A Novel Sarcopenia Screening Approach Using an Osteoporosis-Inspired T-Score Method

Sarcopenia is characterized by reduced muscle mass, strength, and impaired physical function, and it requires effective indicators for early detection. This study introduces a novel screening method using the expected muscle functionality (eMF) indicator and an osteoporosis-inspired T-score.

The model was developed using 4052 individuals from the Korea National Health and Nutrition Examination Survey (KNHANES) and validated with 888 individuals from the Korean Genome and Epidemiology Study (KoGES). eMF was calculated using logistic regression based on grip strength, body mass index (BMI), waist circumference, and age. The T-score was derived by standardizing eMF against the mean and standard deviation of young adults (aged 20-29 years). The T-score cut-off values were determined at the intersection of kernel density estimation plots, set at -1.1 for men and -1.8 for women. Sarcopenia was diagnosed in individuals below these cutoffs.

Performance metrics were calculated based on sarcopenia defined using cutoff values of grip strength and muscle mass. The model demonstrated reliable performance, with sensitivity, specificity, accuracy, and area under the receiver operating characteristic curve of 0.900, 0.889, 0.890, and 0.932, respectively. False negatives exhibited clinical characteristics similar to sarcopenic obesity, while false positives resembled possible sarcopenia.

The eMF-based indicator offers a significant improvement in sarcopenia screening, enabling more accurate identification and supporting early detection and management of the condition, ultimately enhancing patient outcomes and healthcare delivery.