title: Prevalence of sarcopenia based on different diagnostic criteria using DEXA and appendicular skeletal muscle mass reference values in an Italian population aged 20 to 80.
abstract: OBJECTIVE
  To identify the mean values and percentiles for ASMM (appendicular skeletal muscle mass) and the prevalence of sarcopenia, in terms of muscle mass reduction, using different cutoffs in a European population.
  
  
  METHODS
  A retrospective analysis on the dataset from a multicenter study on apparently healthy Italian adults conducted between 1999 and 2002. A significant muscle mass loss, necessary to diagnose sarcopenia, was defined in 3 different ways: (1) by subtracting 2 SDs from the mean ASMM index (ASMMI) of a young adult population (20-39 year-olds), as in the Rosetta study and the NHANES survey; (2) by calculating the 15th percentile of the distribution of our young population, corresponding to about 1 SD below the mean ASMMI; (3) by calculating the 20th percentile of the distribution of the ASMMI (as in the Health ABC study) of an elderly population.
  
  
  METHODS
  Five centers for the diagnosis and treatment of osteoporosis in various parts of the country (Padova, Verona, Parma, Roma, Napoli).
  
  
  METHODS
  Participants were 1535 volunteers (1208 women and 327 men) aged 20 to 80 years, drawn from among staff members, university students, lay people contacted by word of mouth, and patients presenting spontaneously for osteoporosis screening.
  
  
  METHODS
  Body weight and height were measured for all participants. Body composition was assessed by DEXA, and the ASMMI was calculated as the ASMM divided by body height in meters squared.
  
  
  RESULTS
  Both men's and women's lean mass in the arms and ASMM were highest in the young group and became lower in older age. In men, the ASMMI dropped gradually from age 20 to 29 to age 60 to 69, then remained stable in the oldest group. In women, the ASMMI gradually increased from age 20 to 29 to age 60 to 69, then dropped among the 70- to 80-year-olds. Based on the 15th percentile of the ASMMI for our young adult reference population, the cutoffs for sarcopenia were 7.59 kg/m(2) in men and 5.47 kg/m(2) in women; if the 20th percentile of the ASMMI in our elderly subjects (>65 years) was considered, the cutoffs were 7.64 kg/m(2) in men and 5.78 kg/m(2) in women. Applying the different diagnostic criteria to the those older than 65, the prevalence of sarcopenia ranged from 0% to about 20% in both genders.
  
  
  CONCLUSIONS
  The 15th percentile (or 1 SD below the mean) of the ASMMI of our young adults, and the 20th percentile of this index for an elderly reference population proved more effective in identifying cases of sarcopenia than subtracting 2 SD from the mean ASMMI of a young adult population.
authors.affiliation: Clinica Geriatrica, Dipartimento di Medicina, Università di Padova, Padova, Italy. alessandra.coin@unipd.it
authors.forename: Alessandra
authors.initials: A
authors.lastname: Coin
authors.forename: Silvia
authors.initials: S
authors.lastname: Sarti
authors.forename: Elena
authors.initials: E
authors.lastname: Ruggiero
authors.forename: Sandro
authors.initials: S
authors.lastname: Giannini
authors.forename: Mario
authors.initials: M
authors.lastname: Pedrazzoni
authors.forename: Salvatore
authors.initials: S
authors.lastname: Minisola
authors.forename: Maurizio
authors.initials: M
authors.lastname: Rossini
authors.forename: Antonio
authors.initials: A
authors.lastname: Del Puente
authors.forename: Emine Meral
authors.initials: EM
authors.lastname: Inelmen
authors.forename: Enzo
authors.initials: E
authors.lastname: Manzato
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Sergi
mesh_terms: D015502:Absorptiometry, Photon; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D000704:Analysis of Variance; D001823:Body Composition; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012016:Reference Values; D012189:Retrospective Studies; D055948:Sarcopenia / Q000175:diagnosis* / Q000453:epidemiology*; D012727:Sex Characteristics; D055815:Young Adult