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Background: Sarcopenia is an aging-related disorder characterized by a loss of muscle mass and function. Calf circumference (CC) is a useful surrogate marker of muscle mass and function. This prospective study was designed to investigate the association between CC and all-cause mortality during a follow-up for 5 years in the Chinese centenarians. Methods: The China Hainan Centenarian Cohort Study (CHCCS) is conducted in 18 cities and counties of Hainan, China. Results: All 231 centenarians had a mean age of 103.03 years. Survival participants had a longer CC and were often living alone compared with others (P<0.05 for all). Multivariate Cox regression models showed that CC was negatively associated with all-cause mortality (P < 0.05 for all). Participants with a longer CC had a lower mortality risk compared with others [Exp(β): 0.918; 95%confidence interval: 0.863–0.977]. Participants with a longer CC had a lower mortality risk whether they were males or females and lived with family members or alone. Conclusion: CC was negatively associated with all-cause mortality and could be an indicator of future mortality among the Chinese centenarians. Further researches should focus on preventing a decline in the CC in order to promote human longevity. [ABSTRACT FROM AUTHOR]

Background: Among the anthropometric measurements, calf circumference has been widely used as a simple and practical method to diagnose low muscle mass and sarcopenia. However, the association between this measurement and clinical outcomes in people receiving home enteral nutrition is still unknown. Therefore, this study aimed to investigate the association of calf circumference with mortality, discharge from home enteral nutrition, continuity in home enteral nutrition, and new hospitalizations in adult and older adult people. Methods: This retrospective cohort study used secondary data, including people aged ≥18 years receiving home enteral nutrition. The association between calf circumference and the outcomes of mortality, discharge from home enteral nutrition, and continuity in home enteral nutrition was analyzed using multinomial logistic regression. The association between calf circumference and the occurrence of new hospitalizations was investigated using binary logistic regression. Results: Among the 899 people included in the study, 470 were men (52.3%), the median age was 72 years (interquartile range, 56.5–82), and 850 had inadequate calf circumference (94.5%). As calf circumference increased, the odds of mortality decreased and the probability of discharge from home enteral nutrition and continuity in home enteral nutrition increased. Furthermore, in people with oncologic diagnoses, the odds of new hospitalizations were reduced by 71.9% for each additional centimeter in calf circumference. Conclusion: These findings underline the importance of using calf circumference as part of the nutrition assessment because it is a simple, easy, and cost‐effective method that can also be used as a tool to predict clinical outcomes. [ABSTRACT FROM AUTHOR]

Background: Malnutrition and sarcopenia significantly increase the risk of intra-hospital delirium, particularly among older adults. Given the potential correlation between calf circumference (CC) and these conditions, CC emerges as a promising predisposing factor for delirium. This study aims to investigate the independent association between delirium and anthropometric parameters, focusing on evaluating CC's predictive capacity for intra-hospital delirium risk. Additionally, it aims to compare CC's predictive performance with the widely used Mini Nutritional Assessment (MNA), while also considering potential gender disparities. Methods: This is a retrospective study which enrolled patients aged ≥ 65 years from September 2021 to March 2022 at the Padova Hospital (Italy). Physical characteristics, intra-hospital delirium incidence, and body composition were assessed. Sarcopenia was diagnosed using the 2019 European Consensus criteria. Results: Among 207 subjects, delirium affected 19% of patients. CC showed a significant association with intra-hospital delirium among the analyzed anthropometric parameters. ROC curves indicated that CC's predictive capacity for delirium onset was comparable to MNA (p = 0.98), particularly in women. In a multivariable logistic regression model, female gender and higher cognitive and CC scores emerged as protective factors against delirium onset, with each unit increase in CC associated with a 24% reduction in the odds of delirium. Conversely, sarcopenia did not significantly influence delirium onset. Conclusions: CC shows promise as a predisposing factor for intra-hospital delirium, similar to MNA, albeit with significant gender differences. CC could serve as a valuable tool for assessing delirium risk among female patients. Further validation of these findings is necessary through larger-scale studies. [ABSTRACT FROM AUTHOR]

Background/Objectives: Hand grip strength (HGS) is a crucial measure for evaluating muscle function and general physical ability, and it may be associated with several diseases. Previous studies have demonstrated inconsistent associations between anthropometric measurement and body composition with HGS. This study aims to investigate the association between anthropometric measurement and body composition with HGS in the elderly population residing in Indonesia. Methods: This is a cross-sectional study on older adults aged between 60 and 82 years who live in the community. Anthropometric parameters assessed in this study comprised the body mass index (BMI), mid-upper arm circumference (MUAC), calf circumference (CC), and waist circumference (WC). Subsequently, body composition measurements, including fat mass (FM), fat-free mass (FFM), muscle mass (MM), skeletal muscle mass (SMM), and the appendicular skeletal mass index (ASMI), were assessed using a body composition analyzer. Last, the measurement of HGS was conducted using a hand dynamometer. Results: A total of 109 participants were involved in this study. Our study demonstrates a significant association between anthropometric parameters, namely CC and HGS. Subsequently, several body composition parameters, including FFM, SMM, ASMI, and MM in the four extremities, are also significantly associated with HGS. However, in a multivariate analysis, only CC and FFM were able to significantly predict HGS. Conclusions: Improving CC and maintaining FFM may enhance muscle strength in older adults. This suggests that targeted exercise and nutrition programs could increase muscle mass and strength, thereby mitigating age-related decline and improving quality of life. [ABSTRACT FROM AUTHOR]

Background: Calf circumference is currently recommended as a case-finding marker for sarcopenia, but its usefulness has not been determined in chronic pain conditions. Therefore, the present study aimed to evaluate the predictive performance of calf circumference in diagnosing sarcopenia in older patients with chronic low back pain. Methods: Ambulatory adult patients aged ≥ 65 years with chronic low back pain were enrolled. A diagnosis of sarcopenia was established based on the criteria outlined by the Asian Working Group for Sarcopenia in 2019. Patient demographics, pain-related factors, clinical factors, and sarcopenia-related measurements were compared between non-sarcopenic and sarcopenic patients. Linear regression analysis was used to evaluate the correlation of calf circumference with muscle mass, strength, and physical performance. Also, a receiver operating characteristic curve analysis for calf circumference in predicting sarcopenia was conducted; and area under the curve (AUC) values, along with their corresponding 95% confidence intervals (CI), were calculated. Results: Data from 592 patients were included in the analysis. Eighty-five patients were diagnosed with sarcopenia (14.3%), 71 of whom had severe sarcopenia (11.9%). A higher prevalence of sarcopenia was observed in female patients (9.0% vs. 16.7%, p = 0.016). After adjusting for age, BMI, and comorbidities, calf circumference correlated positively with muscle mass but not with muscle strength and physical performance. The AUC values for sarcopenia were 0.754 (95% CI = 0.636–0.871, p = 0.001) in males and 0.721 (95% CI = 0.657–0.786, p < 0.001) in females. The cut-offs for calf circumference in predicting sarcopenia were 34 cm (sensitivity 67.1%, specificity 70.6%) in males, and 31 cm (sensitivity 82.5%, specificity 51.5%) in females. Conclusions: Even though sex differences in its predictive value for sarcopenia should be considered, our findings suggest that calf circumference can be used as an indicator for predicting muscle mass and may serve as a potential marker for identifying sarcopenia in older patients with chronic low back pain. [ABSTRACT FROM AUTHOR]

Introduction-Birth weight is the single most important indicator of survival, growth and overall development of the child. New-borns with less than 2.5 kg birth weight are termed as low birth weight (LBW). Approximately 28% babies in India are LBW. LBW is associated with high neonatal morbidity and mortality. Early diagnosis of LBW and apt intervention can lead to favourable outcome. 70-80% of births take place either at home or at peripheral hospitals. Measuring birth weight is difficult in India due to resource limited set up. There is a need of alternative methods to detect LBW which should be simple, handy, quick and cost effective. Hence, we decided to do study of correlation of calf muscle circumference and chest circumference with birth weight to determine LBW in new-borns. Aims-To study calf circumference and chest circumference in diagnosing low birth weight babies. Objective1)To correlate above-said anthropometric parameters with birth weight 2) To decide indicator with better correlation with birth weight amongst calf circumference and chest circumference Material & Method: Its a cross sectional study conducted in tertiary care centre in North Maharashtra. 162 New-borns (34- 42 weeks gestation) were included in Study. Birth weight, calf circumference and chest circumference were measured with appropriate scientific method. Results are analyzed with SPSS software & Microsoft excel. Results-Cut-off value to detect LBW is 9.2 cm and 26cm for calf circumference and chest circumference respectively. Calf circumference had better correlation (r=0.85) as compared to chest circumference (r=0.58). Chest circumference has 92.2% sensitivity & 68.1% specificity as compare to Chest circumference which has 80.9% sensitivity & 59.6%.specificity respectively. Conclusion: Chest circumference and calf circumference can be used to determine LBW, though larger study with more number of patients is needed to establish precise correlation. [ABSTRACT FROM AUTHOR]

