在严重的肌少症，男女之间各分组分布差异有统计学意义（<0.0001）。股直肌横截面积（CSA）与 BIA 身体细胞质量和握力呈显著正相关，与 TUG 呈显著负相关。各肌少症类别内的截断值相似，CSA 为 2.40cm 至 3.66cm，-轴为 32.57mm 至 40.21mm，-轴为 7.85mm 至 10.4mm。总体而言，这些截断值的灵敏度较高，特别是对确诊和严重肌少症的类别，男性患者的灵敏度也高于女性。
营养不良风险住院患者肌少症患病率较高。建立了股直肌超声测量的更好灵敏度和特异性的截断值。股直肌超声的使用可用于预测肌少症，并有助于将营养研究整合到实际临床实践中。
