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Objective:To investigate the individual and combined effects of calf circumference and vitamin D levels on all-cause mortality risk in community-dwelling older adults based on the Chinese Longitudinal Healthy Longevity Survey.Methods:The calf circumference was measured in the baseline survey in 2012 and 2014.Low calf circumference was defined as <34 cm for men or 33 cm for women at screening.Vitamin D deficiency was defined as plasma 25-hydroxyvitamin D[25(OH)D]levels <50 nmol/L.All participants were followed up until 2018, when death outcomes and survival time were collected.Cox proportional hazard regression models were used to analyze the effects of calf circumference and 25(OH)D levels on the risk of all-cause mortality.Results:A total of 3 052 older adults were included in the analysis, of which 1 960(64.22%)had low calf circumference and 2 245(73.56%)had vitamin D deficiency.After 10 559.9 person-years of follow-up period, 1 312 death events were recorded.After adjusting for sociodemographic characteristics, physical activities, cognitive function, and multiple chronic diseases, calf circumference and 25(OH)D levels were negatively associated with the risk of all-cause mortality(both P<0.05). In the combined analysis, compared with the normal group, the risk of death was highest in the participants with both low calf circumference and vitamin D deficiency, which was higher than those with low calf circumference or vitamin D deficiency alone, with a hazard ratios( HR)(95% CI)of 2.51(1.81-3.45), 1.71(1.22-2.42)and 1.53(1.09-2.15), respectively.There was a significant additive interaction between low calf circumference and vitamin D deficiency on mortality(RERI>0). Conclusions:Low calf circumference and vitamin D deficiency are associated with higher mortality.Older adults with combined conditions had a even higher risk of death.Attention should be paid to joint screening and comprehensive intervention for older adults with both low calf circumference and vitamin D deficiency.
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Objective:To investigate the prevalence of sarcopenia and associated factors in hospitalized elderly patients.Methods:This was a cross-sectional study.A total of 578 patients admitted to the Geriatrics Department of our hospital were consecutively recruited according to the admission criteria.Patients were divided into the sarcopenia group(n=202, 34.95%)and non-sarcopenia group(n=376, 65.05%)based on the diagnostic criteria(2014)of the Asian Working Group for Sarcopenia.Their clinical data and laboratory parameters were collected.All patients underwent comprehensive geriatric assessment.Results:(1)The detection rate of sarcopenia in these hospitalized patients was 34.95%.(2)Age, free thyroxine(FT4), and the prevalences of diabetes and osteoporosis and the incidence of falls in the past year were higher while body mass index(BMI), calf circumference, hemoglobin(Hb), albumin(ALB), triglycerides(TG), low-density cholesterol(LDL), glycosylated hemoglobin(HbA1c)and free triiodothyronine(FT3)were lower in sarcopenia patients than in non-sarcopenia patients, with statistical significance.Scores on the mini-mental state examination(MMSE)and activities of daily living(ADL)were lower in sarcopenia patients than in non-sarcopenia patients while scores on nutritional risk screening 2002(NRS2002)and the FRAIL scale were higher, all with statistical significance.(3)Binary logistic regression analysis revealed that osteoporosis and FRAIL score were risk factors for sarcopenia( OR=9.083 and 2.505, P<0.001)and BMI, calf circumference and ADL score were protective factors for sarcopenia( OR=0.735, 0.774 and 0.967, P<0.05). (4)ROC analysis showed that the areas under the curve for FRAIL score, BMI, calf circumference and ADL score were 0.832, 0.805, 0.841 and 0.812, respectively, with threshold values at 2.5 points, 23.52 kg/m 2, 32.5 cm and 92.5 points.(5)The chi-square test for sarcopenia screening using various related factors found osteoporosis, calf circumference <32.5 cm and ADL <90 points had higher sensitivity(0.787, 0.807, 0.817)while FRAIL ≥ 3 points and BMI <23.5 had slightly lower sensitivity(0.683, 0.708), with each related factor having a high negative detection rate(0.833-0.888). Conclusions:The prevalence of sarcopenia in hospitalized elderly is more than 1/3.Osteoporosis and FRAIL score are risk factors for sarcopenia.BMI, calf circumference and ADL score are protective factors for sarcopenia.All relevant factors have practical clinical value and can be used for preliminary screening of sarcopenia.