Abstract Background Malnutrition and sarcopenia significantly increase the risk of intra-hospital delirium, particularly among older adults. Given the potential correlation between calf circumference (CC) and these conditions, CC emerges as a promising predisposing factor for delirium. This study aims to investigate the independent association between delirium and anthropometric parameters, focusing on evaluating CC’s predictive capacity for intra-hospital delirium risk. Additionally, it aims to compare CC’s predictive performance with the widely used Mini Nutritional Assessment (MNA), while also considering potential gender disparities. Methods This is a retrospective study which enrolled patients aged ≥ 65 years from September 2021 to March 2022 at the Padova Hospital (Italy). Physical characteristics, intra-hospital delirium incidence, and body composition were assessed. Sarcopenia was diagnosed using the 2019 European Consensus criteria. Results Among 207 subjects, delirium affected 19% of patients. CC showed a significant association with intra-hospital delirium among the analyzed anthropometric parameters. ROC curves indicated that CC’s predictive capacity for delirium onset was comparable to MNA (p = 0.98), particularly in women. In a multivariable logistic regression model, female gender and higher cognitive and CC scores emerged as protective factors against delirium onset, with each unit increase in CC associated with a 24% reduction in the odds of delirium. Conversely, sarcopenia did not significantly influence delirium onset. Conclusions CC shows promise as a predisposing factor for intra-hospital delirium, similar to MNA, albeit with significant gender differences. CC could serve as a valuable tool for assessing delirium risk among female patients. Further validation of these findings is necessary through larger-scale studies.

Abstract Background Calf circumference is currently recommended as a case-finding marker for sarcopenia, but its usefulness has not been determined in chronic pain conditions. Therefore, the present study aimed to evaluate the predictive performance of calf circumference in diagnosing sarcopenia in older patients with chronic low back pain. Methods Ambulatory adult patients aged ≥ 65 years with chronic low back pain were enrolled. A diagnosis of sarcopenia was established based on the criteria outlined by the Asian Working Group for Sarcopenia in 2019. Patient demographics, pain-related factors, clinical factors, and sarcopenia-related measurements were compared between non-sarcopenic and sarcopenic patients. Linear regression analysis was used to evaluate the correlation of calf circumference with muscle mass, strength, and physical performance. Also, a receiver operating characteristic curve analysis for calf circumference in predicting sarcopenia was conducted; and area under the curve (AUC) values, along with their corresponding 95% confidence intervals (CI), were calculated. Results Data from 592 patients were included in the analysis. Eighty-five patients were diagnosed with sarcopenia (14.3%), 71 of whom had severe sarcopenia (11.9%). A higher prevalence of sarcopenia was observed in female patients (9.0% vs. 16.7%, p = 0.016). After adjusting for age, BMI, and comorbidities, calf circumference correlated positively with muscle mass but not with muscle strength and physical performance. The AUC values for sarcopenia were 0.754 (95% CI = 0.636–0.871, p = 0.001) in males and 0.721 (95% CI = 0.657–0.786, p

Background As a common geriatric chronic disease, sarcopenia has a high prevalence in patients with coronary heart disease (CHD), which increases the risk of adverse events such as falls and fractures, calf circumference, upper arm circumference, and Ishii score have been shown to be valuable in screening for sarcopenia, but are less commonly used in CHD patients. Objective To evaluate the accuracy and consistency of calf circumference, upper arm circumference, and Ishii score in screening for combined sarcopenia in hospitalized elderly patients with CHD. Methods A total of 213 CHD patients treated at the Department of Cardiology, Affiliated Hospital of North Sichuan Medical College from January 1, 2023 to May 31, 2023, were selected for the study, the body composition test instrument was used to detect indicators such as muscle mass and upper arm circumference, the measurement of calf circumference was performed, and Ishii score was calculated simultaneously. Spearman's rank correlation analysis was used to explore the correlation of upper arm circumference, calf circumference and Ishii score with indicators such as muscle mass, the diagnostic effect of upper arm circumference, calf circumference and Ishii score on sarcopenia in different people was analyzed by plotting receiver operating characteristic (ROC) curves, and the optimal diagnostic cut-off values were determined, which were calculated as Kappa values to determine the consistency of the upper arm circumference, calf circumference and Ishii score with the diagnostic criteria of sarcopenia according to the Chinese Expert Consensus (2023) Criteria for the Prevention and Treatment of Sarcopenia in the elderly. Results The prevalence of combined sarcopenia in CHD patients was 27.2% (58/213). In the whole population, upper arm circumference and calf circumference was positively correlated with appendicular skeletal muscle mass, appendicular skeletal muscle mass index, and grip strength (P

Mengli Li,1,&ast; Tongtong Yin,1,&ast; Jiaying Qi,1 Minhao Shi,1 Fangfang Wang,1 Zhiyu Mao,1 Hui Zhang,1,2 Li Wang1 1School of Nursing, Suzhou Medical College of Soochow University, Suzhou, Jiangsu, People’s Republic of China; 2School of Nursing, Suzhou Vocational Health College, Suzhou, Jiangsu, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Li Wang; Hui Zhang, Email li-wang-1@suda.edu.cn; zhanghuichange@sina.comObjective: To explore the cut-off values and health evaluations of upper arm circumference (AC) and calf circumference (CC) on sarcopenia in Chinese community-dwelling older people.Methods: In this cross-sectional study, AC, CC, handgrip strength, muscle mass and gait speed were measured in 1537 Chinese community-dwelling older people in Sub-study 1. Correlation analysis, receiver operator characteristic curve (ROC curve) analysis, and consistency analysis were used for determination of AC and CC cut-off values for sarcopenia diagnosis (sarcopenia-AC and CC). Thereafter, 269 participants accepted additional assessments on physical function, body composition and muscle strength in Sub-study 2. T-test or Mann-Whitney U-test was used to explore the differential effects of sarcopenia-AC and CC on health indicators between sarcopenic and non-sarcopenic participants.Results: In Sub-study 1, the Area Under ROC (AUC) of AC and CC for sarcopenia screening were greater than 0.700 (P< 0.05). The cut-off values, sensitivity and specificity of AC and CC on sarcopenia in males were 25.9 cm (86.0%, 83.6%) and 33.7 cm (90.7%, 81.4%) whereas in females were 26.5 cm (70.8%, 69.7%) and 33.0 cm (86.5%, 69.4%), respectively. In Sub-study 2, the participants with sarcopenia-AC or sarcopenia-CC showed lower muscle strength and lower fat and muscle mass than the ones without (P< 0.05). Additionally, males instead of females with sarcopenia-AC or sarcopenia-CC showed worse performance in time-up and go test and 6-Minute Walk Test (P< 0.05). However, the 30-second chair stand test was not different between participants with and without sarcopenia-AC or sarcopenia-CC in both sexes.Conclusion: We found accurate and Chinese population targeted cut-off values of AC and CC on sarcopenia diagnosis (25.9 cm and 33.7 cm in males; 26.5 cm and 33.0 cm in females) and a good evaluation effect of AC and CC on fat and muscle mass, muscle strength and physical functions in males, not females.Keywords: sarcopenia, upper arm circumference, calf circumference, health assessment

Objective: this study aimed to explore the agreements between the Global Leadership Initiative on Malnutrition (GLIM) using left calf circumference (CC) as criterion for reduced muscle mass and the Patient-Generated Subjective Global Assessment (PG-SGA), or GLIM using appendicular skeletal muscle index (ASMI) for the diagnosis of malnutrition in gastric cancer patients. Methods: the Nutritional Risk Screening 2002 (NRS 2002) was used as nutritional risk screening. PG-SGA and GLIM were applied for malnutrition diagnosis. Agreements were evaluated by Kappa, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy, and area under the curve (AUC). Results: a total of 405 gastric cancer patients were included. The values of Kappa, sensitivity, specificity, PPV, NPV, accuracy and AUC were 0.463, 67.9 %, 87.3 %, 92.9 %, 52.8 %, 73.6 % and 0.776, and 0.496, 76.7 %, 78.0 %, 89.4 %, 57.9 %,77.0 % and 0.773, respectively, between GLIM using CC with or without NRS 2002 and PG-SGA. All values of agreement were higher than 0.800 or 80.0 % between GLIM using left CC and GLIM using ASMI. Conclusion: the agreements were both acceptable between GLIM using left CC and PG-SGA, and GLIM using ASMI. Left calf circumference can be one of the credible references indicating a reduced muscle mass in patients with gastric cancer. [ABSTRACT FROM AUTHOR]

