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Mthethwa WS, Mampofu ZM, Mokwena MA, Ramoshaba NE. The relationship between mid-upper arm circumference and blood pressure in Walter Sisulu University community. Blood Press 2024; 33:2296904. [PMID: 38254330 DOI: 10.1080/08037051.2023.2296904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 12/13/2023] [Indexed: 01/24/2024]
Abstract
Prevalence of hypertension is increasing to higher levels in South Africa. Anthropometric measures for obesity are well known to predict the development of hypertension. However, the relationship between mid-upper arm circumference (MUAC) and blood pressure (BP) is scant in South African communities such as universities. Therefore, this study was aimed at investigating the correlation between MUAC and BP among the community of Walter Sisulu University (WSU). A total of 230 participants from WSU (students and staff members), 113 females and 117 males aged ≥ 18 years participated in this cross-sectional study. MUAC, systolic BP (SBP) and diastolic BP (DBP) were measured using standard procedures. In a Pearson's correlation analysis, MUAC was positively correlated with SBP and DBP in both women (SBP; r = 0.53, P< 0.001; DBP; r = 0.45 P < 0.001) and men (SBP; r = 0.29 P = 0.001; DBP; r = 0.25 P = 0.007). Furthermore, in the multivariable-adjusted regression analysis, MUAC was positively associated with SBP in women only (adjusted R2 = 0.489, β = 0.29 (95% CI = 0.16; 2.08)), P =0.023) after adjusted for age, body fat percentage, waist-to-height ratio, smoking and alcohol. MUAC is positively correlated with BP in women, not in men of WSU community. MUAC, as a simple and low-cost quantifiable parameter, could be employed as a risk indicator in the early detection and prevention of cardiovascular diseases (CVDs) in women.
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Affiliation(s)
- Wenzile S Mthethwa
- Department of Human Biology, Walter Sisulu University, Nelson Mandela Drive, Mthatha5117, South Africa
| | - Zuqaqambe M Mampofu
- Department of Human Biology, Walter Sisulu University, Nelson Mandela Drive, Mthatha5117, South Africa
| | - Madigoahle A Mokwena
- Department of Human Biology, Walter Sisulu University, Nelson Mandela Drive, Mthatha5117, South Africa
| | - Nthai E Ramoshaba
- Department of Human Biology, Walter Sisulu University, Nelson Mandela Drive, Mthatha5117, South Africa
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Kiss CM, Bertschi D, Beerli N, Berres M, Kressig RW, Fischer AM. Calf circumference as a surrogate indicator for detecting low muscle mass in hospitalized geriatric patients. Aging Clin Exp Res 2024; 36:25. [PMID: 38321234 PMCID: PMC10847205 DOI: 10.1007/s40520-024-02694-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 01/02/2024] [Indexed: 02/08/2024]
Abstract
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.
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Affiliation(s)
- Caroline M Kiss
- University Department of Geriatric Medicine FELIX PLATTER, Basel, Switzerland
| | - Dominic Bertschi
- University Department of Geriatric Medicine FELIX PLATTER, Basel, Switzerland
- Department of Geriatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Nadine Beerli
- University Department of Geriatric Medicine FELIX PLATTER, Basel, Switzerland
- Institute of Nursing Science, Basel, Switzerland
| | - Manfred Berres
- Department of Mathematics and Technology, University of Applied Sciences Koblenz, Koblenz, Germany
| | - Reto W Kressig
- University Department of Geriatric Medicine FELIX PLATTER, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Andreas M Fischer
- University Department of Geriatric Medicine FELIX PLATTER, Basel, Switzerland.
- University of Basel, Basel, Switzerland.
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Mazzini LR, Aquino JLBD, Camargo JGTD, Leandro-Merhi VA. IS CALF CIRCUMFERENCE ASSOCIATED WITH CLINICAL AND NUTRITIONAL OUTCOME IN OLDER PATIENTS? ARQUIVOS BRASILEIROS DE CIRURGIA DIGESTIVA : ABCD = BRAZILIAN ARCHIVES OF DIGESTIVE SURGERY 2023; 36:e1773. [PMID: 37971026 PMCID: PMC10642954 DOI: 10.1590/0102-672020230055e1773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Accepted: 09/02/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND Previous studies have shown a relationship between calf circumference (CC) and outcomes in hospitalized patients. AIMS To investigate the relationship between CC and clinical and nutritional outcomes in older in-patients (OiP) in a surgery ward. METHODS This was a cross-sectional study with 417 OiP in a surgery ward. Clinical variables, anthropometry, and nutritional screening instruments such as subjective global assessment (SGA), mini nutritional assessment (MNA), and nutritional risk screening (NRS) were used in the investigation. The tests Pearson's chi-square, Mann-Whitney, Kruskal-Wallis, and Spearman's coefficient, and multiple linear regression analyses were used to review the factors associated with CC. RESULTS Lower CC values were found in the age group 80 years and over (p<0.0001), presence of complications (p=0.0269), NRS (p<0.0001), SGA (p<0.0001), and MNA (p<0.0001). Gender (p=0.0011; partial R2=0.01151), age (p=0.0002; partial R2=0.06032), body mass index (p≤0.0001; partial R2=0.40820), and arm circumference (p≤0.0001; partial R2=0.11890) are variables that together were associated with CC. There was also a relationship between SGA (p=0.0166; partial R2=0.00605) and absence of complications during hospitalization (p=0.0047; R2=0.01154) with CC. CONCLUSIONS Gender, age, body mass index, and arm circumference were jointly associated with CC, in addition to SGA and absence of complications. The CC is a relevant indicator for OiP in the clinical practice.
