Validation and applicability of appendicular skeletal muscle mass estimation equations in a geriatric hospital setting

IF 2.6 Q3 NUTRITION & DIETETICS

Clinical nutrition ESPEN Pub Date : 2025-07-09 DOI:10.1016/j.clnesp.2025.07.013

Shuzo Miyahara , Keisuke Maeda , Shosuke Satake , Hiroyasu Akatsu , Hidenori Arai

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引用次数: 0

Abstract

Background&aims

Sarcopenia and malnutrition are linked to adverse outcomes in older adults, requiring muscle mass assessment for diagnosis. While specialized equipment is recommended, limited accessibility highlights the need for alternative methods. Various skeletal muscle mass estimation equations exist, but their validity across clinical settings is uncertain. This study evaluated the validity and applicability of previously reported appendicular skeletal mass (ASM) estimation equations in older adults across two hospital settings.

Methods

This study utilized registry data from the National Center for Geriatrics and Gerontology, including patients aged ≥65 years from a frailty outpatient clinic and geriatric ward. ASM was assessed using dual-energy X-ray absorptiometry (DXA) as the reference standard. A comprehensive review identified multiple ASM estimation equations based on age, sex, height, weight, and creatinine-to-cystatin C ratio (Cre/CysC). As an exception, one skeletal muscle mass index (SMI) estimation equation was included in the analysis. In both groups, intraclass correlation coefficients (ICCs) were calculated to assess the agreement between ASM estimates and DXA measurements. Estimation errors were standardized as T-scores, plotted, and visualized with 95 % confidence ellipses for each group.

Results

The analysis included 856 patients from the frailty clinic group (mean age: 78.2 ± 6.1 years, 58.3 % women) and 328 from the geriatric ward group (mean age: 86.2 ± 6.4 years, 60.7 % women). ICCs between the ASM estimation equations and DXA were generally higher in the frailty clinic group. Several equations achieved ICC ≥0.9 in the frailty clinic group and ICC ≥0.8 in the geriatric ward group. Equations based on age, sex, height, and weight performed well in both groups, with minimal benefit from adding Cre/CysC. Estimation errors showed no substantial differences between groups.

Conclusion

Several ASM estimation equations showed strong agreement with DXA in older adults across outpatient and inpatient settings. While dedicated equipment is ideal, using common patient data for muscle mass estimation improves accessibility and may support the wider adoption of muscle assessment for sarcopenia and malnutrition diagnosis.

查看原文本刊更多论文

老年医院阑尾骨骼肌质量估算方程的验证和适用性。

背景与目的：骨骼肌减少症和营养不良与老年人的不良结局有关，需要肌肉质量评估进行诊断。虽然建议使用专门的设备，但有限的可及性突出了替代方法的必要性。存在各种骨骼肌质量估计方程，但它们在临床设置中的有效性是不确定的。本研究评估了先前报道的两家医院老年人阑尾骨量（ASM）估计方程的有效性和适用性。方法：本研究利用来自国家老年病学和老年学中心的登记数据，包括来自虚弱门诊和老年病房的年龄≥65岁的患者。采用双能x线吸收仪（DXA）作为参比标准评估ASM。一项全面的综述确定了基于年龄、性别、身高、体重和肌酐/胱抑素C比值（Cre/CysC）的多个ASM估计方程。作为例外，一个骨骼肌质量指数（SMI）估计方程被纳入分析。在两组中，计算类内相关系数（ICCs）以评估ASM估计值与DXA测量值之间的一致性。估计误差被标准化为t分数，并以95%置信椭圆对每组进行绘制和可视化。结果：分析纳入衰弱临床组856例（平均年龄：78.2±6.1岁，女性58.3%）和老年病房组328例（平均年龄：86.2±6.4岁，女性60.7%）。在虚弱临床组，ASM估计方程与DXA之间的ICCs普遍较高。在一些方程中，衰弱临床组的ICC≥0.9，老年病房组的ICC≥0.8。基于年龄、性别、身高和体重的方程在两组中都表现良好，添加Cre/CysC的益处最小。估计误差在组间无显著差异。结论：几个ASM估计方程在门诊和住院的老年人中显示了与DXA的强烈一致。虽然专用设备是理想的，但使用普通患者数据来估计肌肉质量可以提高可及性，并可能支持更广泛地采用肌肉评估来诊断肌肉减少症和营养不良。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical nutrition ESPEN NUTRITION & DIETETICS-

CiteScore

4.90

自引率

3.30%

发文量

512

期刊介绍： Clinical Nutrition ESPEN is an electronic-only journal and is an official publication of the European Society for Clinical Nutrition and Metabolism (ESPEN). Nutrition and nutritional care have gained wide clinical and scientific interest during the past decades. The increasing knowledge of metabolic disturbances and nutritional assessment in chronic and acute diseases has stimulated rapid advances in design, development and clinical application of nutritional support. The aims of ESPEN are to encourage the rapid diffusion of knowledge and its application in the field of clinical nutrition and metabolism. Published bimonthly, Clinical Nutrition ESPEN focuses on publishing articles on the relationship between nutrition and disease in the setting of basic science and clinical practice. Clinical Nutrition ESPEN is available to all members of ESPEN and to all subscribers of Clinical Nutrition.