Estimation Of Muscle Mass Research Articles

Comparative Analysis of Preoperative and Postoperative Muscle Mass around Hip Joint by Computed Tomography in Patients with Hip Fracture.

PurposeThis study was conducted in order to assess changes in hip muscles by comparing results of preoperative and postoperative computed tomography (CT) in older patients who underwent surgery for treatment of hip fracture.Materials and MethodsA total of 50 patients (aged ≥65 years) who underwent surgery for treatment of intertrochanteric fractures (25 patients) and femoral neck fractures (25 patients) between February 2013 and February 2019 and underwent preoperative and postoperative pelvic CT were enrolled in the study. The cross-sectional area, attenuation and estimates of muscle mass of the gluteus medius, gluteus minimus, iliopsoas, and rectus femoris on the uninjured side were measured. Basic patient data (sex, age, height, weight, body mass index [BMI], bone mineral density [BMD], Harris hip score [HHS], and length of follow-up) were collected from medical records.ResultsNo significant differences in sex, age, height, weight, BMI, BMD, HHS, and length of follow-up were observed between the two groups. No significant difference in the cross-sectional areas and attenuations of gluteus medius and gluteus minimus was observed after surgery; however, a statistically significant decrease was observed in those of iliopsoas and rectus femoris after surgery. Lower estimates with statistical significance of muscle mass of the iliopsoas and rectus femoris were observed on postoperative CT.ConclusionMuscle mass of the hip flexor (iliopsoas, rectus femoris) showed significant decreases on postoperative CT compared with preoperative CT. Based on these findings, selective strengthening exercise for hip flexor should be beneficial in rehabilitation of hip fractures.

Longitudinal Assessment of Body Composition and Its Association With Survival Among Participants of the ACTIVE/ADIPOSE Study

The importance of muscle wasting as a predictor of mortality in the hemodialysis population is not clear. Lack of association of muscle mass with survival in some studies could be related to reliance on single measures or to incorporation of excess extracellular water (ECW) into estimates of muscle mass. We examined changes in body composition over a 2-year period and the association of body composition with survival. We analyzed data from 325 adults receiving hemodialysis in the Bay Area. We estimated ECW, intracellular water (ICW), and fat mass by whole-body bioimpedance spectroscopy (BIS) at 0, 12, and 24months from enrollment. We used linear mixed modeling to examine changes in body mass index and BIS-derived estimates of body composition and Cox modeling with BIS-derived estimates as time-varying independent variables to examine associations between body composition and survival in multivariable analyses. Body mass index declined over time. Considering individual components of body composition, ICW declined (-0.09kg/m2 per year, 95% confidence interval -0.14 to -0.04), but fat mass and ECW did not change significantly. There were 120 deaths over a median of 5.2years. The relationship between ICW and mortality was not linear such that the association was steeper at low values of ICW, whereas higher ICW was associated with better survival that was relatively stable above 9kg/m2. Higher ECW was associated with higher mortality, and fat mass was not associated with survival. These associations were independent of markers of inflammation and nutritional status. ICW declined over 2years in this cohort, whereas fat mass and ECW remained relatively stable. Higher ICW was associated with better survival, but higher fat mass was not. Higher ECW was associated with worse survival. These results suggest that muscle mass may predict survival among patients on hemodialysis.

Deep Learning-Based Body Composition Analysis Predicts Outcome in Melanoma Patients Treated with Immune Checkpoint Inhibitors

