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Sarcopenia is defined by the European Working Group on Sarcopenia in Older People (EWGSOP) as "a syndrome characterized by progressive and generalized loss of skeletal muscle mass and strength, carrying a risk of adverse outcomes such as physical disability, fractures, falls, impaired quality of life, and death." However, despite the severity of the disease, a single diagnostic criterion has not yet been established, and various guidelines have been proposed to standardize the diagnostic criteria and cut-off values. Current European Working Group on Sarcopenia in Older People (EWGSOP) recommendations focus on European populations and, where possible, the use of normative references from healthy young adults. Since measurements such as gait and muscle strength are height-dependent, the use of regional normative populations is recommended whenever possible. Currently, some cut-off points for the diagnosis of sarcopenia are arbitrary. The development of validated cut-off points will depend on normative data and their predictive value for endpoints. Further studies are needed to determine whether gender-specific and region-specific threshold values for the diagnosis of sarcopenia improve the prediction of sarcopenia outcomes.
There are no studies in the literature on dual-energy x-ray absorptiometry cutoff values specific to the Turkish population. In our study, we aimed to define reference cutoff values for muscle mass, muscle strength, and calf circumference in Türkiye in order to improve the general applicability of EWGSOP criteria.
When low muscle strength is detected, the patient is evaluated for possible sarcopenia; the diagnosis is confirmed by the presence of low muscle mass or quality. Severe sarcopenia is considered when low muscle strength, low muscle mass or quality are accompanied by low physical performance. Muscle strength can be assessed by measuring hand grip strength and isometric or isokinetic measurements of lower extremity strength. A wide variety of techniques are used to measure muscle mass, including magnetic resonance imaging (MRI), computed tomography (CT), dual-energy x-ray absorptiometry (DEXA), bioelectrical impedance analysis (BIA), and anthropometric measurements; the most suitable method should be determined based on cost, accessibility, and ease of use. Muscle mass is related to body size; that is, individuals with larger body sizes typically have greater muscle mass. Therefore, to adjust for body size, the skeletal muscle index (SMI) is calculated as appendicular skeletal muscle mass (ALM) / height² (m²). The SMI cut-off value for sarcopenia, as defined by EWGSOP2, is <5.5 kg/m² for women and <7.0 kg/m² for men. There is ongoing debate regarding the preferred adjustment and whether the same method can be used for all populations. Physical performance assessment can be measured in various ways, including walking speed, the Short Physical Performance Battery (SPPB), and the Timed Up and Go Test (TUG).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| young population | Ages 18-39 | ||
| elderly population | Ages 65-99 |
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| Measure | Description | Time Frame |
|---|---|---|
| skeletal muscle mass index | Skeletal muscle mass index: calculated by dividing the sum of the non-bone lean mass of the four extremities by height² (meters). | At the start of the work |
| Measure | Description | Time Frame |
|---|---|---|
| muscle strength | Muscle strength will be assessed by measuring hand grip strength using the Baseline hydraulic hand dynamometer (INC. White Plains NY 10602 U.S.A), which has proven validity and reliability. | at the start of the work |
| walking speed test |
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Inclusion Criteria:
Exclusion Criteria:
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city hospital
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| Name | Affiliation | Role |
|---|---|---|
| Ayşe U Baykut | Ankara City Hospital Bilkent | Principal Investigator |
| Güldal F Yüzer Nakipoğlu | Ankara City Hospital Bilkent | Study Chair |
| Zeynep S Güneş | Ankara City Hospital Bilkent | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Ankara Bilkent City Hospital | Ankara | 06800 | Turkey (Türkiye) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 30312372 | Result | Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyere O, Cederholm T, Cooper C, Landi F, Rolland Y, Sayer AA, Schneider SM, Sieber CC, Topinkova E, Vandewoude M, Visser M, Zamboni M; Writing Group for the European Working Group on Sarcopenia in Older People 2 (EWGSOP2), and the Extended Group for EWGSOP2. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019 Jan 1;48(1):16-31. doi: 10.1093/ageing/afy169. |
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| ID | Term |
|---|---|
| D055948 | Sarcopenia |
| ID | Term |
|---|---|
| D009133 | Muscular Atrophy |
| D020879 | Neuromuscular Manifestations |
| D009461 | Neurologic Manifestations |
| D009422 | Nervous System Diseases |
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For the walking speed test, participants will be asked to walk 4 meters at their normal pace. Walking speed will be measured in m/s. |
| at the start of the work |
| Calf circumference | Calf circumference will be measured at the widest part of the calf. | at the start of the work |
| Mid-arm circumference | Mid-arm circumference will be measured standing with the shoulder abducted at 90 degrees, at the midsection of the humerus. | at the start of the work |
| D001284 | Atrophy |
| D020763 | Pathological Conditions, Anatomical |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D012816 | Signs and Symptoms |