ArticleAging clinical and experimental research2026
Agreement between bioelectrical impedance analysis and equation-derived estimates of appendicular skeletal muscle in acutely hospitalized multiethnic older patients.
Article in Aging clinical and experimental research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundAccurate assessment of appendicular skeletal muscle (ASM) is essential for diagnosing sarcopenia. While bioelectrical impedance analysis (BIA) is widely used, equation-derived estimates may be useful when device-based methods are unavailable. We evaluated agreement between BIA-measured ASM and two equations: the COCONUT Study Group formula (NHANES-based) and the Japanese equation by Furushima et al.
methodsWe conducted a cross-sectional study of hospitalized, multiethnic older adults in Singapore (n = 295). ASM was measured using multi-frequency BIA S10. Equation-derived ASM was calculated using calf circumference, age, and sex (COCONUT) or age, anthropometry, and handgrip strength (HGS; Furushima). Agreement with BIA was assessed by Lin's concordance correlation coefficient (CCC) and Bland-Altman analysis. Diagnostic agreement for low appendicular skeletal muscle mass index (ASMI; AWGS 2019 cut-offs) was evaluated with Cohen's κ and area under the receiver operating characteristic curve (AUC). Analyses were stratified by sex and obesity.
resultsFurushima's equation showed stronger concordance with BIA than COCONUT (CCC 0.696 vs. 0.538) and smaller underestimate bias (1.56 vs. 3.03 kg). For low ASMI, Furushima achieved moderate agreement (κ = 0.48; AUC = 0.78) compared with poor agreement for COCONUT (κ = 0.17; AUC = 0.62). COCONUT performed poorly among women (CCC = 0.192; bias 4.40 kg), whereas Furushima improved performance but remained low overall (CCC = 0.371). Among obese patients, Furushima demonstrated the highest concordance (CCC = 0.862; bias 0.42 kg).
conclusionsFurushima's equation aligns better with BIA-measured ASM than COCONUT and may complement HGS in sarcopenia screening. Equation-based estimation could aid risk stratification when BIA is unavailable, though subgroup-specific biases require caution.
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