Maximal calf circumference reflects calf muscle mass measured using magnetic resonance imaging

Asai, Chikako; Akao, Keigo; Adachi, Takuji; Iwatsu, Kotaro; Fukuyama, Atsushi; Ikeda, Mitsuru; Yamada, Sumio

doi:10.1016/j.archger.2019.04.012

Cited by 24 publications

(18 citation statements)

References 19 publications

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“…Previous studies that examined human cadavers, such as the study involving male cadavers ( n = 12) in Brussels 18 and the study involving white cadavers ( n = 23), 19 reported that the maximal calf circumference was positively correlated with total dissected muscle mass ( r = 0.84, or men: r = 0.90 and women: r = 0.77). Furthermore, maximal calf circumference was strongly correlated with calf muscle mass measured by magnetic resonance imaging (men: r = 0.91, women: r = 0.89) 20 . Calf circumference was positively correlated with muscle mass measured by BIA 21–23 or DXA 7–11 (BIA‐measured ASM: r = 0.68, BIA‐measured ASM/height 2 : r = 0.56–0.78, DXA‐measured ASM: r = 0.55–0.81, DXA‐measured ASM/height 2 : r = 0.42–0.84).…”

Section: Discussionmentioning

confidence: 94%

“…Previous studies that examined human cadavers, such as the study involving male cadavers (n = 12) in Brussels 18 and the study involving white cadavers (n = 23), 19 reported that the maximal calf circumference was positively correlated with total dissected muscle mass (r = 0.84, or men: r = 0.90 and women: r = 0.77). Furthermore, maximal calf circumference was strongly correlated with calf muscle mass measured by magnetic resonance imaging (men: 20 Calf circumference was positively correlated with muscle mass measured by BIA [21][22][23] or DXA [7][8][9][10][11] (BIA-measured ASM: r = 0.68, BIA-measured ASM/height 2 : r = 0.56-0.78, DXA-measured ASM: r = 0.55-0.81, DXAmeasured ASM/height 2 : r = 0.42-0.84). Moreover, the National Health and Nutrition Examination Survey that examined 15 293 participants reported a moderate correlation between calf circumference and DXA-measured ASM across all BMI subgroups (<18.5, 18.5-24.9, 25-29.9, ≥30 kg/m 2 ) or age subgroups (<20, 20-39, 40-59, ≥60 years).…”

Section: Discussionmentioning

confidence: 98%

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Cut‐offs for calf circumference as a screening tool for low muscle mass: WASEDA'S Health Study

Kawakami

Miyachi

Sawada

et al. 2020

Geriatrics Gerontology Int

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To re-evaluate the suitability of calf circumference as a surrogate marker of low muscle mass measured by both bioelectrical impedance analysis (BIA) and dual-energy X-ray absorptiometry (DXA). We also examined the effects of obesity and age on low muscle mass screening using calf circumference. Methods: In total, 1239 adults participated in this cross-sectional study. We measured the maximum calf circumference in a standing position and appendicular skeletal muscle mass (ASM) using BIA and DXA. We defined low muscle mass based on the Asian Working Group for Sarcopenia 2019 consensus. Results: Calf circumference was positively correlated with BIA-measured ASM/height 2 (men: r = 0.81, women: r = 0.73) and DXA-measured ASM/height 2 (men: r = 0.78, women: r = 0.76). In the subgroup analyses by obesity and age, calf circumference was also positively correlated with ASM/height 2. The optimal calf circumference cutoffs for low muscle mass screening measured by BIA and DXA were 35 cm (sensitivity 91%, specificity 84%) and 36 cm (sensitivity 82%, specificity 80%) for men, and 33 cm (sensitivity 82%, specificity 84%) and 34 cm (sensitivity 85%, specificity 72%) for women, respectively. Conclusions: Calf circumference is positively correlated with BIA-and DXA-measured muscle mass regardless of obesity and age and is a simple and accurate surrogate marker of muscle mass for diagnosing sarcopenia.

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Section: Discussionmentioning

confidence: 94%

“…Previous studies that examined human cadavers, such as the study involving male cadavers (n = 12) in Brussels 18 and the study involving white cadavers (n = 23), 19 reported that the maximal calf circumference was positively correlated with total dissected muscle mass (r = 0.84, or men: r = 0.90 and women: r = 0.77). Furthermore, maximal calf circumference was strongly correlated with calf muscle mass measured by magnetic resonance imaging (men: 20 Calf circumference was positively correlated with muscle mass measured by BIA [21][22][23] or DXA [7][8][9][10][11] (BIA-measured ASM: r = 0.68, BIA-measured ASM/height 2 : r = 0.56-0.78, DXA-measured ASM: r = 0.55-0.81, DXAmeasured ASM/height 2 : r = 0.42-0.84). Moreover, the National Health and Nutrition Examination Survey that examined 15 293 participants reported a moderate correlation between calf circumference and DXA-measured ASM across all BMI subgroups (<18.5, 18.5-24.9, 25-29.9, ≥30 kg/m 2 ) or age subgroups (<20, 20-39, 40-59, ≥60 years).…”

Section: Discussionmentioning

confidence: 98%

Cut‐offs for calf circumference as a screening tool for low muscle mass: WASEDA'S Health Study

