Screening effect of phase angle and calf circumference in different stages of sarcopenia in patients with maintenance hemodialysis

Abstract Objective To compare the screening ability of the phase angle (Pha) and the calf circumference (CC) alone and combined detection in the diferent stages of sarcopenia in patients with maintenance hemodialysis. Methods Data were retrospectively collected from outpatient under going MHD at Wenjiang Hemodialysis Center in the Departmalet of Nephrology in West China Hospital, Sichuan University, Chengdu, China. AWGS 2019 and EWGSOP 2010 were used to define the diferent stages of sarcopenia. Pha was measured by bioelectrical impedance analysis (BIA). Muscle strength was evaluated using handgrip strength (HGS), and physical function was assessed by short physical performance battery (SPPB), and skeletal muscle index (SMI) was assessed by the BIA, and CC was measured at the widest part of the calf with a retractable tape measure when the foot is pressed against a hard surface. Results The AUC of Pha in the screening of possible sarcopenia was 0.680, the sensitivity was 64.29%, the specifcity was 66.17%, and the cut-of value was 5.6°. The AUC of the combined Pha and CC for possible sarcopenia was 0.618, the sensitivity was 42.86%, and the specifcity was 76.69%. The AUC of CC for the screening of sarcopenia was 0.771, the sensitivity was 66.67%, the specifcity was 81.36%, and the cut-of value was 29 cm. The AUC of the combined Pha and CC for sarcopenia was 0.767, the sensitivity was 66.67%, and the specifcity was 86.02%. The AUC of Pha in the screening of severe sarcopenia was 0.865, the sensitivity was 86.67%, the specifcity was 78.26%, and the cut-of value was 4.9°. The AUC of CC in the screening of severe sarcopenia was 0.880, the sensitivity was 93.33%, the specifcity was 73.04%, and the cut-of value was 30 cm. The AUC of the combined Pha and CC for severe sarcopenia was 0.922, the sensitivity was 93.33%, and the specifcity was 81.30%. Conclusions The screening ability of Pha alone or in combination was higher than that of CC in the screening of possible sarcopenia. The screening ability of CC alone or in combination was higher than that of Pha in the screening of sarcopenia.Their combined assay performed better in screening for the severe sarcopenia stage compared with CC and Pha alone, which provided references for clinical identification of different stages of sarcopenia in MHD patients.