Previous studies suggest an impact of body composition on outcome in melanoma patients. We aimed to determine the prognostic value of CT-based body composition assessment in patients receiving immune checkpoint inhibitor therapy for treatment of metastatic disease using a deep learning approach. One hundred seven patients with staging CT examinations prior to initiation of checkpoint inhibition between January 2013 and August 2019 were retrospectively evaluated. Using an automated deep learning-based body composition analysis pipeline, parameters for estimation of skeletal muscle mass (skeletal muscle index, SMI) and adipose tissue compartments (visceral adipose tissue index, VAI; subcutaneous adipose tissue index, SAI) were derived from staging CT. The cohort was binarized according to gender-specific median cut-off values. Patients below the median were defined as having low SMI, VAI, or SAI, respectively. The impact on outcome was assessed using the Kaplan–Meier method with log-rank tests. A multivariable logistic regression model was built to test the impact of body composition parameters on 3-year mortality. Patients with low SMI displayed significantly increased 1-year (25% versus 9%, p = 0.035), 2-year (32% versus 13%, p = 0.017), and 3-year mortality (38% versus 19%, p = 0.016). No significant differences with regard to adipose tissue compartments were observed (3-year mortality: VAI, p = 0.448; SAI, p = 0.731). On multivariable analysis, low SMI (hazard ratio (HR), 2.245; 95% confidence interval (CI), 1.005–5.017; p = 0.049), neutrophil-to-lymphocyte ratio (HR, 1.170; 95% CI, 1.076–1.273; p < 0.001), and Karnofsky index (HR, 0.965; 95% CI, 0.945–0.985; p = 0.001) remained as significant predictors of 3-year mortality. Lowered skeletal muscle index as an indicator of sarcopenia was associated with worse outcome in patients with metastatic melanoma receiving immune checkpoint inhibitor therapy.

Ultrasound Measurement of Rectus Femoris Muscle Parameters for Discriminating Sarcopenia in Community-Dwelling Adults.

Sarcopenia patients require more medical attention and caretaking. As such, early detection of sarcopenia and appropriate interventions are crucial for decreasing medical costs and meeting the challenges of aging populations. The aim of the present study was to develop a reliable and accurate model to estimate muscle mass using ultrasound-derived parameters from the rectus femoris (RF), referenced by dual-energy X-ray absorptiometry. Cross-sectional study was performed. The study patients were recruited by Taipei Veterans General Hospital (No. 2016-07-013C) between 2016 and 2019. A total of 91 community-dwelling adults (35 men and 56 women) were enrolled in this study. Ultrasound measurements of RF muscle thickness (MT), cross-sectional area (CSA), and muscle volume (MV) were performed in B-mode. Muscle strength and physical performance were also examined. Multivariate linear regression was used to build models for the prediction of appendicular skeletal muscle index (ASMI) based on MT, CSA, and MV values. The accuracy of ultrasound RF measurements for predicting sarcopenia was evaluated by using receiver operating characteristic (ROC) curve analysis. The regression equations used for ASMI prediction (adjusted body mass index, sex, and leg length) had high precision and low error. Moreover, the MV model results were close to those of the CSA model and higher than those of the MT model. The ROC analysis showed that both MV and CSA had excellent discrimination when assessing sarcopenia (AUC=0.83 and 0.81, respectively), whereas MT showed acceptable discrimination (AUC=0.73). Ultrasound-derived RF MV was accurate when predicting ASMI and diagnosing sarcopenia in community-dwelling adults.

Performance of surrogate methods in estimation of muscle mass in chronic kidney disease

Rationale: Patients with chronic kidney disease (CKD) are vulnerable to loss of muscle mass due to metabolic derangements.Reference methods for body composition evaluation such as dual energy X-ray absorptiometry (DXA) are usually unfeasible in clinical setting.The aim of this study was to evaluate the accuracy of predictive equations in estimating fat free mass (FFM) and appendicular FFM (AFFM),compared to DXA, in non-dialysis-dependent (NDD), hemodialysis (HD), peritoneal dialysis (PD) and kidney transplant (KTx) CKD patients

The validity of ultrasound-derived equation models to predict whole-body muscle mass: A systematic review.

