Ethnic-specific cut-points for sarcopenia: evidence from black South African women

Kruger, Herculina S.; Micklesfield, Lisa K.; Wright, Hattie H; Havemann-Nel, Lize; Goedecke, Julia H.

doi:10.1038/ejcn.2014.279

Cited by 17 publications

(20 citation statements)

References 26 publications

(54 reference statements)

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“…Only Korean population were included in this study. This cut-off values cannot be used in other races or population considering that the cutoff for sarcopenia can differ among different races [27]. However, the validity of reported prognostic factors, such as the GAP score, was confirmed in this study population, which supports the present findings.…”

Section: Discussionsupporting

confidence: 85%

Thoracic skeletal muscle quantification: low muscle mass is related with worse prognosis in idiopathic pulmonary fibrosis patients

et al. 2019

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Background Sarcopenia can contribute to negative outcomes in patients with various lung diseases. However, whether sarcopenia affects prognosis in patients with idiopathic pulmonary fibrosis (IPF) has not been reported. Simple measures of muscle mass, derived from chest computed tomography (CT), are increasingly being used to identify patients with sarcopenia. We hypothesized that skeletal muscle mass could be a predictor of prognosis in IPF patients. Methods We retrospectively evaluated 180 patients diagnosed with IPF between January 2010 and December 2015 at a tertiary care hospital in South Korea. We measured thoracic muscle volume by using the cross-sectional area (CSA) of the pectoralis, paraspinal, serratus, and latissimus muscles at the 4th vertebral region (T4 CSA ) and the erector spinae muscle (ESM CSA ) at the 12th vertebral region. CT scans at the time of diagnosis were used for analysis and respective CSA were divided by height squared to normalize for stature. Survival times were estimated with the Kaplan–Meier method and compared with the log-rank test. Multivariate Cox proportional hazards models were performed to investigate relationships between clinical parameters and mortality. Results Male patients in the lowest quartile of T4 CSA divided by height squared (m 2 ) (T4MI) and in the lowest quartile of ESM CSA divided by height squared (m 2 ) (T12MI) were more likely to have higher Gender-Age-Physiology Index scores (T4MI, 3.3 ± 1.3 vs 4.0 ± 1.6, P = 0.012; T12MI, 3.2 ± 1.3 vs 4.1 ± 1.6, P = 0.002). Male patients in the lowest quartile of T4MI exhibited a significantly lower survival rate ( P = 0.035). After multivariate Cox proportional hazards analysis, T4MI was a significant risk factor for all-cause mortality (HR, 0.955; 95% CI, 0.913–0.998; P = 0.041), whereas T12MI was not (HR, 0.980; 95% CI, 0.856–1.121; P = 0.766). Conclusions Low skeletal mass normalized for stature at the level of 4th vertebrae which can be acquired by quantifying thoracic skeletal muscle on single-slice axial chest CT, may be a strong risk factor for all-cause mortality in patients with IPF. Trial registration The research protocol was approved by the Institutional Review Board of Severance Hospital, South Korea (IRB No.4–2018-0454). Electronic supplementary material The online version of this article (10.1186/s12931-019-1001-6) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 85%

Thoracic skeletal muscle quantification: low muscle mass is related with worse prognosis in idiopathic pulmonary fibrosis patients

et al. 2019

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“…However, the FNIH aLM cut‐point had the greatest specificity and sensitivity in detecting low functional ability in ageing Gambian men and women. Our finding is consistent with a study in Black women aged 45–84 years from the north‐west of South Africa . Also, the FNIH aLM definition identified a higher prevalence of sarcopenia in Gambian women (45%) when compared with the EWGSOP definition.…”

Section: Discussionsupporting

confidence: 91%

“…Also, the FNIH aLM definition identified a higher prevalence of sarcopenia in Gambian women (45%) when compared with the EWGSOP definition. In line with our findings, there was also a greater proportion of women classified as sarcopenic (39%) from the South African study according to the FNIH aLM definition, with a higher prevalence of obesity in the Black South African women compared with Gambian women.…”

Section: Discussionsupporting

confidence: 89%

The prevalence of sarcopenia and relationships between muscle and bone in ageing West‐African Gambian men and women