Sarcopenia, characterized by progressive muscle loss and functional decline, poses significant risks, including falls, impaired daily activities, and increased mortality. We developed Allgeun, a novel device that measures handgrip strength, muscle mass, and physical performance. This study aimed to investigate whether temporal muscle thickness (TMT) could be used as a sarcopenia marker and to evaluate the usability of Allgeun. This prospective study enrolled 28 participants without medical or neurological disorders. They underwent three-dimensional T1-weighted imaging using a 3 Tesla magnetic resonance imaging scanner. TMT was measured based on T1-weighted images by a board-certified neuroradiologist. Allgeun was used to measure the following three key components of sarcopenia: muscle strength (handgrip strength), muscle mass (calf and thigh circumference), and physical performance (five times the chair stand test). Correlation analysis was conducted between TMT and the results of the handgrip strength, calf and thigh circumferences, and chair stand tests. There were moderate positive correlations between TMT and calf circumference (r = 0.413, p = 0.029), thigh circumference (r = 0.486, p = 0.008), and handgrip strength (r = 0.444, p = 0.018). However, no significant correlation was observed between TMT and physical performance (r = −0.000, p = 0.998). Our findings underscore TMT's potential as an indicator of sarcopenia, particularly regarding muscle mass and strength. Additionally, we demonstrated that the new device, Allgeun, is useful for screening and diagnosing the severity of sarcopenia. [ABSTRACT FROM AUTHOR]

Background: COVID-19 is an infectious disease characterized by a severe catabolic and inflammatory state, leading to loss of muscle mass. The assessment of muscle mass can be useful to identify nutritional risk and assist in early management, especially in older adults who have high nutritional risks. The aim of this study was to evaluate the association of calf circumference (CC) with clinical and biochemical markers and mortality in older adults with COVID-19 admitted to the intensive care unit (ICU). Methods: A retrospective cross-sectional study was conducted in a public hospital. CC was adjusted for body mass index (BMI), reducing 3, 7, or 12 cm for a BMI of 25–29.9, 30–39.9, and ≥40 kg/m2, respectively, and classified as reduced when <33 cm for women and <34 cm for men. Pearson's correlation between BMI and CC was performed to assess the association between variables. Regression analysis was adjusted for sex, age, and BMI variables. Cox regression was used to assess survival related to CC. Results: A total of 208 older adults diagnosed with COVID-19 admitted to ICU were included, of which 84% (n = 176) were classified as having reduced CC. These patients were older, with lower BMI, higher nutritional risk, malnourished, and higher concentration of urea and urea–creatinine ratio (UCR) compared with the group with normal CC. There was an association between edematous patients at nutritional risk and malnourished with reduced CC in the Cox regression, either adjusted or not for confounding. Conclusions: CC was not associated with severity, biochemical markers, or mortality in older adults with COVID-19 admitted to the ICU, but it was associated with moderately malnourished patients assessed by subjective global assessment (SGA). [ABSTRACT FROM AUTHOR]

Background: An age-dependent normative values of calf circumference (CC) has been recently proposed as an accessible proxy for muscle mass. However, its usefulness to estimate sarcopenia has not been assessed. The objectives of the present study were to determine if the substitution of the classical way to assess muscle mass by these values have enough diagnostic accuracy and prognostic value among older adults living in the community. Methods: Data from the Toledo Study of Healthy Ageing (TSHA) were used. CC was measured using an anthropometric tape. We used two age-groups CC cut-off points: the TSHA CC median and the one proposed in the Longevity Check-up 7+ (Lookup 7+) project. Sarcopenia was defined based on the European Working Group on Sarcopenia in Older People (EWGSOP2), the Foundation for the National Institutes of Health (FNIH), and FNIH criteria standardized for our population (sFNIH). Frailty (according to the Frailty Phenotype and the Frailty Trait Scale-5) and disability (Katz index) were assessed at baseline and follow-up. Mortality and first hospitalization were also recorded. Logistic (incident frailty and worsening disability) and Cox (mortality and hospitalization) regressions were performed. Diagnostic accuracy was assessed through Kappa index, AUCs, positive and negative predictive values. Predictive ability was assessed through AUCs and integrated AUCs (IAUCs). Results: 1531 participants (74.8 ± 5.8 years; 45.6% men) were included in the analysis. Prevalence rates of sarcopenia were 22.7% (sFNIH), 15.0% (FNIH), and 13.9% (EWGSOP2). Using TSHA-based cut-points of CC, the prevalence of sarcopenia was 16.8% (sFNIH), 11.0% (FNIH), and 11.5% (EWGSOP2). According to LC7+-based CC cut-off points, sarcopenia prevalence was 17.6% (sFNIH), 11.9% (FNIH), and 12.4% (EWGSOP2). CC cut-off points showed low-to-moderate agreement (Kappa Index values between 0.49 and 0.69) with appendicular lean mass for the evaluation of sarcopenia. Sarcopenia identified by Lookup 7+ and TSHA CC cut-off points was associated with the adverse events examined, with similar AUCs and IAUCs than original sarcopenia definitions, and were lost after adjustment by baseline frailty, except when the original EWGSOP2 definition was used. Conclusions: Using normalized values of CC as a criteria of muscle mass shows moderate agreement with classical criteria for diagnosing sarcopenia and offer similar predictive value in community-dwelling older adults.

BackgroundSarcopenia, characterized by muscle mass, strength, and performance decline, significantly impacts outcomes in older adults. This study aims to assess the predictive value of calf circumference (CC), in conjunction with SARC-F and hand grip, concerning in-hospital complications and post-discharge mortality among hospitalized frail older adults.MethodsA cohort of 158 hospitalized patients aged over 65 years underwent Comprehensive Geriatric Assessment and sarcopenia screening, including CC measurement. Multivariable regression analyses, adjusted for confounders, were conducted to assess predictive associations.ResultsThe study cohort, comprising 53% males with a median age of 86 years, exhibited significant sarcopenia prevalence based on SARC-F (85% indicating sarcopenia), hand grip strength (probable sarcopenia in 77% of males and 72% of females), and CC (sarcopenia in 83%). Multivariate analysis, adjusting for age, sex, Clinical Frailty Scale (CFS), and Mini Nutritional Assessment-Short Form (MNA-SF), demonstrated associations of CC and SARC-F with in-hospital complications, while CC also showed a significant association with reduced risks of in-hospital mortality (OR 0.441, 95% CI 0.257 to 0.754, p = 0.003) and 90-day mortality (OR 0.714, 95% CI 0.516 to 0.988, p = 0.043).ConclusionThis study provides insights into the predictive accuracy of sarcopenia screening tools on mortality in real-world hospitalized older adults with frailty. Notably, CC emerges as a robust predictor of mortality outcomes. Further research is warranted to validate and elucidate the respective contributions of CC and frailty to mortality in vulnerable populations.

This prospective, observational, multicenter study assessed the tolerance of Dobenox Forte®, the first approved over-the-counter product containing calcium dobesilate, in 1795 outpatients with chronic venous disease (CVD) in daily clinical practice. In addition, the effectiveness (decrease in circumferences of a more affected limb at the ankle and middle part of the calf, and changes in the severity of CVD signs) was assessed. No adverse events related to use of the preparation were reported in a period of 64 ± 20 days. Dobenox Forte® use was associated with a reduction in calf circumference by 13.1 mm (95%CI: 12.2–14.1) and in ankle circumference by 9.7 mm (95%CI: 9.2–11.0) in patients reporting swelling of the lower legs (60.0% of the cohort). A reduction in calf and ankle circumference by at least 1 cm was achieved in 34.9% and 24.9% of patients, respectively. The percentages of patients reporting moderate to very severe lower limb heaviness decreased from 96.6% to 56.0%, calf cramps decreased from 91.0% to 41.0%, calf pain decreased from 89.2% to 43.7%, swelling decreased from 86.1% to 38.8%, and burning sensation that worsens when standing decreased from 79.0% to 33.7%. The medicinal product Dobenox Forte® is well tolerated by patients and seems to effectively reduce the symptoms of CVD. [ABSTRACT FROM AUTHOR]

