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Comparative Study
. 2025 May 16;25(1):346.
doi: 10.1186/s12877-025-06020-6.

A comparative analysis of sarcopenia screening methods in Thai people with type 2 diabetes mellitus in an outpatient setting

Ornpicha Laohajaroensombat  1 , Thanapat Limpaarayakul  1 , Nattapol Sathavarodom  1 , Apussanee Boonyavarakul  1 , Parinya Samakkarnthai  2
Affiliations
Comparative Study

A comparative analysis of sarcopenia screening methods in Thai people with type 2 diabetes mellitus in an outpatient setting

Ornpicha Laohajaroensombat et al. BMC Geriatr. .

Abstract

Background: Type 2 Diabetes Mellitus (T2DM) is closely linked with sarcopenia. The lack of validated, easy, and effective sarcopenia screening tools for people with T2DM may result in underdiagnosis, delayed interventions, and worsening outcomes. This study evaluated and compared the diagnostic accuracy of various sarcopenia screening tools in T2DM outpatients.

Methodology: A cross-sectional study was conducted on 329 people with T2DM at Phramongkutklao Hospital, Thailand, between December 2023 and November 2024. This study compared eight sarcopenia screening tools. The Asian Working Group for Sarcopenia 2019 (AWGS 2019) criteria served as the reference standard. Sensitivity, Specificity, and diagnostic accuracy were evaluated using receiver operating characteristic (ROC) curve analysis. The optimal cutoffs were identified with the Youden index.

Results: The prevalence of sarcopenia was 23.7%. Calf circumference showed the highest diagnostic accuracy at standard cutoff (AUC: 0.892), with optimised cutoff points of < 37.0 cm for males and < 36.0 cm for females, and achieved high sensitivity (90.1% for males, 91.1% for females) with acceptable specificity (77.2% for males, 67.8% for females). Neck circumference demonstrated diagnostic utility (AUC: 0.741) with proposed thresholds of < 39.5 cm (males) and < 36.5 cm (females), yielding moderate sensitivity (69.7% for males, 82.2% for females) and acceptable specificity (78.9% for males, 62.6% for females). Questionnaire-based tools showed limited diagnostic accuracy with SARC-CalF performing the best (AUC: 0.789, sensitivity: 48.7%, specificity: 93.2%). Among physical performance tests, handgrip strength was the most accurate (AUC: 0.716), although these tests generally exhibited high sensitivity, but lower specificity.

Conclusion: Calf circumference was the most effective screening tool for sarcopenia in people with T2DM. Neck circumference emerged as a promising alternative at optimal cutoff values, offering a simple, novel and practice screening tool option. These findings support the implementation of anthropometric measures for sarcopenia screening in clinical settings, particularly in outpatient care.

Keywords: Sarcopenia; Screening Tools; Sensitivity; Specificity; Type 2 Diabetes Mellitus.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The Royal Thai Army Institutional Board Review approved the study under reference R080h/66. It was performed in accordance with the Declaration of Helsinki, and all participants gave written informed consent before participating. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Infographic representation of screening tools for sarcopenia in this study
Fig. 2
Fig. 2
Flowchart of sarcopenia screening tools and diagnosis based on AWGS 2019 criteria
Fig. 3
Fig. 3
ROC curve analysis of sarcopenia screening tools for discriminate sarcopenia in T2DM
Fig. 4
Fig. 4
ROC curve analysis of calf and neck circumferences to discriminate sarcopenia in T2DM patient
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References

    1. American Diabetes A. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2012;35 Suppl 1(Suppl 1):S64-71. - PMC - PubMed
    1. Antar SA, Ashour NA, Sharaky M, Khattab M, Ashour NA, Zaid RT, et al. Diabetes mellitus: Classification, mediators, and complications; A gate to identify potential targets for the development of new effective treatments. Biomed Pharmacother. 2023;168:115734. - PubMed
    1. Wang X, Hu Z, Hu J, Du J, Mitch WE. Insulin resistance accelerates muscle protein degradation: Activation of the ubiquitin-proteasome pathway by defects in muscle cell signaling. Endocrinology. 2006;147(9):4160–8. - PubMed
    1. Szablewski L. Changes in Cells Associated with Insulin Resistance. Int J Mol Sci. 2024;25(4):2397 - PMC - PubMed
    1. Takahashi F, Hashimoto Y, Kaji A, Sakai R, Okamura T, Kitagawa N, et al. Sarcopenia Is Associated With a Risk of Mortality in People With Type 2 Diabetes Mellitus. Front Endocrinol (Lausanne). 2021;12:783363. - PMC - PubMed

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