Sarcopenia is defined as the age-related loss in muscle quantity and quality which is associated with physical disability. The assessment of muscle quantity plays a role in the diagnosis of sarcopenia. However, the methods used for this assessment have many disadvantages in daily practice and research, like high costs, exposure to radiation, not being portable, or doubtful reliability. Ultrasound has been suggested for the estimation of muscle quantity by estimating muscle mass, using a prediction equation based on muscle thickness. In this systematic review, we aimed to summarize the available evidence on existing prediction equations to estimate muscle mass and to assess whether these are applicable in various adult populations. The databases PubMed, PsycINFO, and Web of Science were used to search for studies predicting total or appendicular muscle mass using ultrasound. The methodological quality of the included studies was assessed using the Quality Assessment of Diagnostic Accuracy Studies, version 2 (QUADAS-2) and the quality assessment checklist (QA) designed by Pretorius and Keating (2008). Twelve studies were included in this systematic review. The participants were between 18 and 79 years old. Magnetic Resonance Imaging and dual-energy X-ray absorptiometry were used as reference methods. The studies generally had low risk of bias and there were low concerns regarding the applicability (QUADAS-2). Nine out of eleven studies reached high quality on the QA. All equations were developed in healthy adults. The ultrasound-derived equations in the included articles are valid and applicable in a healthy population. For a Caucasian population we recommend to use the equation of Abe etal., 2015. While for an Asian population, we recommend to use the equation of Abe etal., 2018, for the South American population, the use of the equation of Barbosa-Silva etal., 2021 is the most appropriate.

A new method in estimating muscle mass in sarcopenic obesity: ultrasonographic muscle measurement adjusted with body mass index

Rationale: Sarcopenic obesity is the coexistence of sarcopenia and obesity in an individual. However, its definition and diagnosis are debated. Ultrasonography, which has been widely used in muscle evaluation in sarcopenia, has also been started to be used in sarcopenic obesity. In this study, we aimed to investigate the importance of ultrasonographic muscle measurements adjusted with body mass index (BMI) to diagnose sarcopenic obesity.

Body composition assessment in overweight obese Srilankans-single tertiary care center study

Rationale: Bioelectrical analysis method is a recognized tool for body composition analysis used for obese patients. It allows correct estimation of visceral fat, resting metabolism and skeletal muscle mass in obese patients. Objective of this study is to describe the body composition characteristics in relation to BMI groups of overweight and obese patients referred to obesity clinic of National Hospital-Kandy during August 2020. BMI groups were chosen according to the indian BMI cut-off values(1).

Should Estimated Glomerular Filtration Rate Be Adjusted for Race?

Should Estimated Glomerular Filtration Rate Be Adjusted for Race?

Serum Creatinine Concentration and Estimates of Muscle Mass Among Race/Ethnicity Groups with End-Stage Kidney Failure

Serum Creatinine Concentration and Estimates of Muscle Mass Among Race/Ethnicity Groups with End-Stage Kidney Failure

Sarcopenia and malnutrition in relation to mortality in hospitalised patients in geriatric care - predictive validity of updated diagnoses.

The definition of sarcopenia was recently updated by the European Working Group on Sarcopenia (EWGSOP2), and consensus criteria for the diagnosis of malnutrition have been presented by the Global Leadership Initiative on Malnutrition (GLIM). The aim of this study was to investigate prevalence and mortality related to categorisation of patients according to these definitions in a geriatric hospital setting. Fifty-six consecutive geriatric inpatients (84y (SD 7.3), 68% women) underwent test of handgrip strength (HGS) and five-rise chair stand test (5CST). Muscle mass and fat free mass (FFM) were evaluated by Dual X-ray Absorptiometry (DXA). Calf circumference (CC) was recorded. Probable sarcopenia was defined, according to EWGSOP2, as low HGS (<27/16kg for men/women) and/or 5CST >15s; sarcopenia was confirmed when coupled with low appendicular skeletal muscle index (ASMI <7.0 and<5.5kg/m2 (m/w)). Malnutrition was defined according to GLIM as weight loss >5% (past 6mo); BMI <20/22kg/m2 (<70/>70y); and FFM-index <17/15kg/m2 (m/w) combined with reduced food intake and/or disease burden/inflammatory condition. Alternatively, CC<31cm was used as a proxy for low muscle mass for both sarcopenia and malnutrition. One- and two-year mortality was registered. All participants displayed probable sarcopenia; 46% and 20% were sarcopenic depending on whether muscle mass was estimated by DXA or CC. Malnutrition according to the GLIM criteria was prevalent in 64% or 60% (muscle mass by DXA or CC, respectively). Nine in ten with sarcopenia were also malnourished. Twenty-six participants (46%) died within two years. Sarcopenia defined by CC<31cm, but not by DXA, was associated with increased mortality; e.g. 2-y mortality HR was 3.19 (95% CI 1.31-7.75). Similarly, malnutrition according to GLIM related to increased 1-y mortality (HR 4.83, 95% CI 1.04-22.39) when DXA was used for muscle mass estimation. All of the participants with CC<31cm were categorised as both sarcopenic and malnourished. In this small set of well-characterised geriatric inpatients all displayed probable sarcopenia. Prevalence of sarcopenia (EWGSOP2) and malnutrition (GLIM) was 20-46% and 60-64%, respectively. Both conditions related to mortality. CC<31cm hold promises to be an acceptable alternative for DXA as a proxy for low muscle mass.

