Relationship between longitudinal changes in calf circumference and skeletal muscle mass

Calf circumference serves as a surrogate marker of skeletal muscle mass. However, its ability to reflect changes in skeletal muscle mass remains unclear. This longitudinal study aimed to assess the relationship between changes in calf circumference and appendicular skeletal muscle mass (ASM) and to explore the effects of age and obesity.

The two-wave cohort data of 227 adults aged 40-87 years were analyzed. The maximum calf circumference was measured in a standing position, whereas body composition, including ASM, was measured using dual-energy X-ray absorptiometry. Pearson's correlation coefficient was calculated to assess this relationship.

The mean follow-up period was 8.0 ± 0.4 years. The mean changes in calf circumference and ASM (follow-up - baseline value) were -0.1 ± 1.2 cm and -0.7 ± 1.0 kg, respectively. Changes in calf circumference and ASM showed a positive correlation in men and women (r = 0.71 and 0.71, respectively). A 1.0 cm reduction in calf circumference corresponded to a 1.4 and 0.9 kg reduction in ASM for men and women, respectively. As in the primary analysis, subgroup analysis based on age and obesity exhibited similar positive correlations between changes in calf circumference and ASM (r = 0.70, 0.67, 0.69, and 0.72 for middle-aged, older, non-obese, and obese adults, respectively).

Longitudinal changes in calf circumference were positively correlated with those in ASM, regardless of age and obesity status. As such, changes in calf circumference could serve as a reliable indicator of variations in skeletal muscle mass.