P656 - DEFINING THRESHOLDS FOR SEVERE MUSCLE MASS DEPLETION USING CALF CIRCUMFERENCE IN THE GLOBAL LEADERSHIP INITIATIVE ON MALNUTRITION FRAMEWORK

P656

DEFINING THRESHOLDS FOR SEVERE MUSCLE MASS DEPLETION USING CALF CIRCUMFERENCE IN THE GLOBAL LEADERSHIP INITIATIVE ON MALNUTRITION FRAMEWORK

Y. Ishida^1,2,*, K. Maeda^1,2,3,4, T. Sakaguchi⁵, M. Motegi^3,6, N. Mori^1,2,3,5

¹Department of Nutrition, Aichi Medical University Hospital, ²Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, Aichi Medical University, ³Nutrition Therapy Support Center, Aichi Medical University Hospital, ⁴Department of Geriatric Medicine, Hospital, National Center for Geriatrics and Gerontology, ⁵Palliative Care Center, Aichi Medical University, ⁶Division of Diabetes, Department of Internal Medicine, Aichi Medical University School of Medicine, Aichi, Japan

Rationale: There is no established cut-off value for severe muscle mass loss using calf circumference (CC) as an indicator in the Global Leadership Initiative on Malnutrition (GLIM)-based diagnosis. Determining this threshold would permit malnutrition diagnosis in most clinical settings, even without specialized equipment for muscle mass evaluation.

Methods: In this retrospective cohort study, we utilized existing clinical records. In the developmental phase (December 2017 to March 2022), severe muscle mass loss in hospitalized patients aged 18 years and older was calculated. CC adjusted for body mass index was used to identify muscle mass loss, with <33 cm and <32 cm being the thresholds for severe muscle mass loss in men and women, respectively, as proposed by the GLIM guidelines. Receiver operating characteristic curve analysis was performed to determine the threshold values for severe muscle mass loss, using 1-year mortality as the outcome. In the validation phase (April 2022 to March 2023), these threshold values were further validated using the Kaplan–Meier and log-rank tests.

Results: During the developmental phase, 5,542 patients were analyzed. The cohort consisted of 2,955 women (mean age 71.8 ± 15.6 years) and 2,587 men (mean age 74.8 ± 12.3 years). The threshold values for severe muscle mass loss were 29.8 cm for men and 28.2 cm for women (area under the curve 0.651 [0.627–0.674] for men, 0.646 [0.618–0.674] for women). During the validation phase, 6,609 patients were analyzed. The mortality rates were 41.3% for the no malnutrition, 18.0% for the moderate malnutrition, and 40.7% for the severe malnutrition groups (p<0.001).

Conclusion: The threshold values for severe muscle mass loss were 29.8 cm for men and 28.2 cm for women. These results could enhance the diagnosis of malnutrition and improve its clinical applicability.

Disclosure of Interest: None declared