CT Muscle Density, D3Cr Muscle Mass, and Body Fat Associations With Physical Performance, Mobility Outcomes, and Mortality Risk in Older Men.

Muscle mass declines with age, while body adiposity increases. Sarcopenic obesity has been proposed to be particularly deleterious. However, previous methods for estimating muscle mass have been inadequate, and the relative contributions of total body fat versus muscle fat to adverse outcomes have been unclear. In a large cohort of older men (N = 1 017), we measured muscle mass (D3-creatine dilution), muscle density (high-resolution peripheral quantitative computed tomography in the diaphyseal tibia) as a proxy of muscle fat, and total body fat (dual-energy x-ray absorptiometry). We examined their associations with physical performance (walking speed, grip strength, chair stand time), the risk of mobility outcomes (mobility limitations, mobility disability), and the risk of death over ~5 years. In combined models, lower muscle mass and muscle density were independently associated with worse physical performance and the risk of adverse outcomes, while total body fat was minimally related to physical performance and not related to mobility outcomes or mortality. For example, the relative risks for mortality per 1 standardized unit increase in muscle density, muscle mass, and total body fat were 0.84 (95% confidence interval: 0.74, 0.96), 0.70 (0.57, 0.86), and 0.90 (0.64, 1.25), respectively. Muscle mass and muscle density were associated with physical performance and adverse outcomes, and had independent, additive effects. There was little additional contribution of total body fat.

Which is the best alternative to estimate muscle mass for sarcopenia diagnosis when DXA is unavailable?

BackgroundDual x-ray absorptiometry (DXA) is widely adopted to estimate muscle mass for research, but for daily practice is only available in a limited number of facilities. AimTo elucidate if it is anthropometry or bioelectrical impedance analysis (BIA) the method more concordant with DXA in estimating muscle mass for sarcopenia diagnosis among older adults, and to investigate the impact of several cut-off points in sarcopenia frequency. Methods159 older adults (≥65 years) were included in a cross-sectional analysis. Sarcopenia was identified using the 2018 EWGSOP2 definition, plus previous definitions for muscle mass. Estimation of muscle mass by DXA (appendicular skeletal muscle mass (ASM) and ASM/height2), by BIA (skeletal muscle mass/height2 (SMM/height2) and skeletal muscle mass index (SMI)), and anthropometry (calf and mid-arm muscle circumferences (CC and MAMC, respectively)) was carried out, as well as measurements of handgrip strength and gait speed. ResultsSarcopenia frequency varied from 5.0 to 42.1% depending on the method and cut-off point applied. All surrogate diagnostic criteria had a higher agreement with the DXA defined criterion ASM over ASM/height2. A substantial agreement was also found with BIA SMM/height2 (κ= 0.67), and with BIA SMI (κ= 0.65), and a moderate agreement with MAMC (κ= 0.42), p<0.001. Using the DXA ASM and ASM/height2 criteria as reference, CC showed a specificity of 100% and 94%, respectively. ConclusionsBIA is a suitable method to evaluate muscle mass in sarcopenia diagnosis when DXA is unavailable. Furthermore, CC showed to be a valid indicator to rule in the presence of sarcopenia.

Estimation of Muscle Mass in the Integrated Assessment of Patients on Hemodialysis.

