Calf circumference measurement as a screening tool for sarcopenia in women with rheumatoid arthritis: a pilot study

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Abstract

Background: Secondary sarcopenia (SP) in rheumatoid arthritis (RA) is not diagnosed due to the complexity of body composition analysis and low information content of muscle strength determination due to joint syndrome. It is necessary to search for available methods for screening low muscle mass.

Objective: Determination of the sensitivity and specificity of calf circumference measurement as a surrogate method for assessing muscle mass in comparison with the «gold standard» – dual-energy X-ray absorptiometry (DXA) in women with RA.

Materials and methods: 201 women with confirmed RA who signed informed consent were examined. Clinical and laboratory examination was performed, including calf circumference measurement and determination of body composition with calculation of appendicular muscle index (AMI) using DXA.

Results: The mean age of the examined women was 59.3±9.0 years. Low AMI was detected in 18.4% of patients. Calf circumference positively correlated with AMI (r=0.52, p<0.001), regardless of the presence of obesity. ROC analysis revealed the value of calf circumference (33.8 cm) with the optimal ratio of sensitivity (73.0%) and specificity (76.2%) for detecting low muscle mass. The area under the curve was 0.789 (95% confidence interval 0.726–0.844, p<0.001).

Conclusion: Calf circumference values are not sensitive enough for screening low muscle mass. It is necessary to search for additional factors to increase the sensitivity of the method without significantly reducing specificity.

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About the authors

Olga V. Dobrovolskaya

V.A. Nasonova Research Institute of Rheumatology

Author for correspondence.
Email: olgavdobr@mail.ru
ORCID iD: 0000-0002-2809-0197

Cand. Sci. (Med.), Researcher, Osteoporosis Laboratory

Russian Federation, Moscow

Maria V. Kozyreva

V.A. Nasonova Research Institute of Rheumatology

Email: doginya@yandex.ru
ORCID iD: 0000-0003-0560-3495

Junior Researcher, Osteoporosis Laboratory

Russian Federation, Moscow

Nikolay V. Demin

V.A. Nasonova Research Institute of Rheumatology

Email: deminick@rambler.ru
ORCID iD: 0000-0003-0961-9785

Junior Researcher, Osteoporosis Laboratory

Russian Federation, Moscow

Natalia V. Toroptsova

V.A. Nasonova Research Institute of Rheumatology

Email: torop@irramn.ru
ORCID iD: 0000-0003-4739-4302

Dr Sci. (Med.), Head of Osteoporosis Laboratory

Russian Federation, Moscow

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2. Figure 1. Calf circumference measuremen

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3. Figure. 2. Association of appendicular muscle index and calf circumference

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4. Figure 3. ROC curve for screening low muscle mass based on calf circumference

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