Low Agreement Between Initial and Revised European Consensus on Definition and Diagnosis of Sarcopenia Applied to People Living With HIV

Abstract

Background: In 2019, the European Working Group on Sarcopenia in Older People (EWGSOP2) proposed low muscle strength as the primary outcome for sarcopenia diagnosis instead of low muscle mass, as proposed in 2010 (EWGSOP1). Therefore, the aim of this study was to compare the prevalence of sarcopenia using both EWGSOP1 and EWGSOP2 operational definitions in people living with HIV (PLHIV) and to determine the agreement and correlation between different tests proposed by EWGSOP2. Setting: Cross-sectional study, where 302 PLHIV (151 men), 51.7 ± 9.0 years old were evaluated for the presence of sarcopenia using both EWGSOP1 and EWGSOP2 operational definitions. Methods: Appendicular skeletal muscle was estimated using bioimpedance analysis. Handgrip strength, chair stand, gait speed, and static balance were used as muscle function measures. Agreement was determined using Cohen kappa and Pearson correlation coefficient was calculated. Results: Sarcopenia prevalence was 4.3% using EWGSOP1 and 1.0% using EWGSOP2. Agreement for sarcopenia diagnosis between EWGSOP1 and EWGSOP2 was fair (k = 0.37, P < 0.01). From the 13 cases of sarcopenia diagnosed using EWGSOP1, only 3 cases (23.1%) were also diagnosed using EWGSOP2. A medium correlation (r = −0.32, P < 0.01) and poor agreement (k = 0.14, P < 0.01) between muscle strength tests (handgrip strength and chair stand) were observed. Concordance between handgrip and chair stand was observed in 11 participants only, whereas 65 participants were considered to have low muscle strength using chair stand but not using handgrip. Conclusions: Lower sarcopenia prevalence using EWGSOP2 and low agreement between EWGSOP1 and EWGSOP2 operational definitions in diagnosing sarcopenia were observed in PLHIV.

Sarcopenia in people living with HIV in Hong Kong: which definition correlates with health outcomes?

“…With the changes in the criteria defining sarcopenia, it would be important to determine which is the more appropriate definition to be adopted in PLWH [ 20 ]. To evaluate this issue, we determined the correlation between different definitions of sarcopenia and health outcomes, including disability and QOL.…”

“…The increase in the prevalence of sarcopenia with the changes in AWGS definitions was in contrast to a reduction in the prevalence of sarcopenia among PLWH with the change from EWGSOP1 to EWGSOP2 [ 20 ]. This reduction was partly due to more conservative cut‐offs for the determination of low muscle strength and low muscle mass in EWGSOP2.…”

“…Moreover, in EWGSOP2, physical performance was only adopted to define severe sarcopenia but not sarcopenia, while AWGS‐2019 expanded the measures for physical performance to define sarcopenia. There were concerns with these changes in the revised EWGSOP2 criteria, which would limit its use in identifying at‐risk PLWH with sarcopenia and prevent the implementation of early interventions for the avoidance of progression to disability [ 20 , 42 ]. Our findings supported both AWGS and EWGSOP guidelines in including both muscle mass and muscle strength in defining sarcopenia.…”

“…We determined agreement between the different definitions of sarcopenia and severe sarcopenia using Cohen's kappa test. Kappa was interpreted as poor if value was < 0.20, fair if 0.21–0.4, moderate if 0.41–0.60, good if 0.61–0.80 and very good if 0.81–1.00 [ 20 ]. We compared baseline demographic and clinical variables between those with and without sarcopenia or severe sarcopenia according to different definitions using chi‐square, Student's t and Mann–Whitney U test, as appropriate.…”

Mapping knowledge structure and global status of sarcopenia in geriatric hip fractures: A bibliometric and visualized study

“…Sarcopenia is an aging-related disease characterized by loss of muscle mass, muscle strength, and physical function ( 7 ). The concept of sarcopenia was first put forward in 1989 by Irwin Rosenberg ( 8 ) and attracted lots of attention from researchers and doctors in the field of geriatrics.…”