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SARC‐F and modified versions using arm and calf circumference: Diagnostic performance for sarcopenia screening and the impact of obesity
Open accessAbstract
Aim: SARC‐F is limited by low sensitivity for sarcopenia identification. As surrogates of muscle mass, mid‐arm circumference (MAC) and/or calf circumference have been proposed as additions to SARC‐F to enhance sarcopenia identification. The aim of this study was to evaluate the diagnostic performance of SARC‐F, SARC‐CalF, SARC‐F + MAC, and SARC‐CalF + MAC in sarcopenia detection, and to assess the impact of obesity on their diagnostic performance. Methods: We studied 230 healthy non‐frail community‐dwelling older adults age >50 years. We performed receiver operating characteristic curve analysis for SARC‐F, SARC‐CalF, SARC‐F + MAC and SARC‐CalF + MAC against sarcopenia diagnosed by the Asian Working Group for Sarcopenia (AWGS) 2019 as the reference standard. Obesity was defined by high waist circumference (men ≥90 cm, women ≥80 cm). We performed subgroup analysis to compare between obese and non‐obese groups. Results: The prevalence of sarcopenia was 27.0% by AWGS 2019. SARC‐CalF + MAC had the best diagnostic performance (area under the curve [AUC] 0.74, 95% confidence interval [CI] 0.67–0.81; sensitivity 66.1%; specificity 69.1%), followed by SARC‐CalF (AUC 0.70, 95% CI 0.62–0.78; sensitivity 21.0%; specificity 95.8%). SARC‐F (AUC 0.57, 95% CI 0.49–0.66; sensitivity 0%; specificity 100%) performed significantly worsethan its modified versions (P < 0.05). There was higher accuracy of sarcopenia identification in obese compared with non‐obese groups for SARC‐F + MAC (AUC 0.75, 95% CI 0.65–0.85 vs. 0.58, 95% CI 0.46–0.70) and SARC‐CalF + MAC (AUC 0.75, 95% CI 0.66–0.85 vs. 0.70, 95% CI 0.59–0.81). Conclusions: The addition of arm circumference to SARC‐CalF confers better diagnostic accuracy for sarcopenia identification, especially in the obese group. Thus, MAC may complement SARC‐CalF for community screening of sarcopenia amongst healthy community‐dwelling older adults by increasing sensitivity for the detection of sarcopenic obesity. Geriatr Gerontol Int 2024; 24: 182–188.
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The risk-benefit profile of GLP-1 receptor agonist treatment in patients with obesity differs depending on whether sarcopenia is present.
“This approach is justified by the differing risk–benefit profile of GLP-1 RA treatment in patients with obesity depending on whether sarcopenia is present [60].”
From A Narrative Review on GLP-1 Receptor Agonists for Obesity in Older Women: Maximizing Weight Loss While Preserving Lean Mass (2026) · cites this paper as [60]
SARC-F performs less reliably in individuals with sarcopenic obesity.
“However, certain studies have shown that SARC-F performs less reliably in individuals with sarcopenic obesity [60].”
From A Narrative Review on GLP-1 Receptor Agonists for Obesity in Older Women: Maximizing Weight Loss While Preserving Lean Mass (2026) · cites this paper as [60]
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Moscucci, F., Baratta, F., Pastori, D., Menichelli, D., Mattioli, A. V., Gallina, S., Lospinuso, I., Sciomer, S., Piccirillo, G., & Desideri, G. (2026) · Nutrients · doi:10.3390/nu18040632 · Cited by 11
Metadata
- Authors
- Lee, S., Lim, J., Tan, C., Yeo, A., Chew, J., & Lim, W.
- Affiliations
- Tan Tock Seng Hospital (SG)
- Corresponding author
- Lee, Shi‐Teng
- Venue
- Geriatrics & Gerontology International
- Publisher
- Wiley
- Published
- 2023-12-14
- Volume
- 24
- Issue
- S1
- Pages
- 182-188
- ISSN
- 1444-1586 (ISSN-L)
- 1447-0594
- OpenAlex
- W4389764277
- Cited by
- 12
- References
- 2
- Citations by year
- 2026: 1 · 2025: 9 · 2024: 2
- FWCI
- 2.13
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Geriatrics and gerontology international/Geriatrics & gerontology international (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Lee Foundation
- Topics
- Health Sciences › Medicine › Physiology (medical) › Nutrition and Health in Aging
- Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
- Health Sciences › Medicine › Physiology (medical) › Body Composition Measurement Techniques
- Keywords
- sarcopenia, SARC-F, SARC-CalF, mid-upper arm circumference, calf circumference, obesity, sarcopenia screening, diagnostic accuracy, older adults, muscle mass, AWGS 2019 criteria, waist circumference, community-dwelling adults, sensitivity and specificity, sarcopenia prevalence, frailty, sarcopenic obesity, sarcopenic frailty
- MeSH terms
- Aged, Female, Humans, Leg, Male, Mass Screening, Obesity, Surveys and Questionnaires, ROC Curve, Geriatric Assessment, Sarcopenia
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