Assessment of muscle mass (MM) or its proxies, lean tissue mass (LTM) or fat-free mass (FFM), is an integral part of the diagnosis of protein-energy wasting (PEW) and sarcopenia in patients on hemodialysis (HD). Both sarcopenia and PEW are related to a loss of functionality and also increased morbidity and mortality in this patient population. However, loss of MM is a part of a wider spectrum, including inflammation and fluid overload. As both sarcopenia and PEW are amendable to treatment, estimation of MM regularly is therefore of major clinical relevance. Whereas, computer-assisted tomography (CT) or dual-energy X-ray absorptiometry (DXA) is considered a reference method, it is unsuitable as a method for routine clinical monitoring. In this review, different bedside methods to estimate MM or its proxies in patients on HD will be discussed, with emphasis on biochemical methods, simplified creatinine index (SCI), bioimpedance spectroscopy (BIS), and muscle ultrasound (US). Body composition parameters of all methods are related to the outcome and appear relevant in clinical practice. The US is the only parameter by which muscle dimensions are measured. BIS and SCI are also dependent on either theoretical assumptions or the use of population-specific regression equations. Potential caveats of the methods are that SCI can be influenced by residual renal function, BIS can be influenced by fluid overload, although the latter may be circumvented by the use of a three-compartment model, and that muscle US reflects regional and not whole body MM. In conclusion, both SCI and BIS as well as muscle US are all valuable methods that can be applied for bedside nutritional assessment in patients on HD and appear suitable for routine follow-up. The choice for either method depends on local preferences. However, estimation of MM or its proxies should always be part of a multidimensional assessment of the patient followed by a personalized treatment strategy.

Evaluation of techniques used to assess skeletal muscle quantity in patients with cirrhosis.

Loss of skeletal muscle mass is a well-recognised complication of cirrhosis. Bedside methods to assess skeletal muscle mass including anthropometrics and bioelectrical impedance analysis (BIA) are negatively impacted by fluid overload in advanced cirrhosis and thus there is a need to identify alternatives. There is a paucity of data on the accuracy of commonly used radiological methods such as dual X-ray absorptiometry (DXA) to assess appendicular lean mass (ALM), and computed tomography (CT) skeletal muscle area in patients with cirrhosis. The aim of this study was to evaluate the relationships and agreement of several skeletal muscle mass estimation methods compared to a reference model in patients with cirrhosis. A cross-sectional, single centre study was performed by prospectively recruiting patients with cirrhosis referred to the Queensland Liver Transplant Service. Patients underwent assessment of skeletal muscle mass using bedside techniques (mid-upper arm muscle circumference (MUAMC), bioelectrical impedance spectroscopy (BIS), ultrasound muscle thickness (USMT)) and radiological methods (DXA ALM, CT skeletal muscle area). These were compared to a reference measurement of body cell mass derived from a multi-compartment model using isotope dilution tests and DXA. Forty-two patients (age 56 years, interquartile range 48-60, 86% male) were recruited. Bedside skeletal muscle mass estimation techniques were strongly correlated to the body cell mass reference, with BIS estimation having the strongest correlation coefficients (r=0.78-0.79; P<0.01). A novel technique measuring USMT offered no advantage over traditional bedside techniques. Of the radiological methods, DXA ALM had the strongest correlation coefficient (r=0.781; P<0.01). Weaker correlation coefficients were observed in patients with ascites, except when using the MUAMC. Bland-Altman analysis of BIS body composition estimates demonstrated significant systematic biases and large limits of agreement compared to reference values. These results confirm the difficulties in assessing skeletal muscle mass in patients with cirrhosis, particularly in those with ascites. DXA ALM and BIS measurements provided the best correlation to body cell mass. We suggest DXA ALM for estimation of skeletal muscle mass in patients with cirrhosis as there are established thresholds for skeletal muscle mass depletion, and an accurate assessment of bone mass and density can also be provided. The use of USMT over other bedside skeletal muscle mass estimates was not supported by our results. Further studies evaluating novel bedside skeletal muscle mass estimation techniques in cirrhosis patients are required.

Validation of skeletal muscle mass estimation equations in active young adults: A preliminary study.