Background: Despite its correlation with skeletal muscle mass and its predictive value for adverse outcomes in clinical settings, calf circumference is a metric underexplored in intensive care. We aimed to determine whether adjusting low calf circumference for adiposity provides prognostic value superior to its unadjusted measurement for intensive care unit (ICU) mortality and other clinical outcomes in critically ill patients. Methods: In a secondary analysis of a cohort study across five ICUs, we assessed critically ill patients within 24 h of ICU admission. We adjusted calf circumference for body mass index (BMI) (25–29.9, 30–39.9, and ≥40) by subtracting 3, 7, or 12 cm from it, respectively. Values ≤34 cm for men and ≤33 cm for women identified low calf circumference. Results: We analyzed 325 patients. In the primary risk‐adjusted analysis, the ICU death risk was similar between the low and preserved calf circumference (BMI‐adjusted) groups (hazard ratio, 0.90; 95% CI, 0.47–1.73). Low calf circumference (unadjusted) increased the odds of ICU readmission 2.91 times (95% CI, 1.40–6.05). Every 1‐cm increase in calf circumference as a continuous variable reduced ICU readmission odds by 12%. Calf circumference showed no significant association with other clinical outcomes. Conclusion: BMI‐adjusted calf circumference did not exhibit independent associations with ICU and in‐hospital death, nor with ICU and in‐hospital length of stay, compared with its unadjusted measurement. However, low calf circumference (unadjusted and BMI‐adjusted) was independently associated with ICU readmission, mainly when analyzed as a continuous variable. [ABSTRACT FROM AUTHOR]

Aim: SARC‐F is limited by low sensitivity for sarcopenia identification. As surrogates of muscle mass, mid‐arm circumference (MAC) and/or calf circumference have been proposed as additions to SARC‐F to enhance sarcopenia identification. The aim of this study was to evaluate the diagnostic performance of SARC‐F, SARC‐CalF, SARC‐F + MAC, and SARC‐CalF + MAC in sarcopenia detection, and to assess the impact of obesity on their diagnostic performance. Methods: We studied 230 healthy non‐frail community‐dwelling older adults age >50 years. We performed receiver operating characteristic curve analysis for SARC‐F, SARC‐CalF, SARC‐F + MAC and SARC‐CalF + MAC against sarcopenia diagnosed by the Asian Working Group for Sarcopenia (AWGS) 2019 as the reference standard. Obesity was defined by high waist circumference (men ≥90 cm, women ≥80 cm). We performed subgroup analysis to compare between obese and non‐obese groups. Results: The prevalence of sarcopenia was 27.0% by AWGS 2019. SARC‐CalF + MAC had the best diagnostic performance (area under the curve [AUC] 0.74, 95% confidence interval [CI] 0.67–0.81; sensitivity 66.1%; specificity 69.1%), followed by SARC‐CalF (AUC 0.70, 95% CI 0.62–0.78; sensitivity 21.0%; specificity 95.8%). SARC‐F (AUC 0.57, 95% CI 0.49–0.66; sensitivity 0%; specificity 100%) performed significantly worsethan its modified versions (P < 0.05). There was higher accuracy of sarcopenia identification in obese compared with non‐obese groups for SARC‐F + MAC (AUC 0.75, 95% CI 0.65–0.85 vs. 0.58, 95% CI 0.46–0.70) and SARC‐CalF + MAC (AUC 0.75, 95% CI 0.66–0.85 vs. 0.70, 95% CI 0.59–0.81). Conclusions: The addition of arm circumference to SARC‐CalF confers better diagnostic accuracy for sarcopenia identification, especially in the obese group. Thus, MAC may complement SARC‐CalF for community screening of sarcopenia amongst healthy community‐dwelling older adults by increasing sensitivity for the detection of sarcopenic obesity. Geriatr Gerontol Int 2024; 24: 182–188. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to validate a Yubi‐wakka (finger‐ring) test to identify older adults at risk for sarcopenia. Generally, measurements of muscle mass are considered to be a gold standard for testing for sarcopenia; such measurements are typically attained using bioelectrical impedance analysis (BIA) or dual‐energy X‐ray absorptiometry (DXA). However, the Yubi‐wakka test is a simple assessment that can also be used to screen for sarcopenia. Methods: An analytic cross‐sectional study was conducted to determine the sensitivity and specificity of the Yubi‐wakka test. The study cohort included 230 adults older than 60 years who had no disabilities or handicaps and who visited the outpatient department of Phramongkutklao Hospital. Each participant underwent the Yubi‐wakka test, a handgrip strength test, the 5‐chair stand test, and BIA. We analyzed the associations between the Yubi‐wakka test results and sarcopenia. The findings were compared with diagnoses that followed from the Asian Working Group for Sarcopenia 2019. Results: The test results were statistically associated with sarcopenia ("just fits" odds ratio [OR]: 8.55, 95% confidence interval [CI]: 3.29–22.18, and "smaller" OR: 10.73, 95% CI: 4.31–26.73, relative to "bigger"). The sensitivity and specificity of the Yubi‐wakka test in men were 85.7% and 71.2% (area under the curve [AUC]: 0.785, 95% CI: 0.618–0.952), respectively. For women, the sensitivity and specificity of the test were 87.5% and 80.8% (AUC: 0.842, 95% CI: 0.764–0.919), respectively. Conclusions: The Yubi‐wakka test is a practical way of identifying the risk of sarcopenia among the elderly; it exhibits promising sensitivity and specificity. Geriatr Gerontol Int 2024; 24: 263–268. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to assess and compare the frequency of positive scores using unadjusted SARC-CalF with the scores derived from SARC-CalF after adjusting calf circumference (CC) for body mass index (BMI). The secondary aim was to assess the prognostic value of SARC-CalF after BMI adjustment, for length of hospital stay (LOS) and mortality. Design, Setting, and Participants: This secondary analysis of a prospective cohort study, included both outpatients and inpatients of an oncology unit hospital in Brazil. Measurements: BMI and CC were measured. Patients with excess weight had their CC adjusted for BMI by subtracting 3 cm, 7 cm, and 12 cm from the unadjusted CC values for respective BMI categories. SARC-CalF was used to screen for sarcopenia. Scores ≥11 were indicative of sarcopenia, considering both unadjusted and BMI-adjusted CC values. Clinical outcomes included prolonged LOS and both short- and long-term mortality. Results: Our study included 206 subjects, with a median age of 69 years, and the majority were males (52.1%). The prevalence of low CC increased from 65% to 84% after BMI adjustment. Positive unadjusted SARC-CalF scores (≥11) were observed in 51% of the population and this prevalence increased to 65% using BMI-adjusted SARC-CalF criteria (≥11). Higher scores on BMI-adjusted SARC-CalF but not unadjusted SARC-CalF were independently associated with prolonged LOS [adjusted HR: 1.26 (1.03–1.53)], and 6-month mortality [adjusted HR: 1.42 (1.07–1.87)]. Both unadjusted and BMI-adjusted SARC-CalF were independently associated with 12-month mortality. Conclusion: BMI-adjusted SARC-CalF may be a promising strategy to enhance the detection of older patients with cancer and excess weight at risk of sarcopenia, and it may serve a dual role as a prognostic tool, as it was independently associated with prolonged LOS and mortality.

Abstract Background Calf circumference is recommended as a marker for low muscle mass and as a case finding in the diagnosis of sarcopenia. However, the cut-off value differed by ethic and region. Currently there is no study among Thai population. Therefore, we aimed to identify the optimal cutoff value of calf circumference as a screening tool for low skeletal muscle mass in independent Thai older adults. Subgroup analysis was performed for obesity and adults over 75 years. Methods This cross-sectional cohort studied in an outpatient geriatric check-up clinic. Participants, aged 60 and above, needed to be independent in basic activities of daily living to meet the inclusion criteria. Exclusion criteria comprised active malignancy, cardiac, pulmonary, or neurovascular diseases necessitating hospitalization in the preceding three months, chronic renal diseases requiring renal replacement therapy, and unstable psychiatric disorders. We measured the maximum calf circumference and appendicular skeletal muscle mass (ASMI) using bioelectrical impedance analysis (BIA). Low muscle mass is defined according to the Asian Working Group of Sarcopenia (AWGS) 2019 consensus. Results We enrolled 6,404 elderly adults (mean age 67.3 ± 5.1 years), with a 47% prevalence of low muscle mass in women and 25% in men. Lower muscle mass significantly correlated with reduced BMI and waist circumference in both genders (p

