To evaluate the value of ultrasound (US) and shear wave velocity (SWV) to assess muscle in postmenopausal women with osteosarcopenia (OSP). This study included 145 postmenopausal women, comprising 115 osteopenia/osteoporosis participants without sarcopenia (OP alone) and 30 OSP participants. All received the evaluation of bone mineral density (BMD), appendicular skeletal muscle mass index (ASMI), handgrip strength, calf circumference, 6-meter walking speed, and 5-time chair stand test. The cross-sectional area (RFcsa), thickness (RFthickness), and mean SWV of rectus femoris (RF) were measured by US and shear wave elastography. The clinical characteristics, RFcsa, RFthickness, and SWV, were compared between OP alone and OSP to determine the independent predictors of OSP. Receiver operating characteristic (ROC) curve analysis was used to evaluate the value of US and SWV for assessment of OSP. The RFcsa, RFthickness, SWV, and BMD of OSP were lower than those of OP alone (all P < 0.05). Through multivariate analysis, the diagnostic performance of the prediction model (area under the ROC curve, AUC, 0.917) composed of RFcsa and SWV was superior to RFcsa (AUC, 0.847), RFthickness (AUC, 0.797), and SWV (AUC, 0.740) alone. Moreover, the prediction model achieved 70.0% sensitivity, 93.0% specificity, and 88.3% accuracy. The RFcsa, RFthickness, and SWV have potential value in assessing muscle in OSP and can be applied to routine clinical management of postmenopausal women. US measured RF thickness, CSA and SWV could assist detection and clinical management of OSP in postmenopausal women.
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