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

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

Autores: 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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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.

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