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Milla, Samara PalmaAuthor

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Ultrasound Cut-Off Values for Rectus Femoris for Detecting Sarcopenia in Patients with Nutritional Risk

Publicated to:Nutrients. 16 (11): 1552- - 2024-06-01 16(11), DOI: 10.3390/nu16111552

Authors: Roman, Daniel de Luis; Almeida, Jose Manuel Garcia; Guerrero, Diego Bellido; Rolo, German Guzman; Martin, Andrea; Martin, David Primo; Garcia-Delgado, Yaiza; Guirado-Pelaez, Patricia; Palmas, Fiorella; Perez, Cristina Tejera; Olivares, Maria Garcia; Jimenez, Maria Maiz; Lesmes, Irene Breton; Teomiro, Carlos Manuel Alzas; Baena, Juan Manuel Guardia; Romero, Laura A Calles; Prior-Sanchez, Inmaculada; Garcia-Luna, Pedro Pablo; Pacheco, Maria Gonzalez; Martinez-Olmos, Miguel Angel; Alabadi, Blanca; Alcantara-Aragon, Valeria; Milla, Samara Palma; Folgueras, Tomas Martin; Garcia, Andrea Mico; Molina-Baena, Begona; Barragan, Henry Rendon; Gomez, Pablo Rodriguez de Vera; Fernandez, Maria Riestra; Portilla, Ana Jimenez; Lopez-Gomez, Juan J; Martin, Nuria Perez; Madrid, Natalia Montero; Eguinoa, Alba Zabalegui; Fernandez, Cristina Porca; Guerrero, Maria Jose Tapia; Aguado, Marta Ruiz; Gimeno, Cristina Velasco; Martinez, Aura D Herrera; Rodriguez, Maria Novo; Hernandez, Natalia C Iglesias; Medina, Maria de Damas; Navarro, Irene Gonzalez; Lopez, Francisco Javier Vilchez; Fernandez-Pombo, Antia; Olveira, Gabriel

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Abstract

Background: A nationwide, prospective, multicenter, cohort study (the Disease-Related caloric-protein malnutrition EChOgraphy (DRECO) study) was designed to assess the usefulness of ultrasound of the rectus femoris for detecting sarcopenia in hospitalized patients at risk of malnutrition and to define cut-off values of ultrasound measures. Methods: Patients at risk of malnutrition according to the Malnutrition Universal Screening Tool (MUST) underwent handgrip dynamometry, bioelectrical impedance analysis (BIA), a Timed Up and Go (TUG) test, and rectus femoris ultrasound studies. European Working Group on Sarcopenia in Older People (EWGSOP2) criteria were used to define categories of sarcopenia (at risk, probable, confirmed, severe). Receiver operating characteristic (ROC) and area under the curve (AUC) analyses were used to determine the optimal diagnostic sensitivity, specificity, and predictive values of cut-off points of the ultrasound measures for the detection of risk of sarcopenia and probable, confirmed, and severe sarcopenia. Results: A total of 1000 subjects were included and 991 of them (58.9% men, mean age 58.5 years) were evaluated. Risk of sarcopenia was detected in 9.6% patients, probable sarcopenia in 14%, confirmed sarcopenia in 9.7%, and severe sarcopenia in 3.9%, with significant differences in the distribution of groups between men and women (p < 0.0001). The cross-sectional area (CSA) of the rectus femoris showed a significantly positive correlation with body cell mass of BIA and handgrip strength, and a significant negative correlation with TUG. Cut-off values were similar within each category of sarcopenia, ranging between 2.40 cm(2) and 3.66 cm(2) for CSA, 32.57 mm and 40.21 mm for the X-axis, and 7.85 mm and 10.4 mm for the Y-axis. In general, these cut-off values showed high sensitivities, particularly for the categories of confirmed and severe sarcopenia, with male patients also showing better sensitivities than women. Conclusions: Sarcopenia in hospitalized patients at risk of malnutrition was high. Cut-off values for the better sensitivities and specificities of ultrasound measures of the rectus femoris are established. The use of ultrasound of the rectus femoris could be used for the prediction of sarcopenia and be useful to integrate nutritional study into real clinical practice.

Keywords

BodMalnutritionMuscle thicknessNutritional risNutritional riskNutritional ultrasoundPrevalenceQuestionnaireRectus femorisSarc-fSarcopeniaStrengthUltrasound cut-off values

Quality index

Bibliometric impact. Analysis of the contribution and dissemination channel

The work has been published in the journal Nutrients due to its progression and the good impact it has achieved in recent years, according to the agency WoS (JCR), it has become a reference in its field. In the year of publication of the work, 2024 there are still no calculated indicators, but in 2023, it was in position 18/114, thus managing to position itself as a Q1 (Primer Cuartil), in the category Nutrition & Dietetics.

Independientemente del impacto esperado determinado por el canal de difusión, es importante destacar el impacto real observado de la propia aportación.

Según las diferentes agencias de indexación, el número de citas acumuladas por esta publicación hasta la fecha 2025-06-06:

  • WoS: 10
  • Scopus: 13

Impact and social visibility

From the perspective of influence or social adoption, and based on metrics associated with mentions and interactions provided by agencies specializing in calculating the so-called "Alternative or Social Metrics," we can highlight as of 2025-06-06:

  • The use, from an academic perspective evidenced by the Altmetric agency indicator referring to aggregations made by the personal bibliographic manager Mendeley, gives us a total of: 52.
  • The use of this contribution in bookmarks, code forks, additions to favorite lists for recurrent reading, as well as general views, indicates that someone is using the publication as a basis for their current work. This may be a notable indicator of future more formal and academic citations. This claim is supported by the result of the "Capture" indicator, which yields a total of: 43 (PlumX).

With a more dissemination-oriented intent and targeting more general audiences, we can observe other more global scores such as:

  • The Total Score from Altmetric: 41.4.
  • The number of mentions on the social network X (formerly Twitter): 65 (Altmetric).

It is essential to present evidence supporting full alignment with institutional principles and guidelines on Open Science and the Conservation and Dissemination of Intellectual Heritage. A clear example of this is:

  • The work has been submitted to a journal whose editorial policy allows open Open Access publication.