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Multicenter Study
. 2024 May 21;16(11):1552.
doi: 10.3390/nu16111552.

Ultrasound Cut-Off Values for Rectus Femoris for Detecting Sarcopenia in Patients with Nutritional Risk

Daniel de Luis Roman  1   2 , José Manuel García Almeida  3 , Diego Bellido Guerrero  4 , Germán Guzmán Rolo  5 , Andrea Martín  5 , David Primo Martín  1   2 , Yaiza García-Delgado  6 , Patricia Guirado-Peláez  3   7 , Fiorella Palmas  8 , Cristina Tejera Pérez  4   9 , María García Olivares  7   10   11 , María Maíz Jiménez  12 , Irene Bretón Lesmes  13 , Carlos Manuel Alzás Teomiro  14 , Juan Manuel Guardia Baena  15 , Laura A Calles Romero  16 , Inmaculada Prior-Sánchez  17 , Pedro Pablo García-Luna  18 , María González Pacheco  19   20 , Miguel Ángel Martínez-Olmos  21   22   23 , Blanca Alabadí  24   25 , Valeria Alcántara-Aragón  26 , Samara Palma Milla  27 , Tomás Martín Folgueras  28 , Andrea Micó García  29 , Begoña Molina-Baena  30 , Henry Rendón Barragán  31 , Pablo Rodríguez de Vera Gómez  32 , María Riestra Fernández  33   34 , Ana Jiménez Portilla  35 , Juan J López-Gómez  1   2 , Nuria Pérez Martín  6 , Natalia Montero Madrid  3   7   36 , Alba Zabalegui Eguinoa  8 , Cristina Porca Fernández  4   9   37 , María José Tapia Guerrero  7   10 , Marta Ruiz Aguado  12   38 , Cristina Velasco Gimeno  13 , Aura D Herrera Martínez  14   39 , María Novo Rodríguez  15 , Natalia C Iglesias Hernández  16 , María de Damas Medina  17 , Irene González Navarro  18 , Francisco Javier Vílchez López  19   20 , Antía Fernández-Pombo  21 , Gabriel Olveira  7   10   36   40
Affiliations
Multicenter Study

Ultrasound Cut-Off Values for Rectus Femoris for Detecting Sarcopenia in Patients with Nutritional Risk

Daniel de Luis Roman et al. Nutrients. .

Abstract

Background: 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.

Methods: 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.

Results: 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 (p < 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 cm2 and 3.66 cm2 for CSA, 32.57 mm and 40.21 mm for the X-axis, and 7.85 mm and 10.4 mm for the Y-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.

Conclusions: 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.

Keywords: malnutrition; nutritional risk; nutritional ultrasound; rectus femoris; sarcopenia; ultrasound cut-off values.

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Conflict of interest statement

G.G.R. and A.M are full employees of Abbott Laboratories. None of the remaining authors have any conflicts of interest. The authors declare that the project was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Percentage of patients in the different categories of sarcopenia for the overall study population and distributed by sex.
See this image and copyright information in PMC

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