Calf circumference is similarly associated with fat mass and lean mass in postmenopausal women with high body fat percentage

Cruz, Raíla P. F.; Barreiro, Sara M.; Mendonça, Anne M.; Rossato, Luana T.; Nahas, Paula C.; Orsatti, Fábio Lera; Oliveira, Erick P. de

doi:10.1186/s41110-019-0109-2

Cited by 5 publications

(3 citation statements)

References 12 publications

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“…Interestingly, our study found prevalence of small calf circumference was significantly lower in higher FMI and FM/FMI tertiles where the prevalence of sarcopenic obesity was also high. Calf circumference has been shown to not be a good predictor of lean muscle mass especially in women with high body fat as it reflects both high muscle and fat content (71). If calf circumference is used as a screening tool for sarcopenia, a large proportion of older adults with high fat mass may be wrongly classified as non-sarcopenic.…”

Section: Discussionmentioning

confidence: 99%

Relationship of Fat Mass Index and Fat Free Mass Index With Body Mass Index and Association With Function, Cognition and Sarcopenia in Pre-Frail Older Adults

Merchant

Seetharaman

et al. 2021

Front. Endocrinol.

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BackgroundBody mass index (BMI) is an inadequate marker of obesity, and cannot distinguish between fat mass, fat free mass and distribution of adipose tissue. The purpose of this study was twofold. First, to assess cross-sectional relationship of BMI with fat mass index (FMI), fat free mass index (FFMI) and ratio of fat mass to fat free mass (FM/FFM). Second, to study the association of FMI, FFMI and FM/FFM with physical function including sarcopenia, and cognition in pre-frail older adults.MethodsCross-sectional study of 191 pre-frail participants ≥ 65 years, 57.1% females. Data was collected on demographics, cognition [Montreal Cognitive Assessment (MoCA)], function, frailty, calf circumference, handgrip strength (HGS), short physical performance battery (SPPB) and gait speed. Body composition was measured using InBody S10. FMI, FFMI and FM/FFM were classified into tertiles (T1, T2, T3) with T1 classified as lowest and T3 highest tertile respectively and stratified by BMI.ResultsHigher FFMI and lower FM/FFM in the high BMI group were associated with better functional outcomes. Prevalence of low muscle mass was higher in the normal BMI group. FMI and FM/FFM were significantly higher in females and FFMI in males with significant gender differences except for FFMI in ≥ 80 years old. Small calf circumference was significantly less prevalent in the highest tertile of FMI, FM/FMI and FFMI. Prevalence of sarcopenic obesity and low physical function (HGS, gait speed and SPPB scores) were significantly higher in the highest FMI and FM/FFM tertile. Highest FFMI tertile group had higher physical function, higher MoCA scores, lower prevalence of sarcopenic obesity and sarcopenia, After adjustment, highest tertile of FFMI was associated with lower odds of sarcopenia especially in the high BMI group. Highest tertile of FM/FFM was associated with higher odds of sarcopenia. Higher BMI was associated with lower odds of sarcopenia.ConclusionFFMI and FM/FFM may be a better predictor of functional outcomes in pre-frail older adults than BMI. Cut-off values for healthy BMI values and role of calf circumference as a screening tool for sarcopenia need to be validated in larger population. Health promotion intervention should focus on FFMI increment.

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Section: Discussionmentioning

confidence: 99%

Relationship of Fat Mass Index and Fat Free Mass Index With Body Mass Index and Association With Function, Cognition and Sarcopenia in Pre-Frail Older Adults

Merchant

Seetharaman

et al. 2021

Front. Endocrinol.

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“…16 CC has been linked to higher body fat percentages in women after menopause. 17 However, some studies indicate a paradoxical finding that higher BMI in hemodialysis patients might link to better nutrition and fewer negative outcomes. This challenges the usual thoughts about weight and health in certain medical cases.…”

Section: Discussionmentioning

confidence: 99%

The expected changes with different periods of home-based resistance exercise in patients with chronic kidney disease