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Objective@#To evaluate the associations of sarcopenia, handgrip strength and calf circumference with cognitive impairment among Chinese older adults.@*Methods@#Totally 2,525 older adults were recruited from the Healthy Aging and Biomarkers Cohort Study. Cognitive impairment was assessed by the Chinese Mini-Mental State Examination. Handgrip strength was calculated from the means of the right and left hand values. Calf circumference was measured at the site of maximum circumference of the non-dominant leg. The formula developed by Ishii was used to define sarcopenia. Multiple logistic regression was performed to evaluate the associations of sarcopenia, handgrip strength, and calf circumference with cognitive impairment.@*Results@#The prevalence of cognitive impairment was 34.36%. The adjusted odds ratio ( @*Conclusion@#Sarcopenia, identified by low handgrip strength and low calf circumference, was positively associated with cognitive impairment.
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Aged , Aged, 80 and over , Female , Humans , Male , China/epidemiology , Cognitive Dysfunction/etiology , Hand Strength , Leg/anatomy & histology , Logistic Models , Sarcopenia/pathologyABSTRACT
Objective:To explore the correlation of upper arm circumference and calf circumference with muscle mass, and the screening effect and the cut-off values for low muscle mass and sarcopenia. Methods:From March to August, 2020, a total of 831 community-dwelling old people (≥ 60 years old) were recruited by using convenience sampling. Muscle mass and other body composition indicators were tested by body composition tester. The upper arm circumference, calf circumference, grip strength and gait speed were measured at the same day. Pearson cofficient was used to analyze the correlation of upper arm circumference and calf circumference with muscle mass, and receiver operation characteristic (ROC) curve was used to analyze the diagnostic effect of upper arm circumference and calf circumference on low muscle mass and sarcopenia, and the Youden index (YI) was used to determine the cut-off values. Results:Upper arm circumference and calf circumference were positively correlated with appendicular skeletal muscle mass (ASM) and skeletal mass index (SMI) (r = 0.6 to 0.8, P < 0.001). For diagnosing low muscle mass, the areas under the ROC curve (AUC) of upper arm circumference were 0.888 for male, 0.787 for female; and that of calf circumference were 0.933 for male, 0.854 for female, respectively. The cut-off values of upper arm circumference for low muscle mass were 26 cm for both male and female; and that of calf circumference were 34 cm for male and 33 cm for female, respectively. For diagnosing sarcopenia, the AUC of upper arm circumference was 0.902 for male, 0.744 for female; and that of calf circumference was 0.923 for male, 0.832 for female, respectively. The cut-off values of upper arm circumference and calf circumference for sarcopenia were 26 cm and 33 cm for both male and female. The AUC of combined diagnosis with age, upper arm circumference, calf circumference, grip strength and gait speed for low muscle mass and sarcopenia in males and females was all greater than 0.85. Conclusion:In the community old adults, upper arm circumference and calf circumference are positively correlated with muscle mass, and both indices can be used to diagnose low muscle mass and sarcopenia. multi-indices combination can improve the diagnosis effect of upper arm circumference in females.
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Background: India having 3rd highest incidence of low birth weight (LBW) infants (28%) in the world. Majority of deliveries in our country are conducted at home by untrained traditional birth attendants or relatives, so it is not possible for untrained birth attenders to operate weighing machine in rural areas, therefore to find an alternative method for the estimation of low birth weight we used simple anthropometric indicators like calf circumference which is easily used by rural communities.Methods: It was a Cross-sectional study done at tertiary care center, Udaipur, Rajasthan, India during 1 year period in 2018. 150 neonates without any congenital malformation delivered at hospital irrespective of gestational age were subjected to anthropometric measurements. The different anthropometric measurements like calf circumference, chest circumference were used and data was analyzed by using Receiver Operating Characteristic curve (ROC) to find out the cut-off values with the highest sensitivity and specificity for birth weight <2500gm and <1800gm. For comparison Pearson's Correlation coefficients was used.Results: From different anthropometric measurements, calf circumference of 9.38 cm and 7.90cm had higher sensitivity and specificity in detecting birth weight babies of <2500gm, and <1800gm respectively. The best correlation was observed in calf circumference (r=0.989) and (r=0.990) for identifying babies with birth weight group 1.21-1.80kg and group 1.81-2.50kg.Conclusions: In the absence of a weighing machine, simple measurements like calf circumference is the best indicator in identifying low birth weight babies.