Kawakami

Miyachi

Sawada

et al. 2020

Geriatrics Gerontology Int

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“…Some human cadaver studies showed that calf circumference was also positively correlated with the total dissected muscle mass (r ¼ 0.77e0.90) [10,31]. Furthermore, calf circumference has also been shown to be strongly correlated with calf muscle mass as measured by magnetic resonance imaging (r ¼ 0.89e0.91) [32]. We believe that the measurement of calf circumference is a simple but effective assessment tool for muscle mass that is easily implementable in the local community setting, as it is a simple procedure that can be carried out anywhere and by anyone.…”

Section: Discussionmentioning

confidence: 99%

“…However, measuring skinfold thickness is difficult to adapt in local communities because it requires specialized measurement devices and techniques. Calf circumference and body mass index were reported to be independently associated factors of calf muscle mass as measured using magnetic resonance imaging [32]. Furthermore, recently, body mass index adjustment has been proposed for predicting muscle mass using calf circumference [35,36].…”

Section: Discussionmentioning

confidence: 99%

Development and validation of a simple anthropometric equation to predict appendicular skeletal muscle mass

et al. 2021

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Background & aims: A limited number of studies have developed simple anthropometric equations that can be implemented for predicting muscle mass in the local community. Several studies have suggested calf circumference as a simple and accurate surrogate maker for muscle mass. We aimed to develop and cross-validate a simple anthropometric equation, which incorporates calf circumference, to predict appendicular skeletal muscle mass (ASM) using dual-energy X-ray absorptiometry (DXA). Furthermore, we conducted a comparative validity assessment of our equation with bioelectrical impedance analysis (BIA) and two previously reported equations using similar variables. Methods: ASM measurements were recorded for 1262 participants (837 men, 425 women) aged 40 years or older. Participants were randomly divided into the development or validation group. Stepwise multiple linear regression was applied to develop the DXA-measured ASM prediction equation. Parameters including age, sex, height, weight, waist circumference, and calf circumference were incorporated as predictor variables. Total error was calculated as the square root of the sum of the square of the difference between DXA-measured and predicted ASMs divided by the total number of individuals. Results: The most optimal ASM prediction equation developed was: ASM (kg) ¼ 2.955 Â sex (men ¼ 1, women ¼ 0) þ 0.255 Â weight (kg) À 0.130 Â waist circumference (cm) þ 0.308 Â calf circumference (cm) þ 0.081 Â height (cm) À 11.897 (adjusted R 2 ¼ 0.94, standard error of the estimate ¼ 1.2 kg). Our equation had smaller total error and higher intraclass correlation coefficient (ICC) values than those for BIA and two previously reported equations, for both men and women (men, total error ¼ 1.2 kg, ICC ¼ 0.91; women, total error ¼ 1.1 kg, ICC ¼ 0.80). The correlation between DXA-measured ASM and predicted ASM by the present equation was not significantly different from the correlation between DXAmeasured ASM and BIA-measured ASM. Conclusions: The equation developed in this study can predict ASM more accurately as compared to equations where calf circumference is used as the sole variable and previously reported equations; it holds potential as a reliable and an effective substitute for estimating ASM.

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“…For muscle mass, the most commonly used measure is calf circumference (57.5%), which is recorded in centimetres at the largest section of the calf [25]. The test has been correlated with more objective measures of muscle mass on MRI [28] and bioelectrical impedance analysis [29]. It has, therefore, been proposed as a surrogate marker of sarcopenia and may even improve the specificity of current sarcopenia scoring systems, such as SARC-F [30,31] Furthermore, calf circumference has been correlated with nutritional status [32] and functional performance [33], which are important components of cachexia [3 && ].…”

Section: Measures Of Muscle Massmentioning

confidence: 99%

Meaningful measures in cancer cachexia: implications for practice and research

McDonald¹,

Fallon

Laird

2019

Current Opinion in Supportive &Amp; Palliative Care

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Purpose of reviewCancer cachexia is a complex inflammatory syndrome, which presents with a variety of discrete symptoms and signs. This creates a challenge for both clinicians and researchers in recognizing and assessing the syndrome. This review explores the evidence for various measures used in the assessment of cachexia. Recent findingsObjectively, cachexia may be assessed using CT-derived measures of skeletal muscle [skeletal muscle index (SMI) and skeletal muscle density (SMD)]. Evidence suggests that SMD may be of equal or greater value than SMI in assessing cachexia. Inflammatory markers are also used, and include interleukin(IL)-1a; IL-1b; IL-6 and Interferon Gamma (IFNg). Other robust measures include performance status and the modified Glasgow prognostic score (mGPS). These measures, however, are more commonly used in academia. By comparison, clinical assessment is limited to individual measures of patient function, such as hand grip strength (HGS), calf circumference, gait speed, and the 'timed up and go test' (TUG). These have each been linked with components of cachexia but are less well evidenced. Evidence also exists for patientreported quality-of-life measures, based upon the EORTC-QLQ-C30 questionnaire, in assessing cachexia.

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Maximal calf circumference reflects calf muscle mass measured using magnetic resonance imaging

Cited by 24 publications

References 19 publications

Cut‐offs for calf circumference as a screening tool for low muscle mass: WASEDA'S Health Study

Cut‐offs for calf circumference as a screening tool for low muscle mass: WASEDA'S Health Study

Development and validation of a simple anthropometric equation to predict appendicular skeletal muscle mass

Meaningful measures in cancer cachexia: implications for practice and research

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