We analyzed the validity of the estimation equations for skeletal muscle mass (SMM) using mass of appendicular lean soft tissue (ALST), evaluated by dual-energy X-ray absorptiometry (DXA), in healthy young males undergoing training, and compared it with the results obtained using whole-body magnetic resonance imaging (MRI). We hypothesized that a novel variable, that is, trunk and trunk-to-appendicular ratio of lean soft tissues (trunk/ALST), would be useful in reducing estimation errors in athletes or physically active participants. We analyzed the data of 30 participants (mean age 19.9±1.8years). SMM was measured using whole-body MRI, while mass of trunk and ALST was assessed using DXA. Three previously utilized estimation equations were retrieved from the literature and used for comparison. The estimated SMM values using previous equations highly correlated with measured SMM, which was determined by MRI, but the mean estimated SMM values were significantly lower than the measured-SMM values. Stepwise regression analysis revealed that mass of ALST, trunk/ALST ratio, and percent body fat were significant predictors of SMM and were incorporated as the new suggested variables. This equation accounted for 90.3% of the variance in SMM. While the previous equations' estimated SMM correlated with measured-SMM in participants with trunk/ALST ratios ≤1.05, they underestimated SMMs in those with trunk/ALST ratios >1.05. The present study confirms that the previously used equations underestimate the actual SMM, particularly in participants with high trunk/ALST ratios (>1.05). The current equation may be used in healthy and active young males, including athletes, as a preliminary tool.

Performance of Bioelectrical Impedance and Anthropometric Predictive Equations for Estimation of Muscle Mass in Chronic Kidney Disease Patients.

Background: Patients with chronic kidney disease (CKD) are vulnerable to loss of muscle mass due to several metabolic alterations derived from the uremic syndrome. Reference methods for body composition evaluation are usually unfeasible in clinical settings.Aims: To evaluate the accuracy of predictive equations based on bioelectrical impedance analyses (BIA) and anthropometry parameters for estimating fat free mass (FFM) and appendicular FFM (AFFM), compared to dual energy X-ray absorptiometry (DXA), in CKD patients.Methods: We performed a longitudinal study with patients in non-dialysis-dependent, hemodialysis, peritoneal dialysis and kidney transplant treatment. FFM and AFFM were evaluated by DXA, BIA (Sergi, Kyle, Janssen and MacDonald equations) and anthropometry (Hume, Lee, Tian, and Noori equations). Low muscle mass was diagnosed by DXA analysis. Intra-class correlation coefficient (ICC), Bland-Altman graphic and multiple regression analysis were used to evaluate equation accuracy, linear regression analysis to evaluate bias, and ROC curve analysis and kappa for reproducibility.Results: In total sample and in each CKD group, the predictive equation with the best accuracy was AFFMSergi (men, n = 137: ICC = 0.91, 95% CI = 0.79–0.96, bias = 1.11 kg; women, n = 129: ICC = 0.94, 95% CI = 0.92–0.96, bias = −0.28 kg). AFFMSergi also presented the best performance for low muscle mass diagnosis (men, kappa = 0.68, AUC = 0.83; women, kappa = 0.65, AUC = 0.85). Bias between AFFMSergi and AFFMDXA was mainly affected by total body water and fat mass. None of the predictive equations was able to accurately predict changes in AFFM and FFM, with all ICC lower than 0.5.Conclusion: The predictive equation with the best performance to asses muscle mass in CKD patients was AFFMSergi, including evaluation of low muscle mass diagnosis. However, assessment of changes in body composition was biased, mainly due to variations in fluid status together with adiposity, limiting its applicability for longitudinal evaluations.

Recruitment strategies for sarcopenia trials: lessons from the LACE randomized controlled trial

