Sarkopenik Yaşlı Hastalarda Ultrasonografik Olarak Kas Mimarisinin Değerlendirilmesi

Abstract

Sarcopenia is a geriatric syndrome characterised by progressive and generalised loss of skeletal muscle mass and strength with a risk of adverse outcomes such as physical disability, falls, poor quality of life and death. The prevalence of sarcopenia in 60- to 70-year-olds is in the range of 5–13%, for the population aged 80 years or older is 11–50%. The current diagnosis of sarcopenia depends on the measurement of muscle mass and strength. However, assessment of muscle architecture with ultrasound (USG) has not been studied in sarcopenic elderly before. The aim of this study was to assess the muscle architecture in sarcopenic elderly patients with USG and to assess the reliability of muscle USG for the diagnosis of sarcopenia. In this cross-sectional study, 100 elderly patients (41 men and 59 women) admitted to the outpatient clinic of the Geriatric Medicine were enrolled. Comprehensive geriatrics assessment tests, anthropometric measurements, bioelectrical impedance analysis (BIA), handgrip strength and muscle ultrasound were performed. Fat-free mass index (FFMI) and handgrip strength tests were used for diagnosis of sarcopenia. Mean± SD age of study population was 73.08 ± 6.18 year. The prevalence of sarcopenia was 16% (19.5% in male, 13.6% in female). The median age was significantly higher, body weight, BMI, handgrip, bilateral mid-arm (MAC) and calf circumferences (CC) were significantly lower in patients with sarcopenia. The prevalence of osteoporosis was significantly higher and Tinetti balance test score was significantly lower in sarcopenic patients. There were no significant differences regarding other co-morbidities and geriatric assessment tests. Thickness (T) and fascicle length (FL) of bilateral muscle gastrocnemius (MG) were significantly lower in patients with sarcopenia. FFMI was significantly and positively correlated with skeletal muscle mass index (SMI), handgrip, T and FL of bilateral MG and bilateral dermis T. Handgrip strength was significantly and positively correlated with T and FL of bilateral MG and significantly and negatively correlated with subcutan tissue T. ROC curve analysis suggested optimal cut-off points for sarcopenia; right CC:35.3 cm, left CC:33 cm, bilateral MAC:26.5 cm, right MG T: 1.69 cm, left MG T: 1.71 cm, right MG FL: 3.62 cm, left MG FL: 3.47 cm. USG imaging was found to be a reliable measurement tool to assess the changes of muscle architecture in sarcopenic patients and can be used for the diagnosis of sarcopenia.