Application of selected muscle strength and body mass cut points for the diagnosis of sarcopenia in men and women with or at risk for HIV infection

Kristine M. Erlandson; Thomas G. Travison; Hao Zhu; Jay Magaziner; Rosaly Correa-De-Araujo; Peggy M. Cawthon; Shalender Bhasin; Todd Manini; Roger A. Fielding; Frank J. Palella; Lawrence Kingsley; Jordan E. Lake; Anjali Sharma; Phyllis C. Tien; Kathleen M. Weber; Michael T. Yin; Todd T. Brown

doi:10.1093/gerona/glaa083

Application of selected muscle strength and body mass cut points for the diagnosis of sarcopenia in men and women with or at risk for HIV infection

Kristine M. Erlandson^*, Thomas G. Travison, Hao Zhu, Jay Magaziner, Rosaly Correa-De-Araujo, Peggy M. Cawthon, Shalender Bhasin, Todd Manini, Roger A. Fielding, Frank J. Palella, Lawrence Kingsley, Jordan E. Lake, Anjali Sharma, Phyllis C. Tien, Kathleen M. Weber, Michael T. Yin, Todd T. Brown

^*Corresponding author for this work

Medicine, Infectious Diseases Division

Research output: Contribution to journal › Article › peer-review

13 Scopus citations

Abstract

Background: Persons with HIV may experience greater mobility limitations than uninfected populations. Accurate tools are needed to identify persons at greatest risk of decline. We evaluated the performance of novel muscle weakness metrics (grip, grip/body mass index [BMI], grip/weight, grip/total body fat, grip/arm lean mass) and association with slowness and falls in older persons with or at risk for HIV infection as part of the work of the Sarcopenia Definitions and Outcomes Consortium (SDOC). Methods: We assessed the prevalence of sarcopenia among 398 men (200 HIV+, 198 HIV-) from the Multicenter AIDS Cohort Study and 247 women (162 HIV+, 85 HIV-) from the Women’s Interagency HIV Study using previously validated muscle weakness metrics discriminative of slowness. Sensitivity and specificity were used to compare new muscle weakness and slowness criteria to previously proposed sarcopenia definitions. Results: The prevalence of muscle weakness ranged from 16% to 66% among men and 0% to 47% among women. Grip/BMI was associated with slowness among men with HIV only. Grip/BMI had low sensitivity (25%–30%) with moderate to high specificity (68%–89%) for discriminating of slowness; all proposed metrics had poor performance in the discrimination of slowness (area under the curve [AUC] < 0.62) or fall status (AUC < 0.56). The combination of muscle weakness and slowness was not significantly associated with falls (p ≥ .36), with a low sensitivity in identifying those sustaining one or more falls (sensitivity ≤ 16%). Discussion: Clinical utility of new sarcopenia metrics for identification of slowness or falls in men and women with or at risk for HIV is limited, given their low sensitivity.

Original language	English (US)
Pages (from-to)	1338-1345
Number of pages	8
Journal	Journals of Gerontology - Series A Biological Sciences and Medical Sciences
Volume	75
Issue number	7
DOIs	https://doi.org/10.1093/gerona/glaa083
State	Published - 2020

Funding

The Sarcopenia Definitions and Outcomes Consortium (SDOC) is supported by the National Institutes of Health (NIH), Error! Bookmark not defined.National Institute on Aging (NIA, grant number AG51421), the Foundation for the National of Institutes of Health (FNIH, grant numbers CAWT16SARC2 and BHAS16SARC2), and the California Pacific Medical Center Foundation. This research was supported in part by the intramural research program at the NIA. The MACS Bone Strength Substudy (BOSS) was supported by NIH (National Institute of Allergy and Infectious Disease [NIAID]) R01AI095089 (T.T.B.). The Multicenter AIDS Cohort Study is supported by the NIAID, with additional supplemental funding from the National Cancer Institute (NCI) grants UO1-AI-35042, UL1-RR025005, UM1-AI-35043, UO1-AI-35039, UO1-AI-35040, and UO1-AI-35041. The WIHS Musculoskeletal Substudy (MSK) was supported by NIH (NIAID) R01AI095089 (M.T.Y.). The WIHS is funded primarily by the NIAID, with additional co-funding from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), the NCI, the National Institute on Drug Abuse (NIDA), and the National Institute on Mental Health (NIMH). Additional support was provided under award numbers: NIAID K24