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Affiliation(s)
- Lucas Rosasco Mazzini
- Pontificia Universidade Católica de Campinas, School of Medicine - Campinas (SP), Brazil
| | - José Luis Braga de Aquino
- Pontificia Universidade Católica de Campinas, School of Medicine - Campinas (SP), Brazil
- Pontificia Universidade Católica de Campinas, Postgraduate Program in Health Sciences - Campinas (SP), Brazil
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Leandro-Merhi VA, Dos Santos HAV, Almendra AAR, de Aquino JLB. Nutritional indicators' performance in malnutrition diagnosis of hospitalized elderly patients. Exp Gerontol 2023; 181:112286. [PMID: 37683730 DOI: 10.1016/j.exger.2023.112286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 05/29/2023] [Accepted: 09/05/2023] [Indexed: 09/10/2023]
Abstract
BACKGROUND Several nutritional diagnosis methods and their relationship with clinical outcomes have been described. This study investigated malnutrition in hospitalized elderly patients (HEP) using different nutritional indicators and determined criteria to identify malnutrition and explore the variables that discriminate the risk of malnutrition. METHOD Cross-sectional study with 500 HEP; different methods of nutritional diagnosis, their relationship with clinical outcomes and criteria for defining malnutrition were investigated. The GLIM criteria for the diagnosis of malnutrition was applied in this study. In the statistical analysis, the Chi-square test, Fisher's exact test, Mann-Whitney test, univariate and multiple logistic regression and the ROC curve were used. RESULTS Patients aged 65-79 years, at nutritional risk or with malnutrition, had longer hospital stays (p = 0.0099; OR = 1.047; 95% CI = 1.011; 1.084) and lower body mass index (BMI) (p < 0.0001; OR = 0.867 (1153)); 95% CI = 0.813; 0.924 (1085; 1225). Patients aged ≥80 years had a lower BMI (p = 0.0053; OR = 0.779 (1284); 95% CI = 0.653; 0.928 (1078; 1531)). Accuracy was significant in both age groups for BMI (p < 0.0001; 65-79 years and p = 0.001; ≥80 years); for the lymphocyte count (p = 0.0167; 65-79 years and p = 0.0028; ≥80 years), and for the calf circumference (CC) (p < 0.0001; 65-79 years and p = 0.001; ≥80 years). Using the GLIM criteria, 27.78% of patients were considered malnourished. CC showed good accuracy, good specificity, but low sensitivity while BMI was more accurate to detect malnutrition in both age groups. CONCLUSION CC showed good accuracy, good specificity, but low sensitivity to detect malnutrition. BMI was more accurate in both age groups to detect malnutrition.
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Zhao X, Chen S, Yu J. Evaluating the association between anthropometric parameters and successful aging in older adults. Geriatr Nurs 2023; 50:240-246. [PMID: 36812848 DOI: 10.1016/j.gerinurse.2023.01.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 01/25/2023] [Accepted: 01/25/2023] [Indexed: 02/22/2023]
Abstract
This study aimed to determine the relationship between successful aging (SA) and anthropometric parameters in older adults. We used body mass index (BMI), waist circumference, hip circumference, and calf circumference to reflect anthropometric parameters. SA was assessed by the following five aspects: self-rated health, self-rated psychological status or mood, cognitive function, activities of daily life, and physical activity. Logistic regression analyses were employed to examine the relationship between anthropometric parameters and SA. Results showed that larger BMI, waist circumference, and calf circumference are related to a higher prevalence of SA in older women; greater waist circumference and calf circumference are associated with a higher rate of SA in old-old adults. These findings suggest that the greater BMI, waist circumference, hip circumference, and calf circumference are associated with a higher rate of SA in older adults, and the associations are influenced to some extent by the sex and age.
