Zhongguo quanke yixue (Dec 2024)
Comparison of the Diagnostic Value of Calf Circumference, Upper Arm Circumference and Ishii Score in Patients with Coronary Heart Disease Complicated with Sarcopenia
Abstract
Background As a common geriatric chronic disease, sarcopenia has a high prevalence in patients with coronary heart disease (CHD), which increases the risk of adverse events such as falls and fractures, calf circumference, upper arm circumference, and Ishii score have been shown to be valuable in screening for sarcopenia, but are less commonly used in CHD patients. Objective To evaluate the accuracy and consistency of calf circumference, upper arm circumference, and Ishii score in screening for combined sarcopenia in hospitalized elderly patients with CHD. Methods A total of 213 CHD patients treated at the Department of Cardiology, Affiliated Hospital of North Sichuan Medical College from January 1, 2023 to May 31, 2023, were selected for the study, the body composition test instrument was used to detect indicators such as muscle mass and upper arm circumference, the measurement of calf circumference was performed, and Ishii score was calculated simultaneously. Spearman's rank correlation analysis was used to explore the correlation of upper arm circumference, calf circumference and Ishii score with indicators such as muscle mass, the diagnostic effect of upper arm circumference, calf circumference and Ishii score on sarcopenia in different people was analyzed by plotting receiver operating characteristic (ROC) curves, and the optimal diagnostic cut-off values were determined, which were calculated as Kappa values to determine the consistency of the upper arm circumference, calf circumference and Ishii score with the diagnostic criteria of sarcopenia according to the Chinese Expert Consensus (2023) Criteria for the Prevention and Treatment of Sarcopenia in the elderly. Results The prevalence of combined sarcopenia in CHD patients was 27.2% (58/213). In the whole population, upper arm circumference and calf circumference was positively correlated with appendicular skeletal muscle mass, appendicular skeletal muscle mass index, and grip strength (P<0.001), while Ishii score was negatively correlated with appendicular skeletal muscle mass, appendicular skeletal muscle mass index, and grip strength (P<0.001). In males, upper arm circumference and calf circumference was positively correlated with appendicular skeletal muscle mass, appendicular skeletal muscle mass index, and grip strength (P<0.001), while Ishii score was negatively correlated with appendicular skeletal muscle mass, appendicular skeletal muscle mass index, and grip strength (P<0.001). In females, upper arm circumference and calf circumference was positively correlated with appendicular skeletal muscle mass, appendicular skeletal muscle mass index, and grip strength (P<0.001), while Ishii score was negatively correlated with appendicular skeletal muscle mass, appendicular skeletal muscle mass index, and grip strength (P<0.001). ROC curve showed that the optimal cut-off value of calf circumference for the diagnosis of sarcopenia in males was 34.3 cm (sensitivity=86.5%, specificity=64.6%) ; the optimal cut-off value of calf circumference for the diagnosis of sarcopenia in females was 33.8 cm (sensitivity=100.0%, specificity=50.0%) ; the optimal cut-off value for upper arm circumference to diagnose sarcopenia in males was 28.0 cm (sensitivity=70.3%, specificity=85.9%) ; the optimal cut-off value for upper arm circumference diagnosis of sarcopenia in women was 27.5 cm (sensitivity=81.0%, specificity=69.6%) ; the optimal cut-off value of Ishii score for the diagnosis of sarcopenia in males was 114.07 points (sensitivity=91.9%, specificity=62.6%) ; the optimal cut-off value of Ishii score for the diagnosis of sarcopenia in females was 120.08 points (sensitivity=100.0%, specificity=64.3%). The concordance of indicators with the diagnostic criteria was good, except for low concordance (Kappa=0.353) between calf circumference in women and the diagnostic criteria for sarcopenia in Chinese Expert Consensus (2023) Criteria for the Prevention and Treatment of Sarcopenia in the elderly. Conclusion In hospitalized elderly patients with CHD, both upper arm circumference and calf circumference are positively correlated with muscle mass, and Ishii score is negatively correlated with muscle mass, and all three indicators are effective in screening for sarcopenia. However, this study recommends Ishii score for screening of sarcopenia and early preventive interventions by medical staff.
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