Chen,

Hsu,

Chang

et al. 2024

Journal of the Chinese Medical Association

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Background: The comprehensive impact of prolonged home-based resistance training on individuals grappling with chronic kidney disease (CKD) have yet to be fully elucidated. This study aimed to explore the outcomes of varying exercise durations on physical performance, nutritional status, and kidney function within this specific population, encompassing patients undergoing dialysis and those affected by severe sarcopenia. Methods: This was a one-year observational double cohort study following a 52-week longitudinal design, we enrolled 101 adult CKD outpatients. These participants were divided into two groups: the continuous group, comprising individuals who consistently exercised for over six months, and the interrupted group, which included those who didn't sustain regular exercise for the same duration. The exercise regimen involved resistance exercises conducted at least 3 to 5 days per week, involving activities like lifting dumbbells and executing weighted wall squats. Physical activity assessments and biochemical blood tests were conducted at weeks 0, 4, 16, 28, 40, and 52 for all participants. Results: The continuous exercise group exhibited better handgrip strength and sit-to-stand movement compared to the interrupted group. Their estimated glomerular filtration rate stayed steady while the interrupted group was declined. Additionally, those who exercised consistently had better metabolism: higher carbon dioxide levels, increased albumin, better nutritional scores, and lower levels of blood urea nitrogen, creatinine, fasting blood glucose, and body weight. Subsequent adjustments for potential confounding factors continued to show improved physical performance and kidney function over time. Conclusion: Our findings indicate the advantageous impact of extended resistance exercise training on overall health of CKD patients, even those on dialysis or with severe sarcopenia. Dedication to this exercise routine could improve kidney function, metabolism, and physical abilities in these patients.

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“…A longitudinal study indicated a calf circumference decline of 1.1–3.4 cm over a 15-year period, with a more pronounced decrease observed in older-old adults compared to their younger counterparts [ 31 ]. Additionally, research has identified lower calf circumference cut-off values signifying low muscle mass in older adults with limited mobility, such as stroke patients (32 cm for women and 33 cm for men) [ 32 ], or those who have been hospitalized (28 cm for women and 30 cm for men) [ 33 ], in contrast to community-dwelling older adults. In our study, the cut-off value for calf circumference indicating low muscle mass in older-old adults (age ≥ 75 years) appeared similar to the overall results.…”

Section: Discussionmentioning

confidence: 99%

Calf circumference as a screening tool for low skeletal muscle mass: Cut-off values in independent Thai older adults

Champaiboon,

Petchlorlian,

Manasvanich

et al. 2023

BMC Geriatr

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Background Calf circumference is recommended as a marker for low muscle mass and as a case finding in the diagnosis of sarcopenia. However, the cut-off value differed by ethic and region. Currently there is no study among Thai population. Therefore, we aimed to identify the optimal cutoff value of calf circumference as a screening tool for low skeletal muscle mass in independent Thai older adults. Subgroup analysis was performed for obesity and adults over 75 years. Methods This cross-sectional cohort studied in an outpatient geriatric check-up clinic. Participants, aged 60 and above, needed to be independent in basic activities of daily living to meet the inclusion criteria. Exclusion criteria comprised active malignancy, cardiac, pulmonary, or neurovascular diseases necessitating hospitalization in the preceding three months, chronic renal diseases requiring renal replacement therapy, and unstable psychiatric disorders. We measured the maximum calf circumference and appendicular skeletal muscle mass (ASMI) using bioelectrical impedance analysis (BIA). Low muscle mass is defined according to the Asian Working Group of Sarcopenia (AWGS) 2019 consensus. Results We enrolled 6,404 elderly adults (mean age 67.3 ± 5.1 years), with a 47% prevalence of low muscle mass in women and 25% in men. Lower muscle mass significantly correlated with reduced BMI and waist circumference in both genders (p < 0.001). Optimal cut-off values for low muscle mass screening were < 33 cm (sensitivity 80.1%, specificity 60.5%) for women and < 34 cm (sensitivity 85.4%, specificity 70.2%) for men. Subgroup analysis for those with BMI ≥ 25 kg/m² suggested raising the cut-off for women to < 34 cm (sensitivity 80.6%, specificity 54.0%) and for men to < 35 cm (sensitivity 88.7%, specificity 55.2%) to enhance specificity without substantial sensitivity loss. In the older-old adult subgroup (≥ 75 years), optimal cut-off values were < 33 cm (sensitivity 84.6%, specificity 79.9%) for women and < 34 cm (sensitivity 75.6%, specificity 87.0%) for men. Conclusions There is a strong correlation between calf circumference and ASMI in independent Thai older adults. Calf circumference can serve as a screening tool for identifying low muscle mass. The recommended cut-off values for men and women are 34 cm and 33 cm, respectively in alignment with AWGS 2019 recommendation. Incorporating a 1-cm higher cut-off value for obese older adults improves the accuracy of muscle mass screening. Trial registration Thai clinical trial registry: TCTR20200511003.

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Calf circumference is similarly associated with fat mass and lean mass in postmenopausal women with high body fat percentage

Cited by 5 publications

References 12 publications

Relationship of Fat Mass Index and Fat Free Mass Index With Body Mass Index and Association With Function, Cognition and Sarcopenia in Pre-Frail Older Adults

Relationship of Fat Mass Index and Fat Free Mass Index With Body Mass Index and Association With Function, Cognition and Sarcopenia in Pre-Frail Older Adults

The expected changes with different periods of home-based resistance exercise in patients with chronic kidney disease

Calf circumference as a screening tool for low skeletal muscle mass: Cut-off values in independent Thai older adults

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