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Affiliation(s)
- Xiaoguang Zhao
- Faculty of Sport Science, Ningbo University, Ningbo, Zhejiang, China; Research Academy of Grand Health, Ningbo University, Ningbo, Zhejiang, China.
| | - Siyuan Chen
- Faculty of Sport Science, Ningbo University, Ningbo, Zhejiang, China
| | - Jiabin Yu
- Faculty of Sport Science, Ningbo University, Ningbo, Zhejiang, China; Research Academy of Grand Health, Ningbo University, Ningbo, Zhejiang, China
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Wang PC, Yeh WC, Tsai YW, Chen JY. Calf circumference has a positive correlation with physical performance among community-dwelling middle-aged, older women. Front Public Health 2022; 10:1038491. [PMID: 36568803 PMCID: PMC9780591 DOI: 10.3389/fpubh.2022.1038491] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 11/14/2022] [Indexed: 12/13/2022] Open
Abstract
Introduction Sarcopenia and frailty are well-known public health problems in middle-aged and older people. Calf circumference (CC) is a representative anthropometric index that may be useful for screening sarcopenia. Physical performance, assessed by hand grip strength and gait speed, measures sarcopenia and frailty. This community-based, cross-sectional study was conducted in Guishan District, Taoyuan City, between April and October 2017 to investigate the relationship between CC and physical performance among community-dwelling middle-aged, older people in Taiwan and to evaluate potential sex differences. CC tends to be an efficient predictor of physical performance in community health screenings and outpatient clinics for community health examinations, where there is limited time for surveys. Methods A total of 1,308 volunteers aged 50-85 were recruited. Volunteers who declined to participate, those with recent cardiovascular disease, and those with an inability to complete an interview, physical performance examinations, and body composition measurements were excluded from the study. A total of 828 participants were enrolled in this study (237 men and 591 women). The statistical methods applied in this study were the Mann-Whitney U-test, independent two-sample t-test, Chi-square test, and multivariate logistic regression models. Result and discussion Significant differences were observed in age, waist circumference, appendicular skeletal mass index, calf circumference, hand grip strength, and income between men and women. No significant differences were observed between the men and women regarding body mass index, gait speed, exercise habits, or underlying disorders of diabetes mellitus, hypertension, or hyperlipidemia. Comparing across three different CC tertiles, we discovered significant differences in age, body mass index, waist circumference, appendicular skeletal muscle index, gait speed, and hand grip strength in both men and women. On multivariate logistic regression, after adjusting for age, appendicular skeletal mass index, body mass index, exercise habits, income levels, and CC were positively correlated with physical performance as measured by both gait speed (β = 0.15, p = 0.01) and hand grip strength (β = 0.25, p < 0.001) in women, compared to only hand grip strength (β = 0.41, p < 0.001) in men. Lower calf circumference is an independent risk factor for poor physical performance, especially among women.
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Affiliation(s)
- Po-Chun Wang
- Department of Family Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Wei-Chung Yeh
- Department of Family Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan,Department of Family Medicine, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Yi-Wen Tsai
- Department of Family Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan,Department of Family Medicine, New Taipei Municipal Tu-Cheng Hospital (Built and Operated by Chang Gung Medical Foundation), New Taipei City, Taiwan,College of Medicine, Chang-Gung University, Taoyuan, Taiwan
| | - Jau-Yuan Chen
- Department of Family Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan,College of Medicine, Chang-Gung University, Taoyuan, Taiwan,*Correspondence: Jau-Yuan Chen
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Hwang D, Ahn S, Park YB, Kim SH, Han HS, Lee MC, Ro DH. Deep Learning-Based Muscle Segmentation and Quantification of Full-Leg Plain Radiograph for Sarcopenia Screening in Patients Undergoing Total Knee Arthroplasty. J Clin Med 2022; 11:3612. [PMID: 35806895 PMCID: PMC9267147 DOI: 10.3390/jcm11133612] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 06/18/2022] [Accepted: 06/21/2022] [Indexed: 02/04/2023] Open
Abstract
Sarcopenia, an age-related loss of skeletal muscle mass and function, is correlated with adverse outcomes after some surgeries. Here, we present a deep-learning-based model for automatic muscle segmentation and quantification of full-leg plain radiographs. We illustrated the potential of the model to predict sarcopenia in patients undergoing total knee arthroplasty (TKA). A U-Net-based deep learning model for automatic muscle segmentation was developed, trained and validated on the plain radiographs of 227 healthy volunteers. The radiographs of 403 patients scheduled for primary TKA were reviewed to test the developed model and explore its potential to predict sarcopenia. The proposed deep learning model achieved mean IoU values of 0.959 (95% CI 0.959-0.960) and 0.926 (95% CI 0.920-0.931) in the training set and test set, respectively. The fivefold AUC value of the sarcopenia classification model was 0.988 (95% CI 0.986-0.989). Of seven key predictors included in the model, the predicted muscle volume (PMV) was the most important of these features in the decision process. In the preoperative clinical setting, wherein laboratory tests and radiographic imaging are available, the proposed deep-learning-based model can be used to screen for sarcopenia in patients with knee osteoarthritis undergoing TKA with high sarcopenia screening performance.