Keywords

Falls
Gait speed
Muscle
Weakness

ASJC Scopus subject areas

General Medicine

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1093/gerona/glaa083

Cite this

Erlandson, K. M., Travison, T. G., Zhu, H., Magaziner, J., Correa-De-Araujo, R., Cawthon, P. M., Bhasin, S., Manini, T., Fielding, R. A., Palella, F. J., Kingsley, L., Lake, J. E., Sharma, A., Tien, P. C., Weber, K. M., Yin, M. T., & Brown, T. T. (2020). Application of selected muscle strength and body mass cut points for the diagnosis of sarcopenia in men and women with or at risk for HIV infection. Journals of Gerontology - Series A Biological Sciences and Medical Sciences, 75(7), 1338-1345. https://doi.org/10.1093/gerona/glaa083

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title = "Application of selected muscle strength and body mass cut points for the diagnosis of sarcopenia in men and women with or at risk for HIV infection",

abstract = "Background: Persons with HIV may experience greater mobility limitations than uninfected populations. Accurate tools are needed to identify persons at greatest risk of decline. We evaluated the performance of novel muscle weakness metrics (grip, grip/body mass index [BMI], grip/weight, grip/total body fat, grip/arm lean mass) and association with slowness and falls in older persons with or at risk for HIV infection as part of the work of the Sarcopenia Definitions and Outcomes Consortium (SDOC). Methods: We assessed the prevalence of sarcopenia among 398 men (200 HIV+, 198 HIV-) from the Multicenter AIDS Cohort Study and 247 women (162 HIV+, 85 HIV-) from the Women{\textquoteright}s Interagency HIV Study using previously validated muscle weakness metrics discriminative of slowness. Sensitivity and specificity were used to compare new muscle weakness and slowness criteria to previously proposed sarcopenia definitions. Results: The prevalence of muscle weakness ranged from 16% to 66% among men and 0% to 47% among women. Grip/BMI was associated with slowness among men with HIV only. Grip/BMI had low sensitivity (25%–30%) with moderate to high specificity (68%–89%) for discriminating of slowness; all proposed metrics had poor performance in the discrimination of slowness (area under the curve [AUC] < 0.62) or fall status (AUC < 0.56). The combination of muscle weakness and slowness was not significantly associated with falls (p ≥ .36), with a low sensitivity in identifying those sustaining one or more falls (sensitivity ≤ 16%). Discussion: Clinical utility of new sarcopenia metrics for identification of slowness or falls in men and women with or at risk for HIV is limited, given their low sensitivity.",

keywords = "Falls, Gait speed, Muscle, Weakness",

author = "Erlandson, {Kristine M.} and Travison, {Thomas G.} and Hao Zhu and Jay Magaziner and Rosaly Correa-De-Araujo and Cawthon, {Peggy M.} and Shalender Bhasin and Todd Manini and Fielding, {Roger A.} and Palella, {Frank J.} and Lawrence Kingsley and Lake, {Jordan E.} and Anjali Sharma and Tien, {Phyllis C.} and Weber, {Kathleen M.} and Yin, {Michael T.} and Brown, {Todd T.}",

note = "Publisher Copyright: {\textcopyright} The Author(s) 2020.",

year = "2020",

doi = "10.1093/gerona/glaa083",

language = "English (US)",

volume = "75",

pages = "1338--1345",

journal = "Journals of Gerontology - Series A Biological Sciences and Medical Sciences",

issn = "1079-5006",

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number = "7",

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Erlandson, KM, Travison, TG, Zhu, H, Magaziner, J, Correa-De-Araujo, R, Cawthon, PM, Bhasin, S, Manini, T, Fielding, RA, Palella, FJ, Kingsley, L, Lake, JE, Sharma, A, Tien, PC, Weber, KM, Yin, MT & Brown, TT 2020, 'Application of selected muscle strength and body mass cut points for the diagnosis of sarcopenia in men and women with or at risk for HIV infection', Journals of Gerontology - Series A Biological Sciences and Medical Sciences, vol. 75, no. 7, pp. 1338-1345. https://doi.org/10.1093/gerona/glaa083

Application of selected muscle strength and body mass cut points for the diagnosis of sarcopenia in men and women with or at risk for HIV infection. / Erlandson, Kristine M.; Travison, Thomas G.; Zhu, Hao et al.
In: Journals of Gerontology - Series A Biological Sciences and Medical Sciences, Vol. 75, No. 7, 2020, p. 1338-1345.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Application of selected muscle strength and body mass cut points for the diagnosis of sarcopenia in men and women with or at risk for HIV infection

AU - Erlandson, Kristine M.