To evaluate limitations in jaw function, oral health-related quality of life (OHRQoL), and nutritional status during extensive oral rehabilitation procedures. Fourteen participants (mean age ± SD: 70 ± 3.8) undergoing major oral rehabilitation involving the restoration of a minimum of eight teeth were recruited in the study. Jaw function limitations scores (JFLS), oral health-impact profile (OHIP), and nutritional status were measured at different time points during, six months, and one year after the rehabilitation procedures. Nutritional status was evaluated by measuring the body weight and arm and calf muscle circumference. The effect of time points on the measured variables was evaluated with Friedman's test. Trends in nutritional status were evaluated with linear regression analysis. The results of the analysis showed significant main effects of time points on the JLFS (p <.001) and OHIP scores (p =.005). However, there was no effect of time points on the body weight (p =.917) and calf muscle circumference (p =.424), but a significant effect on arm circumference (p =.038). Further, there was a decreasing trend for body weight (64.3%), arm (71.4%), and calf circumference (64.3%) in the majority of the patients. The results of the preliminary study suggest that people undergoing extensive oral rehabilitation procedures show improvement in jaw function and an increase in OHRQoL after the rehabilitation procedure. Despite no major changes in the nutritional indicators, most patients showed a negative trend in their body weight, arm circumference, and calf circumference, suggesting that they may be susceptible to nutritional changes. [ABSTRACT FROM AUTHOR]

Background: Sarcopenia is characterized by low muscle strength, decreased muscle mass, and decline in physical performance. While the measurements of muscle strength and physical performance are easy to perform, an accurate evaluation of muscle mass is technically more demanding. We therefore evaluated the suitability of calf circumference (CC) as a clinical indicator for muscle mass. Methods: In a cross-sectional single-centre study, geriatric inpatients were assessed for sarcopenia according to the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) consensus. Calf circumference was tested for correlation with appendicular skeletal muscle mass index (ASMI). Receiver operating characteristic curves (ROC) were used to calculate the discriminatory value of the CC cut-off values to differentiate patients above and below ASMI cut-offs for sarcopenia. Results: In this study population (n = 305, age 83.5 ± 7.0 years, BMI 25.7 kg/m2, 65.6% female), the prevalence of sarcopenia was 22.6%. In subjects with low ASMI, mean CC was 29.5 ± 3.4 cm for females and 32.0 ± 3.4 cm for males. A positive relationship between CC and ASMI was found. The optimized cut-off value for CC to identify patients with low ASMI was <31.5 cm for females (sensitivity 78%, specificity 79%), and <33.5 cm for males (sensitivity 71%, specificity 62%). Conclusion: In clinical settings where imaging technology for muscle mass quantification is not available, simple calf circumference measurement may be used as a dependable indicator for low muscle mass in older adults. [ABSTRACT FROM AUTHOR]

Background: Calf circumference is recommended as a marker for low muscle mass and as a case finding in the diagnosis of sarcopenia. However, the cut-off value differed by ethic and region. Currently there is no study among Thai population. Therefore, we aimed to identify the optimal cutoff value of calf circumference as a screening tool for low skeletal muscle mass in independent Thai older adults. Subgroup analysis was performed for obesity and adults over 75 years. Methods: This cross-sectional cohort studied in an outpatient geriatric check-up clinic. Participants, aged 60 and above, needed to be independent in basic activities of daily living to meet the inclusion criteria. Exclusion criteria comprised active malignancy, cardiac, pulmonary, or neurovascular diseases necessitating hospitalization in the preceding three months, chronic renal diseases requiring renal replacement therapy, and unstable psychiatric disorders. We measured the maximum calf circumference and appendicular skeletal muscle mass (ASMI) using bioelectrical impedance analysis (BIA). Low muscle mass is defined according to the Asian Working Group of Sarcopenia (AWGS) 2019 consensus. Results: We enrolled 6,404 elderly adults (mean age 67.3 ± 5.1 years), with a 47% prevalence of low muscle mass in women and 25% in men. Lower muscle mass significantly correlated with reduced BMI and waist circumference in both genders (p < 0.001). Optimal cut-off values for low muscle mass screening were < 33 cm (sensitivity 80.1%, specificity 60.5%) for women and < 34 cm (sensitivity 85.4%, specificity 70.2%) for men. Subgroup analysis for those with BMI ≥ 25 kg/m² suggested raising the cut-off for women to < 34 cm (sensitivity 80.6%, specificity 54.0%) and for men to < 35 cm (sensitivity 88.7%, specificity 55.2%) to enhance specificity without substantial sensitivity loss. In the older-old adult subgroup (≥ 75 years), optimal cut-off values were < 33 cm (sensitivity 84.6%, specificity 79.9%) for women and < 34 cm (sensitivity 75.6%, specificity 87.0%) for men. Conclusions: There is a strong correlation between calf circumference and ASMI in independent Thai older adults. Calf circumference can serve as a screening tool for identifying low muscle mass. The recommended cut-off values for men and women are 34 cm and 33 cm, respectively in alignment with AWGS 2019 recommendation. Incorporating a 1-cm higher cut-off value for obese older adults improves the accuracy of muscle mass screening. Trial registration: Thai clinical trial registry: TCTR20200511003. [ABSTRACT FROM AUTHOR]

Serum creatinine is used to measure the estimated glomerular filtration rate (eGFR); however, it is influenced by muscle mass and may therefore overestimate renal function in patients with sarcopenia. We examined calf circumference (CC) as a convenient muscle mass evaluation tool that can potentially indicate the need to test for cystatin C instead of creatinine in elderly inpatients. We retrospectively reviewed the electronic health record of 271 inpatients aged 65 or over. CC was determined by measuring the thickest part of the nondominant calf. eGFRcys and eGFRcr were calculated using cystatin C and creatinine levels, respectively. We evaluated optimum CC cutoff values using the eGFRcys/eGFRcr ratio for detecting hidden renal impairment (HRI, defined as eGFRcr ≥ 60 mL/min/1.73 m2 but eGFRcys < 60 mL/min/1.73 m2). CC showed a significant positive correlation with the eGFRcys/eGFRcr ratio in both sexes. The areas under the receiver operating characteristic curve were 0.725 and 0.681 for males and females, respectively. CC cutoffs with a sensitivity or specificity of 90% or 95% might be used to detect HRI in males. In conclusion, utilizing the optimum cutoff, CC could be a cost-effective screening tool for detecting HRI in elderly male patients using cystatin C as an add-on test. [ABSTRACT FROM AUTHOR]

Background Sarcopenia may be associated with the long-term prognosis of renal transplant recipients, so it is essential to early and rapidly screening for sarcopenia in these patients. Studies suggest that calf circumference may be an effective indicator in early screening for sarcopenia. Objective To investigate the relationship between calf circumference and sarcopenia, and to explore the feasibility of using calf circumference as a predictive marker for sarcopenia in kidney transplant recipients. Methods We selected 80 kidney transplant recipients who were treated in the department of organ transplantation of Guangdong Second Provincial General Hospital from October 2021 to June 2022 as the subjects. Demographic information (sex, age, educational attainment, marital status) , anthropometric indicators〔height, weight, body mass index (BMI) , calf circumference, mid-arm circumference (MAC) , triceps skin-fold thickness (TSF) , arm muscle circumference (AMC) , waist circumference, hip circumference, waist-to-hip ratio〕, muscle strength indicators (grip strength, pinch strength) , body composition indicators〔appendicular skeletal muscle mass (ASM) , skeletal muscle mass index (SMI) , 50 kHz phase angle (PhA) , body cell mass (BCM) , intracellular and extracellular fluids〕 were collected. Sarcopenia was diagnosed by the Asian Working Group for Sarcopenia 2019 consensus. Kidney transplant recipients who meet the diagnostic criteria were included in the sarcopenia group, and those who do not meet the diagnostic criteria were included in the non-sarcopenia group. Demographic information, anthropometric indicators, muscle strength indicators, and body composition indicators between sarcopenia and non-sarcopenia patient groups were compared by sex. Pearson correlation analysis and Spearman rank correlation analysis were used to observe the correlation of calf circumference with diagnostic indicators of sarcopenia (ASM, SMI, grip strength) . Univariate and multivariate logistic regression analyses were used to explore the influencing factors of sarcopenia. The predictive value of calf circumference for sarcopenia in kidney transplant of male and female subjects was analyzed by using the receiver operating characteristic (ROC) curve, and the area under the curve (AUC) , sensitivity, specificity and optimal cut-off values were calculated. Results A total of 80 patients〔51 men (63.8%) and 29 women (36.2%) 〕 with an average age of (44.3±11.7) years were included, including 19 (23.75%) with sarcopenia, and 61 (76.25%) without. Sex-based analysis found that male patients with sarcopenia group had lower values of weight, BMI, calf circumference, MAC, TSF, hip circumference, grip strength, pinch strength, ASM, SMI, PhA, BCM, extracellular fluid and intracellular fluid than those without (P

