Mid-Upper Arm Circumference as an Alternative Screening Instrument to Appendicular Skeletal Muscle Mass Index for Diagnosing Sarcopenia

Feng-Juan Hu,1,2 Hu Liu,3 Xiao-Lei Liu,1,2 Shu-Li Jia,1,2 Li-Sha Hou,2 Xin Xia,2 Bi-Rong Dong1,2 1Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China; 2National Clinical Research Center of Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China; 3Department of Liver Surgery, Liver Transplantation Division, Laboratory of Liver Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of ChinaCorrespondence: Bi-Rong DongCenter of Gerontology and Geriatrics, West China Hospital, Sichuan University, GuoXueXiang 37, Chengdu, Sichuan, 610041, People’s Republic of ChinaTel +86-28-85421550Fax +86-28-85421550Email birongdong123@outlook.comPurpose: Mid-upper arm circumference (MUAC) is a simple, noninvasive anthropometric indicator. This study evaluated the applicability of MUAC as an alternative screening instrument to appendicular skeletal muscle mass index (ASMI) for detecting sarcopenia, and determined the optimal MUAC cutoff values.Patients and Methods: A total of 4509 subjects ≥ 50 years of age from the West China Health and Aging Trend study were included in the present study. ASM was measured by bioelectrical impedance analysis. MUAC, calf circumference (CC), and grip strength were evaluated and the Short Physical Performance Battery and 3-m timed up-and-go test were administered. Low muscle mass was diagnosed based on Asian Working Group for Sarcopenia 2019 (AWGS2019) and updated European Working Group on Sarcopenia in Older People 2 (EWGSOP2) criteria.Results: ASMI was positively correlated with MUAC in both men (r=0.726, P< 0.001) and women (r=0.698, P< 0.001). The area under the receiver operating characteristic curve (AUC) for MUAC as an indicator of low muscle mass in men and women was 0.86 (95% confidence interval [CI]: 0.85– 0.88) and 0.85 (95% CI: 0.84– 0.86), respectively, according to AWGS2019 criteria; and 0.86 (95% CI: 0.85– 0.88) and 0.86 (95% CI: 0.85– 0.88), respectively, according to EWGSOP2 criteria. Optimal MUAC cutoff values for predicting low muscle mass were ≤ 28.6 cm for men and ≤ 27.5 cm for women. There was no significant difference between the AUCs of MUAC and CC in men according to the 2 reference standards (P=0.809), whereas the AUC of CC was superior to that of MUAC in women according to AWGS2019 (P< 0.001) and EWGSOP2 (P=0.008) criteria.Conclusion: MUAC is strongly correlated with ASMI among community-dwelling middle-aged and older adults in China. MUAC can be used as a simple screening instrument to ASMI for diagnosing sarcopenia, especially in men.Keywords: anthropometry, low muscle mass, diagnosis, older adults