AU - Travison, Thomas G.

AU - Zhu, Hao

AU - Magaziner, Jay

AU - Correa-De-Araujo, Rosaly

AU - Cawthon, Peggy M.

AU - Bhasin, Shalender

AU - Manini, Todd

AU - Fielding, Roger A.

AU - Palella, Frank J.

AU - Kingsley, Lawrence

AU - Lake, Jordan E.

AU - Sharma, Anjali

AU - Tien, Phyllis C.

AU - Weber, Kathleen M.

AU - Yin, Michael T.

AU - Brown, Todd T.

PY - 2020

Y1 - 2020

N2 - Background: Persons with HIV may experience greater mobility limitations than uninfected populations. Accurate tools are needed to identify persons at greatest risk of decline. We evaluated the performance of novel muscle weakness metrics (grip, grip/body mass index [BMI], grip/weight, grip/total body fat, grip/arm lean mass) and association with slowness and falls in older persons with or at risk for HIV infection as part of the work of the Sarcopenia Definitions and Outcomes Consortium (SDOC). Methods: We assessed the prevalence of sarcopenia among 398 men (200 HIV+, 198 HIV-) from the Multicenter AIDS Cohort Study and 247 women (162 HIV+, 85 HIV-) from the Women’s Interagency HIV Study using previously validated muscle weakness metrics discriminative of slowness. Sensitivity and specificity were used to compare new muscle weakness and slowness criteria to previously proposed sarcopenia definitions. Results: The prevalence of muscle weakness ranged from 16% to 66% among men and 0% to 47% among women. Grip/BMI was associated with slowness among men with HIV only. Grip/BMI had low sensitivity (25%–30%) with moderate to high specificity (68%–89%) for discriminating of slowness; all proposed metrics had poor performance in the discrimination of slowness (area under the curve [AUC] < 0.62) or fall status (AUC < 0.56). The combination of muscle weakness and slowness was not significantly associated with falls (p ≥ .36), with a low sensitivity in identifying those sustaining one or more falls (sensitivity ≤ 16%). Discussion: Clinical utility of new sarcopenia metrics for identification of slowness or falls in men and women with or at risk for HIV is limited, given their low sensitivity.

AB - Background: Persons with HIV may experience greater mobility limitations than uninfected populations. Accurate tools are needed to identify persons at greatest risk of decline. We evaluated the performance of novel muscle weakness metrics (grip, grip/body mass index [BMI], grip/weight, grip/total body fat, grip/arm lean mass) and association with slowness and falls in older persons with or at risk for HIV infection as part of the work of the Sarcopenia Definitions and Outcomes Consortium (SDOC). Methods: We assessed the prevalence of sarcopenia among 398 men (200 HIV+, 198 HIV-) from the Multicenter AIDS Cohort Study and 247 women (162 HIV+, 85 HIV-) from the Women’s Interagency HIV Study using previously validated muscle weakness metrics discriminative of slowness. Sensitivity and specificity were used to compare new muscle weakness and slowness criteria to previously proposed sarcopenia definitions. Results: The prevalence of muscle weakness ranged from 16% to 66% among men and 0% to 47% among women. Grip/BMI was associated with slowness among men with HIV only. Grip/BMI had low sensitivity (25%–30%) with moderate to high specificity (68%–89%) for discriminating of slowness; all proposed metrics had poor performance in the discrimination of slowness (area under the curve [AUC] < 0.62) or fall status (AUC < 0.56). The combination of muscle weakness and slowness was not significantly associated with falls (p ≥ .36), with a low sensitivity in identifying those sustaining one or more falls (sensitivity ≤ 16%). Discussion: Clinical utility of new sarcopenia metrics for identification of slowness or falls in men and women with or at risk for HIV is limited, given their low sensitivity.

KW - Falls

KW - Gait speed

KW - Muscle

KW - Weakness

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U2 - 10.1093/gerona/glaa083

DO - 10.1093/gerona/glaa083

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C2 - 32301484

AN - SCOPUS:85086748976

SN - 1079-5006

VL - 75

SP - 1338

EP - 1345

JO - Journals of Gerontology - Series A Biological Sciences and Medical Sciences

JF - Journals of Gerontology - Series A Biological Sciences and Medical Sciences

IS - 7

ER -

Application of selected muscle strength and body mass cut points for the diagnosis of sarcopenia in men and women with or at risk for HIV infection

Abstract

Funding

Keywords

ASJC Scopus subject areas

UN SDGs

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