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

• Published in: Nutrients Vol. 16; no. 11; p. 1552
• Main Authors: de Luis Roman, Daniel, García Almeida, José Manuel, Bellido Guerrero, Diego, Guzmán Rolo, Germán, Martín, Andrea, Primo Martín, David, García-Delgado, Yaiza, Guirado-Peláez, Patricia, Palmas, Fiorella, Tejera Pérez, Cristina, García Olivares, María, Maíz Jiménez, María, Bretón Lesmes, Irene, Alzás Teomiro, Carlos Manuel, Guardia Baena, Juan Manuel, Calles Romero, Laura A, Prior-Sánchez, Inmaculada, García-Luna, Pedro Pablo, González Pacheco, María, Martínez-Olmos, Miguel Ángel, Alabadí, Blanca, Alcántara-Aragón, Valeria, Palma Milla, Samara, Martín Folgueras, Tomás, Micó García, Andrea, Molina-Baena, Begoña, Rendón Barragán, Henry, Rodríguez de Vera Gómez, Pablo, Riestra Fernández, María, Jiménez Portilla, Ana, López-Gómez, Juan J, Pérez Martín, Nuria, Montero Madrid, Natalia, Zabalegui Eguinoa, Alba, Porca Fernández, Cristina, Tapia Guerrero, María José, Ruiz Aguado, Marta, Velasco Gimeno, Cristina, Herrera Martínez, Aura D, Novo Rodríguez, María, Iglesias Hernández, Natalia C, de Damas Medina, María, González Navarro, Irene, Vílchez López, Francisco Javier, Fernández-Pombo, Antía, Olveira, Gabriel
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 21.05.2024; MDPI
• Subjects: Aged; Analysis; Care and treatment; Clinical medicine; Cohort analysis; Complications and side effects; Diagnosis; Diagnosis, Ultrasonic; Electric Impedance; Female; Geriatric Assessment - methods; Hand Strength; Hospitals; Humans; Informed consent; Magnetic resonance imaging; Male; Malnutrition; Malnutrition - diagnosis; Middle Aged; Muscle strength; Muscles; Musculoskeletal system; Nutrition Assessment; nutritional risk; Nutritional Status; nutritional ultrasound; Patients; Prospective Studies; Quadriceps Muscle - diagnostic imaging; Questionnaires; rectus femoris; Reference values (Medicine); Risk Factors; ROC Curve; Sarcopenia; Sarcopenia - diagnosis; Sarcopenia - diagnostic imaging; Sarcopenia - etiology; Sensitivity and Specificity; Thigh; Ultrasonic imaging; Ultrasonography - methods; ultrasound cut-off values; Working groups; Spain; United States > US; malnutrition; nutritional risk; rectus femoris; ultrasound cut-off values; nutritional ultrasound; sarcopenia
• ISSN: 2072-6643; 2072-6643
• DOI: 10.3390/nu16111552

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. 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. 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 ( < 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 cm and 3.66 cm for CSA, 32.57 mm and 40.21 mm for the -axis, and 7.85 mm and 10.4 mm for the -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. 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.