AbstractBackgroundSarcopenia is rarely diagnosed and is not recorded electronically in routine clinical care, posing challenges to trial recruitment. We describe the performance of four components of a strategy to efficiently recruit participants with sarcopenia to a trial of perindopril and/or leucine for sarcopenia: primary care vs. hospital recruitment, a comparison of central vs. local telephone pre‐screening, performance of a questionnaire on physical function conducted as part of the pre‐screening telephone call, and performance of bioimpedance measurement to identify low muscle mass.MethodsHospital‐based recruitment took place through inpatient and outpatient geriatric medicine services. Local research nurses reviewed medical notes and approached potentially eligible patients. Primary care recruitment reviewed primary care lists from collaborating practices, sending mailshots to patients aged 70 and over who were not taking angiotensin‐converting enzyme inhibitors. Telephone pre‐screening was conducted either by research nurses at each site or centrally by Tayside Clinical Trials Unit. The 10‐point SARC‐F questionnaire was used for pre‐screening. De‐identified recruitment information was held on a central electronic tracking system and analysed using SPSS. Bioimpedance was measured using the Akern BIA 101 system, with the Sergi equation used to estimate lean mass.ResultsFourteen UK sites recruited to the trial. The 1202 sets of notes in hospital‐based care were reviewed at these sites; 7 participants (0.6% of total notes screened) were randomized. From primary care, 13 808 invitations were sent; 138 (1.0% of total invited) were randomized. 633/2987 primary care respondents were pre‐screened centrally; the mean number of calls per respondent was 2.3. For 10 sites where central and local pre‐screening could be compared, the conversion rate from pre‐screening to randomization was 18/588 (3.1%) for centralized calls, compared with 73/1814 (4.0%) for local pre‐screening calls (P = 0.29). A weak relationship was seen between higher (worse) SARC‐F score at screening and lower likelihood of progression to randomization (r = −0.08, P = 0.03). Muscle mass estimates generated using the Sergi equation were systematically biased, and a recalibrated equation for bioimpedance‐estimated muscle mass was derived.ConclusionsPrimary care recruitment led to higher response rates and overall numbers randomized than hospital‐based recruitment. Centralized pre‐screening saved local research nurses' time but did not improve conversion to randomization. SARC‐F did not help to target screening activity in this sarcopenia trial, and a recalibration of the equation for estimating muscle mass from bioimpedance measures may improve accuracy of the screening process.

Characteristics of select and non-select U15 male soccer players.

Baseline characteristics of 31 healthy male U15 soccer players who were classified as select or non-select at the end of the season were compared. Players were 14.4 ± 0.54 years (13.6–15.3 years) at baseline; characteristics included body size, proportions and composition, estimated maturity status, several functional capacities, and coach classifications of potential in the sport. Decisions regarding selection or non-selection were made about two months after baseline. Select and non-select U15 soccer players differed significantly in estimated maturity status, body size, proportions and estimated muscle mass, functional tests related to speed, power and strength, and coach evaluation of potential, specifically tactical skills on offense and skills associated with creativity and decision making. When age and biological maturity status were statistically controlled, select and non-select players differed significantly only on the vertical jump, grip strength, and coach ratings of tactical skills on offense and of creativity and decision making. Results of stepwise discriminant analysis highlighted the importance of coach evaluation of tactical skills associated with offense, and of power and strength in distinguishing select from non-select players. The results highlight the advantages of advanced biological maturity status among adolescent male soccer players and also the importance of coach perceptions of talent. The latter implies a need for further study of the basis of coach perceptions, specifically how they are influenced by and perhaps interact with player characteristics at different ages, and how the perceptions influence playing time and player behaviors and interactions.

Comparison of Agreement between Several Diagnostic Criteria of Sarcopenia in Community-Dwelling Older Adults.

Several diagnostic algorithms exist to detect sarcopenia in older adults. We compared the prevalence of sarcopenia according to the selected diagnostic algorithms. This cross-sectional study compared the European Working Group of Sarcopenia in Older People (EWGSOP) 2010, updated EWGSOP 2019, the Foundation for National Institutes of Health (FNIH) and the International Working Group on Sarcopenia (IWGS) criteria in 778 outpatients of the Geriatric Clinic aged 60 to 89 years. Bioimpedance analysis (BIA) to estimate muscle mass, hand-held hydraulic dynamometer to measure muscle strength, the TUG test and gait speed to assess physical function were used. The prevalence of sarcopenia varied from 0% to 6.43% depending on the algorithm. For the majority of associations between the different definitions of sarcopenia the agreement was null or fair (Cohen's kappa between 0.2 and 0.4). Moderate agreement (Cohen's kappa between 0.4 and 0.6) was found for only three relationships. Nevertheless, for these three relationships, McNemar's test has given different results, indicating that even in the moderately agreeing algorithms, the shared diagnoses of sarcopenia concerned only part of subjects. According to diagnostic algorithms the prevalence of sarcopenia is low in independent community-dwelling older adults. The agreement between the different definitions is poor.