Abstract Background Waist circumference (WC), calf circumference (CC), and body mass index (BMI) have been independently linked to mortality. However, it's not yet clear how the waist-calf circumference ratio (WCR) relates to mortality. This study aims to investigate the relationship between WCR, WC, CC, and BMI with all-cause and cause-specific mortality in older adults. Methods In the 2014 Chinese Longitudinal Healthy Longevity Survey, 4627 participants aged 65 years and older were included, and they were subsequently followed up in 2018. Cox proportional hazards models were utilized to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause and cause-specific mortality, based on WCR, WC, CC, and BMI. Results During a median follow-up of 3.4 years, 1671 deaths (36.1%) occurred. Compared to the second quartile of WCR, the highest quartile had a higher risk of mortality from all causes (HR 1.42, 95%CI 1.24–1.64), cardiovascular disease (CVD) (HR 1.88, 95%CI 1.38–2.56), and other causes (HR 1.37, 95%CI 1.15–1.63). The first and fourth quartiles of WC had HRs of 2.19 (1.00–4.79) and 2.69 (1.23–5.89), respectively, for cancer mortality. The highest quartile of CC was associated with a lower risk of all-cause and other-cause mortality, whereas the lowest quartile was associated with a higher risk of all-cause, CVD, and other-cause mortality compared to the second CC quartile. Additionally, the lowest quartile of BMI was associated with a higher risk of all-cause and respiratory disease mortality. Interaction analyses showed that the effects of CC on all-cause and CVD mortality were more pronounced in adults aged ≥ 80 years (P-interaction

Abstract Background The waist-calf circumference ratio (WCR) has been suggested as a potential indicator of visceral adiposity. Nevertheless, the relationship between WCR and the risk of frailty remains unclear. Therefore, our study aimed to investigate the association between WCR and longitudinal changes in WCR with frailty risk in older adults. Methods We included 2359 participants aged ≥ 65 years without frailty (frailty index [FI] ≤ 0.21) from the Chinese Longitudinal Healthy Longevity Survey in the 2014 wave. The follow-up was conducted in 2018. We investigated the relationship of WCR, waist circumference (WC), and calf circumference (CC) with frailty using both the Cox proportional hazards model and the generalized estimating equation (GEE). Results During a median follow-up of 4.0 years, 668 (28.2%) frailty occurred. Those with higher WCR and WC had a significantly increased risk of frailty (fifth quintile compared with first quintile: hazard ratio [HR] = 1.59, 95% confidence interval [CI] 1.24–2.04 for WCR; HR = 1.69, 95% CI 1.27–2.24 for WC), whereas those in the fourth quintile of CC had a lower likelihood of developing frailty compared to those in the first quintile (HR = 0.67, 95% CI 0.50–0.89). Interaction analyses showed that the effects of WCR on frailty were more pronounced in females (P-interaction = 0.016). GEE analyses revealed that increased WCR and WC were associated with a higher risk of frailty (odds ratio [OR] = 1.74, 95% CI 1.43–2.12 for WCR; OR = 1.03, 95% CI 1.02–1.04 for WC), while CC showed opposite results (OR = 0.95, 95% CI 0.93–0.97). Conclusions A higher WCR and WC, as well as a lower CC, were significantly associated with higher frailty. Of these measures, WCR demonstrated the strongest association with frailty, suggesting that having a combination of high central fat and low lean body mass may increase the risk of developing frailty.

Sarcopenia, characterized by progressive muscle loss and functional decline, poses significant risks, including falls, impaired daily activities, and increased mortality. We developed Allgeun, a novel device that measures handgrip strength, muscle mass, and physical performance. This study aimed to investigate whether temporal muscle thickness (TMT) could be used as a sarcopenia marker and to evaluate the usability of Allgeun. This prospective study enrolled 28 participants without medical or neurological disorders. They underwent three-dimensional T1-weighted imaging using a 3 Tesla magnetic resonance imaging scanner. TMT was measured based on T1-weighted images by a board-certified neuroradiologist. Allgeun was used to measure the following three key components of sarcopenia: muscle strength (handgrip strength), muscle mass (calf and thigh circumference), and physical performance (five times the chair stand test). Correlation analysis was conducted between TMT and the results of the handgrip strength, calf and thigh circumferences, and chair stand tests. There were moderate positive correlations between TMT and calf circumference (r = 0.413, p = 0.029), thigh circumference (r = 0.486, p = 0.008), and handgrip strength (r = 0.444, p = 0.018). However, no significant correlation was observed between TMT and physical performance (r = −0.000, p = 0.998). Our findings underscore TMT’s potential as an indicator of sarcopenia, particularly regarding muscle mass and strength. Additionally, we demonstrated that the new device, Allgeun, is useful for screening and diagnosing the severity of sarcopenia.

Background: COVID-19 is an infectious disease characterized by a severe catabolic and inflammatory state, leading to loss of muscle mass. The assessment of muscle mass can be useful to identify nutritional risk and assist in early management, especially in older adults who have high nutritional risks. The aim of this study was to evaluate the association of calf circumference (CC) with clinical and biochemical markers and mortality in older adults with COVID-19 admitted to the intensive care unit (ICU). Methods: A retrospective cross-sectional study was conducted in a public hospital. CC was adjusted for body mass index (BMI), reducing 3, 7, or 12 cm for a BMI of 25–29.9, 30–39.9, and ≥40 kg/m2, respectively, and classified as reduced when n = 176) were classified as having reduced CC. These patients were older, with lower BMI, higher nutritional risk, malnourished, and higher concentration of urea and urea–creatinine ratio (UCR) compared with the group with normal CC. There was an association between edematous patients at nutritional risk and malnourished with reduced CC in the Cox regression, either adjusted or not for confounding. Conclusions: CC was not associated with severity, biochemical markers, or mortality in older adults with COVID-19 admitted to the ICU, but it was associated with moderately malnourished patients assessed by subjective global assessment (SGA).

Zhen-Yun Wu,1,&ast; Xiang-Min Lu,2,&ast; Rui Liu,1,&ast; Yan-Xia Han,3 Hong-Ying Qian,1 Qian Zhao,1 Mei’e Niu3 1Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Soochow University, Suzhou, People’s Republic of China; 2School of Nursing, Suzhou Medical College of Soochow University, Suzhou, People’s Republic of China; 3Department of Nursing, The First Affiliated Hospital of Soochow University, Suzhou, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Mei’e Niu, Department of Nursing, the First Affiliated Hospital of Soochow University, No. 899, Pinghai Road, Suzhou, Jiangsu, 215006, People’s Republic of China, Email meniu_123@163.com Qian Zhao, Department of Pulmonary and Critical Care Medicine, the First Affiliated Hospital of Soochow University, No. 188, Shizi Street, Suzhou, Jiangsu, 215006, People’s Republic of China, Email xujiali1983_01@163.comPurpose: This study was designed to investigate the differences in skeletal-muscle atrophy between patients with stable chronic obstructive pulmonary disease (COPD) and healthy controls; associated factors were also considered. The study comprised selected residents of communities near the First Affiliated Hospital of Soochow University in Suzhou City, East China.Patients and Methods: Included in this study were 123 COPD patients and 60 controls. All patients completed spirometry as well as examinations to determine their functional exercise capacity, body composition, and handgrip strength (HGS).Results: COPD patients had less fat-free mass (FFM), a lower FFM index (FFMI), and a lower 6-min walking distance (6MWD) compared with controls (P = 0.007, P = 0.020, and P < 0.001, respectively) (FFMI: 17.59 ± 1.83 vs 18.34 ± 1.64). The HGS of these patients was also lower compared with that of controls (32.88 ± 7.84 vs 35.48 ± 7.42), and HGS tended toward statistical significance (P = 0.064, respectively). In multivariate analysis, age (β = − 0.107, P < 0.001), gender (β = 0.212, P < 0.001), body mass index (BMI) (β = 0.462, P < 0.001), FEV1% (β = 0.108, P = 0.009), and calf circumference (CC) (β = 0.457, P < 0.001) were significantly associated with FFMI.Conclusion: Impaired skeletal muscle mass was more common in COPD patients than in controls. Multiple regression analysis showed that CC may be used to detect the degree of impairment, particularly by health-care providers working outside of the hospital.Keywords: airflow obstruction, calf circumference, chronic obstructive pulmonary disease, fat-free mass index, skeletal muscle atrophy, skeletal muscle mass

Objectives: The concept of possible sarcopenia (PS) was recently introduced to enable timely intervention in settings without the technologies required to make a full diagnosis of sarcopenia. This study aimed to investigate the association between PS and all-cause mortality in patients with solid cancer. Design: Retrospective observational study. Setting and participants: 13,736 patients with 16 types of solid cancer who were ≥18 years old. Measurements: The presence of both a low calf circumference (men

