title: Calf circumference as a surrogate marker of muscle mass for diagnosing sarcopenia in Japanese men and women.
abstract: OBJECTIVE
  To examine the relationship between calf circumference and muscle mass, and to evaluate the suitability of calf circumference as a surrogate marker of muscle mass for the diagnosis of sarcopenia among middle-aged and older Japanese men and women.
  
  
  METHODS
  A total of 526 adults aged 40-89 years participated in the present cross-sectional study. The maximum calf circumference was measured in a standing position. Appendicular skeletal muscle mass was measured using dual-energy X-ray absorptiometry, and the skeletal muscle index was calculated as appendicular skeletal muscle mass divided by the square of the height (kg/m(2)). The cut-off values for sarcopenia were defined as a skeletal muscle index of less than -2 standard deviations of the mean value for Japanese young adults, as defined previously.
  
  
  RESULTS
  Calf circumference was positively correlated with appendicular skeletal muscle (r = 0.81 in men, r = 0.73 in women) and skeletal muscle index (r = 0.80 in men, r = 0.69 in women). In receiver operating characteristic analysis, the optimal calf circumference cut-off values for predicting sarcopenia were 34 cm (sensitivity 88%, specificity 91%) in men and 33 cm (sensitivity 76%, specificity 73%) in women.
  
  
  CONCLUSIONS
  Calf circumference was positively correlated with appendicular skeletal muscle mass and skeletal muscle index, and could be used as a surrogate marker of muscle mass for diagnosing sarcopenia. The suggested cut-off values of calf circumference for predicting low muscle mass are <34 cm in men and <33 cm in women.
authors.affiliation: Graduate School of Sport Sciences, Waseda University, Saitama, Japan.|Department of Health Promotion and Exercise, National Institute of Health and Nutrition, Tokyo, Japan.|Japan Society for the Promotion of Science, Tokyo, Japan.
authors.forename: Ryoko
authors.initials: R
authors.lastname: Kawakami
authors.affiliation: Department of Health Promotion and Exercise, National Institute of Health and Nutrition, Tokyo, Japan.
authors.forename: Haruka
authors.initials: H
authors.lastname: Murakami
authors.affiliation: College of Sport and Health Science, Ritsumeikan University, Shiga, Japan.
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Sanada
authors.affiliation: Department of Health Promotion and Exercise, National Institute of Health and Nutrition, Tokyo, Japan.
authors.forename: Noriko
authors.initials: N
authors.lastname: Tanaka
authors.affiliation: Department of Health Promotion and Exercise, National Institute of Health and Nutrition, Tokyo, Japan.
authors.forename: Susumu S
authors.initials: SS
authors.lastname: Sawada
authors.affiliation: College of Sport and Health Science, Ritsumeikan University, Shiga, Japan.
authors.forename: Izumi
authors.initials: I
authors.lastname: Tabata
authors.affiliation: Faculty of Sport Sciences, Waseda University, Saitama, Japan.
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Higuchi
authors.affiliation: Department of Health Promotion and Exercise, National Institute of Health and Nutrition, Tokyo, Japan.
authors.forename: Motohiko
authors.initials: M
authors.lastname: Miyachi
mesh_terms: D015502:Absorptiometry, Photon / Q000379:methods*; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D000886:Anthropometry; D015415:Biomarkers / Q000032:analysis; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007564:Japan; D007866:Leg / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000502:physiology*; D016017:Odds Ratio; D009929:Organ Size; D011237:Predictive Value of Tests; D012372:ROC Curve; D055948:Sarcopenia / Q000175:diagnosis*; D012737:Sex Factors
chemical_list: D015415:Biomarkers
keywords: Japanese; anthropometric; body composition; dual-energy X-ray absorptiometry; muscle strength