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Affiliation(s)
- Doohyun Hwang
- Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul 03080, Korea; (D.H.); (S.A.); (H.-S.H.); (M.C.L.)
- Department of Orthopedic Surgery, Seoul National University Hospital, Seoul 03080, Korea
| | - Sungho Ahn
- Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul 03080, Korea; (D.H.); (S.A.); (H.-S.H.); (M.C.L.)
- Department of Orthopedic Surgery, Seoul National University Hospital, Seoul 03080, Korea
| | - Yong-Beom Park
- Department of Orthopedic Surgery, Chung-Ang University Hospital, Seoul 06973, Korea; (Y.-B.P.); (S.H.K.)
| | - Seong Hwan Kim
- Department of Orthopedic Surgery, Chung-Ang University Hospital, Seoul 06973, Korea; (Y.-B.P.); (S.H.K.)
| | - Hyuk-Soo Han
- Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul 03080, Korea; (D.H.); (S.A.); (H.-S.H.); (M.C.L.)
- Department of Orthopedic Surgery, Seoul National University Hospital, Seoul 03080, Korea
| | - Myung Chul Lee
- Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul 03080, Korea; (D.H.); (S.A.); (H.-S.H.); (M.C.L.)
- Department of Orthopedic Surgery, Seoul National University Hospital, Seoul 03080, Korea
| | - Du Hyun Ro
- Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul 03080, Korea; (D.H.); (S.A.); (H.-S.H.); (M.C.L.)
- Department of Orthopedic Surgery, Seoul National University Hospital, Seoul 03080, Korea
- Connecteve Co., Ltd., Seoul 03080, Korea
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Ren C, Zhang X, Zhu Y, Xu J, Xie Y. Low calf circumference can predict nutritional risk and mortality in adults with metabolic syndrome aged over 80 years. BMC Endocr Disord 2022; 22:47. [PMID: 35193560 PMCID: PMC8864893 DOI: 10.1186/s12902-022-00964-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 02/16/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Metabolic disorders and malnutrition are a double burden worldwide. The aim was to determine whether low calf circumference (CC) could predict nutritional risk and the cut-off values of CC for predicting nutritional risk in metabolic syndrome (MetS) patients aged over 80 years. We aimed to evaluate the risk factors for predicting mortality in MetS. METHODS A total of 514 patients aged over 80 years with MetS were enrolled and followed for 2.5 years. On admission, demographic data, CC, and laboratory parameters were obtained. Patients with a Nutritional Risk Screening 2002 (NRS 2002) total score ≥ 3 were considered to have nutritional risk. RESULTS The CC level was significantly lower in the nutritional risk group than in the non-nutritional risk with MetS group (27.1 ± 4.0 cm vs. 30.8 ± 3.9 cm). Logistic regression analysis of nutritional risk revealed that increasing CC (adjusted OR, 0.81; 95% CI, 0.74-0.88) was an independent protective factor against nutrition risk. The best CC cut-off value for predicting nutritional risk according to the NRS 2002 was 28.8 cm. Cox regression multivariate models showed nutritional risk (HR, 2.48; 95% CI, 1.22-5.04) and decreased CC (HR, 2.78; 95% CI, 1.27-5.98) remained independent risk factors for mortality. CONCLUSION Decreased CC could predict not only nutritional risk but also mortality in MetS patients aged over 80 years. The elderly who had MetS with nutritional risk should be discovered early, early intervention and early treatment. CC may be a valuable index to screen out this population.
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Affiliation(s)
- Chenxi Ren
- Department of Endocrinology, The Second Affiliated Hospital of Soochow University, Sanxiang Road, 1055, Gusu District, Suzhou City, Jiangsu Province People’s Republic of China
- Department of Geriatrics, Shanghai Jiaotong University Affiliated Sixth People’s Hospital, Shanghai, 200233 People’s Republic of China
| | - Xiaoyan Zhang
- Department of Geriatrics, Shanghai Jiaotong University Affiliated Sixth People’s Hospital, Shanghai, 200233 People’s Republic of China
| | - Yunxia Zhu
- Department of Geriatrics, Shanghai Jiaotong University Affiliated Sixth People’s Hospital, Shanghai, 200233 People’s Republic of China
| | - Jun Xu
- Department of Geriatrics, Shanghai Jiaotong University Affiliated Sixth People’s Hospital, Shanghai, 200233 People’s Republic of China
| | - Ying Xie
- Department of Endocrinology, The Second Affiliated Hospital of Soochow University, Sanxiang Road, 1055, Gusu District, Suzhou City, Jiangsu Province People’s Republic of China
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