Background and aims: Malnutrition is widely present and influences the prognosis of elderly inpatients, so it is helpful to be able to identify it with a convenient method. However, in the widely accepted criteria for malnutrition, the Global Leadership Initiative on Malnutrition (GLIM), a lot of metrics can be used to define the phenotypic and etiological criteria. To identify muscle mass reduction, anthropometric parameters such as calf circumference (CC) and hand grip strength (HGS) are preferable to other expensive methods in many situations because they are easy and inexpensive to measure, but their applicability needs to be verified in specific clinical scenarios. This study aims to verify the value of CC- and HGS-identified muscle loss in diagnosing malnutrition and predicting in-hospital complications (IHC) and prolonged length of hospital stay (PLOS) in elderly inpatients using machine learning methods. Methods: A sample of 7122 elderly inpatients who were enrolled in a previous multicenter cohort study in China were screened for eligibility for the current study and were then retrospectively diagnosed for malnutrition using 33 GLIM criteria that differ in their combinations of phenotypic and etiological criteria, in which CC or CC+HGS were used to identify muscle mass reduction. The diagnostic consistency with the subjective global assessment (SGA) criteria at admission was evaluated according to Kappa coefficients. The association and the predictive value of the GLIM-defined malnutrition with 30-day IHC and PLOS were evaluated with logistic regression and randomized forest models. Results: In total, 2526 inpatients (average age 74.63 ± 7.12 years) were enrolled in the current study. The prevalence of malnutrition identified by the 33 criteria combinations ranged from 3.3% to 27.2%. The main IHCs was infectious complications (2.5%). The Kappa coefficients ranged from 0.130 to 0.866. Logistic regression revealed that malnutrition was identified by 31 GLIM criteria combinations that were significantly associated with 30-day IHC, and 22 were significantly associated with PLOS. Random forest prediction revealed that GLIM 15 (unconscious weight loss + muscle mass reduction, combined with disease burden/inflammation) performs best in predicting IHC; GLIM 30 (unconscious weight loss + muscle mass reduction + BMI reduction, combined with disease burden/inflammation) performs best in predicting PLOS. Importantly, CC alone performs better than CC+HGS in the criteria combinations for predicting adverse clinical outcomes. Conclusion: Muscle mass reduction defined by a reduced CC performs well in the GLIM criteria combinations for diagnosing malnutrition and predicting IHC and PLOS in elderly Asian inpatients. The applicability of other anthropometric parameters in these applications needs to be further explored. [ABSTRACT FROM AUTHOR]

Background and Objectives: This study focused on investigating sarcopenic factors and immune cells in older adulthood. To achieve this, the variables related to sarcopenia and immune cells in people living in the same community were analyzed. Materials and Methods: A total of 433 elderly individuals aged 61 to 85 years were randomly categorized as follows in 5-year intervals: 68 in the youngest-old group (aged 61–65), 168 in the young-old group (aged 66–70), 127 in the middle-old group (aged 71–75), 46 in the old-old group (aged 76–80), and 19 in the oldest-old group (aged 81–85). Results: With the progression of age, calf circumference (−8.4 to −11.05%; p = 0.001) and grip strength (−9.32 to −21.01%; p = 0.001) exhibited a noticeable reduction with each successive 5-year age bracket. Conversely, the capability to complete the five-time chair stand demonstrated a clear incline (32.49 to 56.81%; p = 0.001), starting from the middle-aged group. As for appendicular skeletal muscle mass, there was an evident tendency for it to decrease (−7.08 to −26.62%; p = 0.001) with increasing age. A gradual decline in natural killer cells became apparent within the old-old and oldest-old groups (−9.28 to −26.27%; p = 0.001). The results of the post hoc test revealed that CD3 T cells showcased their peak levels in both the youngest-old and young-old groups. This was followed by the middle-old and old-old groups, with slightly lower levels. This pattern was similarly observed in CD4 T cells, CD8 T cells, and CD19 B cells. Conclusions: This study reaffirmed that sarcopenia and immune cell function decline with each successive 5-year increase in age. Considering these findings, the importance of implementing programs aimed at ensuring a high-quality extension of life for the elderly is strongly underscored. [ABSTRACT FROM AUTHOR]

Background: Waist circumference (WC), calf circumference (CC), and body mass index (BMI) have been independently linked to mortality. However, it's not yet clear how the waist-calf circumference ratio (WCR) relates to mortality. This study aims to investigate the relationship between WCR, WC, CC, and BMI with all-cause and cause-specific mortality in older adults. Methods: In the 2014 Chinese Longitudinal Healthy Longevity Survey, 4627 participants aged 65 years and older were included, and they were subsequently followed up in 2018. Cox proportional hazards models were utilized to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause and cause-specific mortality, based on WCR, WC, CC, and BMI. Results: During a median follow-up of 3.4 years, 1671 deaths (36.1%) occurred. Compared to the second quartile of WCR, the highest quartile had a higher risk of mortality from all causes (HR 1.42, 95%CI 1.24–1.64), cardiovascular disease (CVD) (HR 1.88, 95%CI 1.38–2.56), and other causes (HR 1.37, 95%CI 1.15–1.63). The first and fourth quartiles of WC had HRs of 2.19 (1.00–4.79) and 2.69 (1.23–5.89), respectively, for cancer mortality. The highest quartile of CC was associated with a lower risk of all-cause and other-cause mortality, whereas the lowest quartile was associated with a higher risk of all-cause, CVD, and other-cause mortality compared to the second CC quartile. Additionally, the lowest quartile of BMI was associated with a higher risk of all-cause and respiratory disease mortality. Interaction analyses showed that the effects of CC on all-cause and CVD mortality were more pronounced in adults aged ≥ 80 years (P-interaction <.05). Conclusions: Higher WCR and lower CC increased the risk of all-cause, CVD, and other-cause mortality. Lower BMI was associated with higher all-cause and respiratory disease mortality risk, while WC only predicted cancer mortality. [ABSTRACT FROM AUTHOR]

Background: The waist-calf circumference ratio (WCR) has been suggested as a potential indicator of visceral adiposity. Nevertheless, the relationship between WCR and the risk of frailty remains unclear. Therefore, our study aimed to investigate the association between WCR and longitudinal changes in WCR with frailty risk in older adults. Methods: We included 2359 participants aged ≥ 65 years without frailty (frailty index [FI] ≤ 0.21) from the Chinese Longitudinal Healthy Longevity Survey in the 2014 wave. The follow-up was conducted in 2018. We investigated the relationship of WCR, waist circumference (WC), and calf circumference (CC) with frailty using both the Cox proportional hazards model and the generalized estimating equation (GEE). Results: During a median follow-up of 4.0 years, 668 (28.2%) frailty occurred. Those with higher WCR and WC had a significantly increased risk of frailty (fifth quintile compared with first quintile: hazard ratio [HR] = 1.59, 95% confidence interval [CI] 1.24–2.04 for WCR; HR = 1.69, 95% CI 1.27–2.24 for WC), whereas those in the fourth quintile of CC had a lower likelihood of developing frailty compared to those in the first quintile (HR = 0.67, 95% CI 0.50–0.89). Interaction analyses showed that the effects of WCR on frailty were more pronounced in females (P-interaction = 0.016). GEE analyses revealed that increased WCR and WC were associated with a higher risk of frailty (odds ratio [OR] = 1.74, 95% CI 1.43–2.12 for WCR; OR = 1.03, 95% CI 1.02–1.04 for WC), while CC showed opposite results (OR = 0.95, 95% CI 0.93–0.97). Conclusions: A higher WCR and WC, as well as a lower CC, were significantly associated with higher frailty. Of these measures, WCR demonstrated the strongest association with frailty, suggesting that having a combination of high central fat and low lean body mass may increase the risk of developing frailty. [ABSTRACT FROM AUTHOR]

Abstract Background The objective of this study was to analyze the association between calf circumference and incontinence in Chinese elderly, and to find out the maximal cut-off point by gender for the use of calf circumference in screening for incontinence. Methods In this study, participants were from the 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS). The maximal calf circumference cut-off point and other incontinence-related risk factors were explored using receiver operating characteristic (ROC) curves and logistic regression analysis. Results The study included 14,989 elderly people (6,516 males and 8,473 females) over 60. The prevalence of incontinence in elderly males was 5.23% (341/6,516), significantly lower than females, which was 8.31% (704/8,473) (p

This prospective, observational, multicenter study assessed the tolerance of Dobenox Forte®, the first approved over-the-counter product containing calcium dobesilate, in 1795 outpatients with chronic venous disease (CVD) in daily clinical practice. In addition, the effectiveness (decrease in circumferences of a more affected limb at the ankle and middle part of the calf, and changes in the severity of CVD signs) was assessed. No adverse events related to use of the preparation were reported in a period of 64 ± 20 days. Dobenox Forte® use was associated with a reduction in calf circumference by 13.1 mm (95%CI: 12.2–14.1) and in ankle circumference by 9.7 mm (95%CI: 9.2–11.0) in patients reporting swelling of the lower legs (60.0% of the cohort). A reduction in calf and ankle circumference by at least 1 cm was achieved in 34.9% and 24.9% of patients, respectively. The percentages of patients reporting moderate to very severe lower limb heaviness decreased from 96.6% to 56.0%, calf cramps decreased from 91.0% to 41.0%, calf pain decreased from 89.2% to 43.7%, swelling decreased from 86.1% to 38.8%, and burning sensation that worsens when standing decreased from 79.0% to 33.7%. The medicinal product Dobenox Forte® is well tolerated by patients and seems to effectively reduce the symptoms of CVD.