Zengin

Jarjou

Prentice

et al. 2018

J cachexia sarcopenia muscle

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BackgroundThe rapidly rising ageing population in low and middle‐income countries (LMIC) will lead to a concurrent increase in musculoskeletal diseases. Sarcopenia is a disease caused by progressive loss of skeletal muscle mass and strength, leading to adverse outcomes including frailty, falls, fractures, and premature mortality. We investigated the prevalence of sarcopenia, assessed the suitability of current diagnostic guidelines and explored muscle–bone relationships in ageing men and women from rural Gambia.MethodsA total of 249 women and 239 men aged 40–75+ years were recruited. Body composition was measured using dual energy X‐ray absorptiometry. Comparisons of the Foundations for the National Institutes of Health (FNIH) and European Working Group On Sarcopenia (EWGSOP) definitions of sarcopenia to define prevalence and to identify poor physical capability were determined. Functional ability was assessed by jumping mechanography to calculate lower limb muscle force and power; grip strength was assessed by a hand dynamometer. Peripheral quantitative computed tomography was used to assess muscle–bone relationships.ResultsThe prevalence of sarcopenia in Gambian men and women significantly varied depending on the definition used; in men 20% and 19% and in women 45% and 10% for FNIH and EWGSOP, respectively. The FNIH appendicular lean mass cut‐off had greatest sensitivity and specificity in identifying low functional ability in Gambian adults. Muscle force was positively associated with measures of tibial bone size, strength, and mineral content.ConclusionsThe variation in the prevalence of sarcopenia depends on the definition used and highlights the importance of measuring functional capability across ethnic populations.

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“…Different criteria include the European Working Group on Sarcopenia (EWGSOP) (30), EWGSOP2 (31), Asian Working Group for Sarcopenia (AWGS) (32), International Working Group for Sarcopenia (IWGS) (34), and the Foundation for the National Institutes of Health (FNIH) criteria (35). More locally, Kruger et al have suggested ethnic-specific cut-points for use in classifying low appendicular skeletal muscle mass index in black South African women (36). Each criterion defines sarcopenia using muscle mass and muscle function indices; however, the diagnostic cut-off values and diagnostic process differs.…”

Section: Begin With the End In Mind: Classification Of Sarcopenia And Sarcopenic Obesitymentioning

confidence: 99%

Sarcopenic Obesity in Africa: A Call for Diagnostic Methods and Appropriate Interventions

et al. 2021

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This perspective aims to highlight the lack of current knowledge on sarcopenic obesity in Africa and to call for diagnostic methods and appropriate interventions. Sarcopenic obesity has been defined as obesity that occurs in combination with low muscle mass and function, which is typically evident in older adults. However, there has been no clear consensus on population-specific diagnostic criterion, which includes both gold-standard measures that can be used in a more advanced health care system, and surrogate measures that can be used in low-income settings with limited resources and funding. Importantly, low and middle-income countries (LMICs) across Africa are in an ongoing state of economic and social transition, which has contributed to an increase in the aging population, alongside the added burden of poverty, obesity, and associated co-morbidities. It is anticipated that alongside the increased prevalence of obesity, these countries will further experience an increase in age-related musculoskeletal diseases such as sarcopenia. The developmental origins of health and disease (DOHaD) approach will allow clinicians and researchers to consider developmental trajectories, and the influence of the environment, for targeting high-risk individuals and communities for treatment and/or prevention-based interventions that are implemented throughout all stages of the life course. Once a valid and reliable diagnostic criterion is developed, we can firstly assess the prevalence and burden of sarcopenic obesity in LMICs in Africa, and secondly, develop appropriate and sustainable interventions that target improved dietary and physical activity behaviors throughout the life course.

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Ethnic-specific cut-points for sarcopenia: evidence from black South African women

Abstract: The new SA cut-point had similar or greater odds of predicting reduced functional ability in older SA women when compared with other internationally accepted cut-points.

Cited by 17 publications

References 26 publications

Thoracic skeletal muscle quantification: low muscle mass is related with worse prognosis in idiopathic pulmonary fibrosis patients

Thoracic skeletal muscle quantification: low muscle mass is related with worse prognosis in idiopathic pulmonary fibrosis patients

The prevalence of sarcopenia and relationships between muscle and bone in ageing West‐African Gambian men and women

Sarcopenic Obesity in Africa: A Call for Diagnostic Methods and Appropriate Interventions

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