Güner Merve, Öztürk Yelda, Ceylan Serdar, Okyar Baş Arzu, Koca Meltem, Balci Cafer, Doğu Burcu Balam, Cankurtaran Mustafa, Halil Meltem Gülhan
Ministry of Health of Republic of Türkiye, Erzurum City Hospital, Erzurum, Turkey.
Division of Geriatric Medicine, Faculty of Medicine, Hacettepe University, Antalya, Turkey.
Eur Geriatr Med. 2024 Oct;15(5):1469-1475. doi: 10.1007/s41999-024-01024-8. Epub 2024 Aug 5.
Proponents argue that a high waist-to-calf ratio (WCR) may indicate an imbalance between muscle and fat in the body, making it a potential predictor for sarcopenic obesity (SO). The WCR is a new index incorporating both measurements, providing a reliable approach for assessing the imbalance between abdominal fat and leg muscle mass. The present study aimed to examine the association of WCR with SO and reveal the predictive effect of SO in community-dwelling older adults.
The study population was composed of 234 geriatric outpatients with obesity. WCR was calculated by dividing the waist circumference (in cm) by the calf circumference (in cm). SO was defined according to the ESPEN and EASO Consensus Statement.
The mean age was 72.7 ± 5.8 years, and 78.7% (n = 175) were female. Eighty-one patients (34.6%) were considered as sarcopenic obese. The WCR was 3.04 [Interquartile range (IQR), 2.88-3.32] in the sarcopenic obese group, and in the nonsarcopenic obese group, it was 2.82 [IQR, 2.7-3.0] (p < 0.001). Independent of age, sex, nutritional and frailty status WCR was associated with SO (OR 12.7, 95% CI 4.0-40.1 and p < 0.001). The cut-off value of WCR for SO was calculated as 2.94 with 72.8% sensitivity and 67.3% specificity (Area Under Curve: 0.72 and Positive likelihood ratio: 2.23, p < 0.001).
WCR, a simple and accessible method, indicates promise as a possible and potential diagnostic tool for SO in community-dwelling older adults.
支持者认为，高腰小腿比（WCR）可能表明身体肌肉与脂肪之间的失衡，使其成为肌肉减少性肥胖（SO）的潜在预测指标。WCR是一个综合了这两项测量值的新指标，为评估腹部脂肪与腿部肌肉量之间的失衡提供了一种可靠的方法。本研究旨在探讨WCR与SO之间的关联，并揭示SO在社区居住的老年人中的预测作用。
研究人群由234名老年肥胖门诊患者组成。WCR通过腰围（以厘米为单位）除以小腿围（以厘米为单位）计算得出。SO根据欧洲临床营养与代谢学会（ESPEN）和欧洲肥胖研究学会（EASO）的共识声明进行定义。
平均年龄为72.7±5.8岁，78.7%（n = 175）为女性。81名患者（34.6%）被认为是肌肉减少性肥胖。肌肉减少性肥胖组的WCR为3.04[四分位数间距（IQR），2.88 - 3.32]，非肌肉减少性肥胖组为2.82[IQR，2.7 - 3.0]（p < 0.001）。独立于年龄、性别、营养和虚弱状态，WCR与SO相关（比值比12.7，95%置信区间4.0 - 40.1，p < 0.001）。SO的WCR截断值计算为2.94，敏感性为72.8%，特异性为67.3%（曲线下面积：0.72，阳性似然比：2.23，p < 0.001）。
WCR作为一种简单易行的方法，有望成为社区居住老年人中SO的一种可能且潜在的诊断工具。
