ArticleBMC geriatrics2023
Calf circumference as a screening tool for low skeletal muscle mass: Cut-off values in independent Thai older adults.
Article in BMC geriatrics, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.
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Who cites it
22 citing papers in PubMed, 26 citations in OpenAlex.
- Agreement between bioimpedance-measured and calf-derived appendicular skeletal muscle mass in amyotrophic lateral sclerosis patients.European journal of clinical nutrition · 2026Article
- Sex-specific predictive ability of SARC-F and SARC-CalF for ultrasound-based sarcopenia in older adults.BMC geriatrics · 2026Article
- The relationship between malnutrition, frailty, and sarcopenia according to the GLIM and MNA-SF.Irish journal of medical science · 2026Observational
- Predictive Model Development and Validation for Low Appendicular Skeletal Muscle Mass in Chinese Older Adults.Aging medicine (Milton (N.S.W)) · 2026Article
- Association of estimated muscle mass and its changes with all-cause mortality: a Chinese population-based cohort study.BMC geriatrics · 2026Article
- Calf circumference as a simple tool versus chest-CT derived skeletal muscle index in assessing osteosarcopenia and one-year outcomes in osteoporotic vertebral fractures.Aging clinical and experimental research · 2026Article
- Accuracy of sarcopenia screening tools among older adults with stroke undergoing inpatient rehabilitation.PloS one · 2026Article
- Measuring Muscle Mass in Adults With Intellectual Disabilities: The Reliability and Construct Validity of Calf Circumference.Journal of intellectual disability research : JIDR · 2026Article
- Enhancing cardiovascular risk prediction in Asian populations: A machine learning approach integrated with digital health platforms.International journal of cardiology. Cardiovascular risk and prevention · 2025Article
- Age-specific prevalence and risk factors for severe activity of daily living disability among older adults residing in long-term care facilities in Korea: A cross-sectional study using first year of a longitudinal study.Journal of Korean gerontological nursing · 2025Article
- Research progress on evaluation methods for skeletal muscle mass assessment in sarcopenia (Review).Oncology letters · 2025Review
- The Usefulness of Anthropometric Measurements and Indicators in Assessing Muscle Mass in Older Adults.Journal of clinical medicine · 2025Article
- Waist-Calf Circumference Ratio Is Associated with Body Composition, Physical Performance, and Muscle Strength in Older Women.Geriatrics (Basel, Switzerland) · 2025Article
- Association of Nutritional Status and Possible Sarcopenia Among Formerly Older Homeless Adults in Supportive Housing, Thailand.Nutrients · 2025Article
- A comparative analysis of sarcopenia screening methods in Thai people with type 2 diabetes mellitus in an outpatient setting.BMC geriatrics · 2025Article
- Calf circumference predicts changes of bone mineral density in postmenopausal osteoporotic women receiving denosumab.Aging clinical and experimental research · 2025Article
- Probable and confirmed sarcopenia are still better predictors of disability than sarcopenic obesity following ESPEN/EASO consensus steps.BMC geriatrics · 2025Article
- The predictive values of sarcopenia screening tools in preoperative elderly patients with colorectal cancer: applying the diagnostic criteria of EWGSOP2 and AWGS2019.BMC geriatrics · 2025Article
- Measurement of the Calf Muscle Circumference is Useful for Diagnosing Sarcopenia in Older Adults Requiring Long-Term Care.Annals of geriatric medicine and research · 2025Article
- Prevalence and Diagnostic Strategies for Sarcopenia in Menopausal and Non-Menopausal Women: A Cross-Sectional Comparative Study.International journal of women's health · 2025Article
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Authors and funding
10 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundCalf circumference is recommended as a marker for low muscle mass and as a case finding in the diagnosis of sarcopenia. However, the cut-off value differed by ethic and region. Currently there is no study among Thai population. Therefore, we aimed to identify the optimal cutoff value of calf circumference as a screening tool for low skeletal muscle mass in independent Thai older adults. Subgroup analysis was performed for obesity and adults over 75 years.
methodsThis cross-sectional cohort studied in an outpatient geriatric check-up clinic. Participants, aged 60 and above, needed to be independent in basic activities of daily living to meet the inclusion criteria. Exclusion criteria comprised active malignancy, cardiac, pulmonary, or neurovascular diseases necessitating hospitalization in the preceding three months, chronic renal diseases requiring renal replacement therapy, and unstable psychiatric disorders. We measured the maximum calf circumference and appendicular skeletal muscle mass (ASMI) using bioelectrical impedance analysis (BIA). Low muscle mass is defined according to the Asian Working Group of Sarcopenia (AWGS) 2019 consensus.
resultsWe enrolled 6,404 elderly adults (mean age 67.3 ± 5.1 years), with a 47% prevalence of low muscle mass in women and 25% in men. Lower muscle mass significantly correlated with reduced BMI and waist circumference in both genders (p < 0.001). Optimal cut-off values for low muscle mass screening were < 33 cm (sensitivity 80.1%, specificity 60.5%) for women and < 34 cm (sensitivity 85.4%, specificity 70.2%) for men. Subgroup analysis for those with BMI ≥ 25 kg/m² suggested raising the cut-off for women to < 34 cm (sensitivity 80.6%, specificity 54.0%) and for men to < 35 cm (sensitivity 88.7%, specificity 55.2%) to enhance specificity without substantial sensitivity loss. In the older-old adult subgroup (≥ 75 years), optimal cut-off values were < 33 cm (sensitivity 84.6%, specificity 79.9%) for women and < 34 cm (sensitivity 75.6%, specificity 87.0%) for men.
conclusionsThere is a strong correlation between calf circumference and ASMI in independent Thai older adults. Calf circumference can serve as a screening tool for identifying low muscle mass. The recommended cut-off values for men and women are 34 cm and 33 cm, respectively in alignment with AWGS 2019 recommendation. Incorporating a 1-cm higher cut-off value for obese older adults improves the accuracy of muscle mass screening.
trial registrationThai clinical trial registry: TCTR20200511003.
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