Clinical nutrition ESPEN · 2026
Comparison of sarcopenia diagnosis based on BIA-versus CT-estimated skeletal muscle mass combined with grip strength: External validation of JSH definition in older adults with cancer.
СтатьяСравнительное исследованиеВалидационное исследованиеНазвание и аннотация: Перевод в очереди
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Nishijima Tomohiro F, Shimokawa Mototsugu, Okahara Keita, Izaki Noriyoshi, Saito Mikio, Honda Takeo, Arimizu Kohei, Shinozaki Kenji, Esaki Taito, Morita Masaru
Аннотация
BACKGROUND & AIMS: The Japan Society of Hepatology (JSH) defines sarcopenia as low muscle mass measured by computed tomography (CT) or bioelectrical impedance analysis (BIA), combined with low muscle strength. We aimed to externally validate the JSH definition in the oncology setting.
METHODS: We included 630 consecutive Japanese patients with cancer who underwent BIA as part of a comprehensive geriatric assessment (CGA) and had a routine CT image at the L3 vertebra level within 30 days of the BIA. Reliability was assessed by agreement between sarcopenia diagnoses using the CT- and BIA-based low muscle mass criteria combined with low grip strength. Agreement was analyzed using cross-tabulation, Cohen's kappa and Gwet's AC1. Construct validity was evaluated by comparing physical performance measures obtained during CGA between patients with and without sarcopenia.
RESULTS: Using the CT- and BIA-based diagnostic criteria, sarcopenia was diagnosed in 189 (30%) and 177 (28%) patients, respectively. The overall agreement, kappa and AC1 between the two methods were 89% (95% CI 86%-91%), 0.73 (95% CI 0.67-0.79), and 0.81 (95% CI 0.77-0.86), respectively. Using the BIA-based criteria as a non-reference standard, the positive and negative percent agreement of the CT-based criteria were 84% (95% CI 77%-89%) and 91% (95% CI 88%-93%), respectively. Patients with sarcopenia-based on either CT-or BIA-based criteria-took longer to complete the 4-m gait speed, Five Times Sit-to-Stand, and Timed Up and Go tests than those without sarcopenia.
CONCLUSIONS: Our findings support the reliability and construct validity of the JSH definition for sarcopenia in older adults with cancer.
METHODS: We included 630 consecutive Japanese patients with cancer who underwent BIA as part of a comprehensive geriatric assessment (CGA) and had a routine CT image at the L3 vertebra level within 30 days of the BIA. Reliability was assessed by agreement between sarcopenia diagnoses using the CT- and BIA-based low muscle mass criteria combined with low grip strength. Agreement was analyzed using cross-tabulation, Cohen's kappa and Gwet's AC1. Construct validity was evaluated by comparing physical performance measures obtained during CGA between patients with and without sarcopenia.
RESULTS: Using the CT- and BIA-based diagnostic criteria, sarcopenia was diagnosed in 189 (30%) and 177 (28%) patients, respectively. The overall agreement, kappa and AC1 between the two methods were 89% (95% CI 86%-91%), 0.73 (95% CI 0.67-0.79), and 0.81 (95% CI 0.77-0.86), respectively. Using the BIA-based criteria as a non-reference standard, the positive and negative percent agreement of the CT-based criteria were 84% (95% CI 77%-89%) and 91% (95% CI 88%-93%), respectively. Patients with sarcopenia-based on either CT-or BIA-based criteria-took longer to complete the 4-m gait speed, Five Times Sit-to-Stand, and Timed Up and Go tests than those without sarcopenia.
CONCLUSIONS: Our findings support the reliability and construct validity of the JSH definition for sarcopenia in older adults with cancer.