BackgroundCentral obesity increases the risk of several diseases, including diabetes, cardiovascular disease (CVD), and cancer. However, the association between extremity obesity and mortality has not been extensively evaluated. The objective of this study was to investigate the quantitative effects of waist circumference (WC), arm circumference (AC), calf circumference (CC), and thigh circumference (TC) on all-cause mortality and CVD mortality.MethodsThe study used data from the National Health and Nutrition Examination Survey (NHANES) sample survey from 1999 to 2006. A total of 19,735 participants were included in the study. We divided the participants into four groups (Q1–Q4) and used Q1 as a reference to compare the risk of all-cause mortality and CVD mortality in Q2–Q4. COX proportional hazard regression model was used to analyze the relationship between WC, AC, CC and TC on all-cause and CVD mortality. In addition, we conducted a stratified analysis of gender.ResultsAfter a mean follow-up of 11.8 years, we observed a total of 3,446 deaths, of which 591 were due to cardiovascular disease. The results showed that for both men and women, compared to the first group, the risk of all-cause mortality was significantly higher in the other three groups of WC and significantly lower in the other three groups of AC, CC, and TC. Similar results were observed after adjusting for confounding factors such as demographics.ConclusionsOur results show that all-cause and CVD mortality are positively associated with measures of central obesity and negatively associated with measures of extremity obesity, and that AC, CC, and TC can be used as potential tools to measure prognosis in the general population.

This study tested the effectiveness of a 6-month vitality acupunch (VA) exercise program on muscle mass, hand grip strength, and sleep quality in institutional older adults with probable sarcopenia. A cluster randomized controlled trial was conducted. A total of 103 older adults were assigned to the experimental group (n = 52) and control group (n = 51) according to the institution they inhabited. After the 6-month VA exercise intervention, the experimental group showed significant increases in muscle mass (F = 5.93, p =.017), hand grip strength (F = 56.73, p <.001), and improved sleep quality (F = 23.20, p <.001) compared to the control group. Based on the meridian theory that promotes qi and blood circulation, VA exercise has positive effects on muscle mass, hand grip strength, and sleep quality in older adults with probable sarcopenia. [ABSTRACT FROM AUTHOR]

Abstract Aims Reduction in appendicular skeletal muscle mass index (ASMI) assessed by dual‐energy X‐ray absorptiometry (DEXA) has been shown to be independently associated with a higher mortality rate in patients with heart failure (HF). However, DEXA is not suitable for measurement of muscle mass in a daily clinical setting and in large population‐based studies. The aim of this study was to determine whether ASMI predicted from anthropometric indicators (predicted ASMI) serves as an alternative to DEXA‐measured ASMI for predicting all‐cause death in HF patients. Methods and Results Data for 539 HF patients who received a DEXA scan and measurements of calf circumferences (CC) and mid‐arm circumferences (MAC) in our hospital were analysed. Predicted ASMI was calculated as we previously reported: predicted ASMI (kg/m2) = [0.214 × weight (kg) + 0.217 × CC (cm) − 0.189 × MAC (cm) + 1.098 (male = 1, female = −1) + 0.576]/height2 (m2). Low ASMI values were defined as

Abstract Background Although frailty is a common geriatric syndrome in old adults, a simple method to assess the degree of frailty in a person has not yet been established. In this study we have tried to establish the association between calf circumference (CC) and frailty among older Chinese people. Methods We used the data obtained from the 2014 edition of the Chinese Longitudinal Healthy Longevity Survey; 1216 participants aged ≥60 years were included for the study. Body mass index, CC and waist circumference measurement data, and laboratory test results were collected. Frailty status was measured using the frailty index (FI). Participants were then classified into non-frail (FI

Abstract Background and Aim Sarcopenia is a problem affecting inflammatory bowel disease (IBD) outcome and should be evaluated by measuring muscle mass (using dual‐energy X‐ray absorptiometry [DXA]), muscle strength, and physical performance. DXA has drawbacks as it is expensive, not covered by a national program, and requires a technician. Other inexpensive and simple examinations are needed. The objective is to explore cutoff point and diagnostic accuracy of thigh circumference (TC), calf circumference (CC), subjective global assessment (SGA), and handgrip strength (HGS) to identify sarcopenia in IBD patients. Methods The study was conducted in Cipto Mangunkusumo Hospital during November 2020–June 2021. Analysis was performed to discover the cutoff point and diagnostic accuracy of TC, CC, SGA, and HGS to identify sarcopenia. Results As assessed by DXA, 7 of 60 women (11.7%) with IBD had sarcopenia. Using CC cutoff ≤31 cm, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ration (PLR), and negative likelihood ratio (NLR) were 100%, 60.38%, 25%, 100%, 2.52, and 0, respectively. Using TC cutoff ≤50 cm, the sensitivity, specificity, PPV, NPV, PLR, and NLR were 100%, 83.02%, 43.75%, 100%, 5.90, and 0, respectively. SGA has sensitivity, specificity, PPV, NPV, PLR, and NLR of 42.86%, 84.91%, 27.27%, 91.84%, 2.84, and 0.67, respectively. The area under curve of HGS was 33.3%. Conclusion In this survey of Indonesian women with IBD, the frequency of sarcopenia was 11.7%. When compared with DXA, TC and CC values over 50 cm and 31 cm, respectively, were helpful to exclude the diagnosis of sarcopenia. SGA and HGS were of lesser value for the identification of a decrease in muscle mass.

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Background: The objective of this study was to analyze the association between calf circumference and incontinence in Chinese elderly, and to find out the maximal cut-off point by gender for the use of calf circumference in screening for incontinence. Methods: In this study, participants were from the 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS). The maximal calf circumference cut-off point and other incontinence-related risk factors were explored using receiver operating characteristic (ROC) curves and logistic regression analysis. Results: The study included 14,989 elderly people (6,516 males and 8,473 females) over 60. The prevalence of incontinence in elderly males was 5.23% (341/6,516), significantly lower than females, which was 8.31% (704/8,473) (p < 0.001). There was no correlation between calf circumference < 34 cm in males and < 33 cm in females and incontinence after adjusting the confounders. We further stratified by gender to predict incontinence in elderly based on the Youden index of ROC curves. We found the association between calf circumference and incontinence was the strongest when the cut-off points were < 28.5 cm for males and < 26.5 cm for females, with an odds rate (OR) value of 1.620 (male, 95%CI: 1.197–2.288) and 1.292 (female, 95%CI: 1.044–1.600) after adjusting the covariates, respectively. Conclusions: Our study suggests that calf circumference < 28.5 cm in males and < 26.5 cm in females is a risk factor for incontinence in the Chinese elderly population. Calf circumference should be measured in routine physical examination, and timely interventions should be made to reduce the risk of incontinence in subjects with calf circumference less than the threshold. [ABSTRACT FROM AUTHOR]

Previous studies have described an association between single time point calf circumference (CC) and mortality. Evidence of associations between CC change and mortality is lacking. We aimed to determine the relationship between the CC change over time and all-cause mortality. We conducted a retrospective cohort study of 906 participants in the 2014–2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS). Restricted cubic splines were used to analyze associations between the relative CC change (exposure) and all-cause mortality (primary outcome). When there was evidence of non-linearity, a piecewise Cox regression model was next fitted, adjusting for sociodemographic characteristics, health behaviours, health status and baseline CC. The mean (SD) age was 83.8 (12.2) years old, and 50.2% (455/906) of participants were male. We observed a U-shaped association between the relative CC change (%) and all-cause mortality (P for non-linearity <0.001). Participants with stable CC over time had the lowest risk of death. After adjusting for covariates, when CC decreased over time, the hazard ratio per 10% higher in CC change was 1.32 (1.01–1.69). When CC increased over time, the hazard ratio per 10% higher in CC change was 1.35 (1.10–1.66). Stable CC over time was associated with the lowest mortality risk. Our findings indicate the practical significance of monitoring CC change in older adult. [ABSTRACT FROM AUTHOR]