Study On The Value Of Predicting Sarcopenia Based On Multi-parameter Ultrasonic Index Of Gastrocnemius Muscle

Objective: To explore the prediction value of multi-parameter ultrasound index based on gastrocnemius muscle for sarcopenia,and to provide theoretical and data basis for the prediction of elderly patients with sarcopenia through ultrasound in clinic.Methods: This study included 127 inpatients over 60 years old in Ordos Central Hospital of Inner Mongolia Medical University from July 2021 to November 2022 as research objects,among which 66 were males,accounting for 52.0%,and 61 were females,accounting for48.0%.The muscle mass was measured by BIA(bioelectrical impedance analysis),the walking speed was measured by 6-meter walking test,the grip strength was measured by electronic grip device,and the MT(muscle thickness),FT(fat thickness),PA(pinnation angle),FL(fascicle length)was measured by ultrasound.The truncation value in the 2019 consensus update on sarcopenia diagnosis and treatment released by the Asian sarcopenia Working Group was used as the diagnostic criteria.The subjects were divided into normal walking speed group and low walking speed group,normal grip strength group and low grip strength group,normal muscle mass group and low muscle mass group,and sarcopenia group and non-sarcopenia group.Mann-Whitney U test or t test were used to analyze the difference of indicators among the groups,and multiple logistic stepwise regression analysis was used to explore the influencing factors of sarcopenia.ROC curve was drawn to explore the diagnostic and predictive value of ultrasonic indicators for sarcopenia.Results:(1)The levels of ASMI,MT and PA in non-sarcopenia group were higher than those in sarcopenia group(P < 0.05).In men,BMI levels were higher in the non-sarcopenia group than in the sarcopenia group,and in women,age was lower in the non-sarcopenia group than in the sarcopenia group(P < 0.05).(2)In men,BMI(OR:0.52,95%CI:0.35-0.77),MT(OR:0.54,95%CI:0.35-0.84),PA(OR:0.68,95%CI:0.48-0.98)were protective factors for the occurrence of sarcopenia,while FT(OR:3.21,95%CI:1.09-9.45)is a risk factor for sarcopenia.In women,age(OR:1.67,95%CI:1.13-2.48) was a risk factor for the development of sarcopenia,while MT(OR:0.74,95%CI: 0.88-0.94) and PA(OR:0.77,95%CI:0.60-0.98)were protective factors.(3)In males,BMI,MT,PA and FT had good diagnostic and predictive value for sarcopenia,and their area under ROC curve was 0.78,0.84,0.68 and 0.57,respectively.The area under ROC curve of the combined prediction of the four groups was 0.96,and their sensitivity and specificity were 91.43% and 93.55%,respectively.In females,age,MT and PA had good diagnostic and predictive value for sarcopenia,and their area under ROC curve was 0.78,0.79 and 0.79,respectively.The area under ROC curve of the combined prediction of these three factors was 0.89,and their sensitivity and specificity were 84.00% and 80.56%,respectively.Conclusion: Ultrasonic measurements of MT and PA in gastrocnemius muscle can be used as predictive indicators of sarcopenia.The combined detection of multiple parameters can significantly improve the clinical prediction value of sarcopenia.