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Background: In developing countries 15 per cent of infants weigh less than 2,500 grams at birth .It is not possible to provide expensive weighing scales to the community members and families due to logistic (carrying a heavy scale) and operational (inability of Trained Birth Attenders to read) problems. Therefore it is essential to find out an alternative method for the estimation of birth weight. Almost 60 per cent of newborns in developing countries are not weighed. Which can lead to an underestimation of the incidence of low birth weight. That's why' we done' present study' to know the simple indicators to detect low birth weight babies. Aim of this study to compare calf circumference with other Low birth weight indicators as a reliable predictor of low birth weight babies.Methods: It is a cross-sectional study done during period 2018 January to 2018 October done at Niloufer Hospital Hyderabad. Statistical analysis is done using SPSS (version 17) statistical software. For comparison Pearson's Correlation coefficients used.Results: The best correlation was observed with both calf circumference (r=0.818) and head circumference (r=0.744) for identifying babies with birth weight <2 kg. For babies with birth weight <2.5 kg, calf circumference had the highest order of correlation (r = 0.986) followed closely by head circumference (r=0.886).Conclusion: In the absence of a weighing machine, simple measurements like calf circumference is the best indicator in identifying low birth weight babies (<2.5kg) at birth.
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Background: Obesity and Diabetes mellitus are well knownrisk factors for cardiovascular diseases (CVD). Though bodyfat appears to play important role in insulin resistance, the waybody fat is distributed is also significant. Waist circumference(WC), calf circumference (CC), and wait to calf ratio (WCR)can be used as predictors of risk of CVD. This study aims toevaluate the utility of WCR as a simple non-invasive, cheaper,easy to use and non-instrumental modality which can be usedas screening tool and as an indicator of coronaryatherosclerosis and resulting cardiovascular risk in patients(OPD as well as Inpatients) with Diabetes mellitus bycorrelating WCR with Carotid Intima Media Thickness (CIMT)which itself is an established indicator for risk of CVD.Methods: 100 adult patients with Type-2 diabetes werediagnosed on the basis of latest ADA criteria. Detailed history,clinical examination, anthropometric measurements,biochemical indices were assessed for all the selectedpatients. Carotid atherosclerosis was measured by scanningthe bilateral common carotid arteries using a high resolutionUSG system with 10 MHz linear transducer. The carotid intimamedia thickness (CIMT) was measured at three points on farwall of mid and distal CCA and 1 cm proximal to dilation ofcarotid bulb. Mean value of six measurements from right andleft CCA were used.Results: There is an expected negative correlationbetween calf circumference and prevalence of abnormal CIMT(p<0.011). WCR correlated with CIMT more strongly than theindependent measures with (p<0.001) and is a good predictorof CIMT abnormality as AUC (area under the curve) is 97.7%Conclusion: Waist to calf circumference ratio is a simple noninvasive, cheaper, easy to use and non-instrumental modalitywhich can be used as screening tool in assessment ofatherosclerotic burden of the vasculature at an early stage intype 2 diabetic OPD as well as in patients. WCR will serve assurrogate marker of coronary artery disease.
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OBJECTIVE@#The aim of this study was to determine whether low calf circumference (CC) could predict nutritional risk and the cutoff values of CC for predicting nutritional risk in hospitalized patients aged ⪖ 80 years.@*METHODS@#A total of 1,234 consecutive patients aged ⪖ 80 years were enrolled in this study. On admission, demographic data, CC, and laboratory parameters were obtained. Patients with Nutritional Risk Screening 2002 (NRS-2002) total score ⪖ 3 were considered as having nutritional risk.@*RESULTS@#CC values were significantly lower in patients with nutritional risk compared to those in patients without nutritional risk [27.00 (24.50-31.00) vs. 31.00 (29.00-33.50], P < 0.001]. CC was negatively correlated with age and nutritional risk scores. Logistic regression analysis of nutritional risk revealed that body mass index, albumin level, hemoglobin level, cerebral infarction, neoplasms, and CC (OR, 0.897; 95% confidence interval, 0.856-0.941; P < 0.001) were independent impact factors of nutritional risk. Nutritional risk scores increased with a decrease in CC. In men, the best CC cutoff value for predicting nutritional risk according to the NRS-2002 was 29.75 cm. In women, the cutoff value was 28.25 cm.@*CONCLUSION@#CC is a simple, noninvasive, and valid anthropometric measure to predict nutritional risk for hospitalized patients aged ⪖ 80 years.
