Diagnostic merit of using the calf circumference to estimate the muscle mass as a component of sarcopenia in elderly outpatients

Objective: Sarcopenia is a geriatric syndrome that can lead to poor clinical outcomes. Therefore, a simple measurement is necessary to estimate the muscle mass as a component of sarcopenia. The aim of this study was to determine the diagnostic merit of using the calf circumference (CC) to estimate the muscle mass in elderly individuals. Materials and Methods: This was a cross-sectional study of patients over 60 years conducted at the Geriatric Clinic of the Dr. Cipto Mangunkusumo Hospital in Jakarta, Indonesia, from April to June of 2018. Dual-energy X-ray absorptiometry was used as a reference test for the muscle mass measurements, and the classification of normal or low muscle mass was based on the Asian Working Group for Sarcopenia criteria. The nondominant leg was used to measure the CC. Results: Out of 120 patients, 74 were female (61.7%). The optimal CC cutoff points for low muscle mass were 34 cm for the male patients (the values for the sensitivity [Sn], specificity [Sp], positive predictive value [PPV], negative predictive value [NPV], and area under the receiver operating characteristic curve [AUC] were 64.7%, 79.3%, 64.7%, 79.3%, and 73.1%, respectively) and 29 cm for the female patients (the values for the Sn, Sp, PPV, NPV, and AUC were 71.4%, 95.5%, 62.5%, 97.0%, and 96.4%, respectively). Conclusion: The sensitivities and specificities of the CCs were 64.7% and 79.3%, respectively, for the males and 71.4% and 95.5%, respectively, for the females. The CC could be used in clinical practice to estimate the muscle mass of elderly outpatients.