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Aged, 80 and over , Female , Humans , Male , Anthropometry , Methods , China , Hospitalization , Leg , Nutritional Status , Risk Assessment , MethodsABSTRACT
Objective To investigate the relationship between calf circumference and skeletal muscle mass, strength and function in the elderly in Shanghai. Methods A total of 401 old people were recruited from physical examination centers in our hospital with the mean age of (71. 8±7. 4) years, including 202 males and 199 females. Adipose tissue, skeletal muscle mass (SMM) and appendicular skeletal muscle mass (ASM) were measured by bioelectrical impedance analysis. The ASM index ( ASM/height2) and SMM index ( SMM/height2) were calculated. Muscle function was measured by testing gait speed (m/s). Muscle strength was measured by handgrip strength (HGS) using an electronic hand dynamometer, with the dominant hand gripping for three times and taking the maximum value. Height, weight, right calf circumference and waist circumference were measured. Results Height, weight, ASM, ASM/height2, SMM, SMM/height2and HGS were significantly higher in men than in women ( P<0. 01); adipose tissue was significantly higher in women than in men (P<0. 05). The age, body mass index, calf circumference, waist circumference and gait speed were not statistically different (P=0. 426, P=0. 143, P=0. 425, P=0. 093, P=0. 143). There were linear correlations between calf circumference and height, weight, BMI, waist circumference, ASM, ASM/height2, adipose tissue, grip strength, SMM and SMM/height2( P=0. 001, P<0. 001, P<0. 001, P<0. 001, P<0. 001, P<0. 001, P<0. 001, P=0. 003, P<0. 001, P<0. 001). There was no linear correlation between calf circumference and pace and age (P=0. 818, P=0. 078). Multiple stepwise regression analysis showed that height, BMI, ASM/height2and SMM were correlated with the calf circumference. Conclusions Skeletal muscle mass and strength are higher in men than in women, while adipose tissue is higher in women than in men. Skeletal musle mass is an important factor affecting the calf circumference. There is a linear correlation be-tween skeletal muscle strength and calf circumference.
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Objective To evaluate the muscle mass in elderly patients with inguinal hernia using CT scan.Methods 30 male (age 70-90 years) hospitalized patients scheduled to receive surgery for inguinal hernia were selected into study group, 10 male health volunteers (40-50 years) were involved in adult control group, and 10 men of the same age as the study receiving annual physical examination were enrolled as elderly control group.General information were recorded;CT scanning of the stomach muscles and thigh muscles were conducted, and the muscle area was calculated using a special software.Results The index of grip strength in the study group was significantly lower than the adult control group [(36.44 ± 14.15) kg vs.(77.30 ± 22.69) kg, P =0.001], the calf circumference in the study group was significantly less than the adult control group [(25.18 ±2.31) cm vs.(27.62 ±2.33) cm, P =0.006].There was no significant difference in L3 abdominal area, subcutaneous fat area, abdominal fat area, and vertical spinal muscular volume between the study group and the adult control group;while the L3 abdominal muscle area and vertical spinal muscular mass was significantly less in the study group than in the adult control group [(12 094.23 ± 1 970.30) mm2 vs.(17462.00±1 600.58) mm2, P=0.001;(1 642.60±266.90) mm2 vs.(2 003.50±350.91) mm2,P =0.007].L3 skeletal muscle index of the study group was 50.64 ±7.52 and 66.7％ (20/30) of the study group had sarcopenia (≤52.4％).The CT findings of abdominal muscle of the study group were not significantly different from those of the elderly control group.The thigh muscle mass in the study group was significantly less than that in the control group (P =0.001), but there was no significant inter-group difference in thigh fat and femur areas (P ＞ 0.05).Conclusion The muscle mass and strength in elderly patients with inguinal hernia are significantly lower than those of adult controls, for which CT scan can be applied for assessment.