Comparison of Seven Sarcopenia Screening Tools in Older Type 2 Diabetes Patients Using Four Diagnostic Criteria

To compare the diagnostic accuracy of seven sarcopenia screening tools against four international guidelines.

This cross-sectional study recruited 330 Chinese older patients from a tertiary hospital. Sarcopenia was diagnosed based on muscle mass, strength, and physical performance using four guidelines: the Asian Working Group for Sarcopenia (AWGS) 2019 consensus, The updated version of the European Working Group on Sarcopenia in Older People (EWGSOP2), Foundation for the National Institutes of Health Sarcopenia Project (FNIH), and the International Working Group on Sarcopenia (IWGS). Seven screening tools included: SARC-F, MSRA-7, MSRA-5, Calf Circumference (CC), Finger-ring Test, SARC-CalF, and Ishii Score. Diagnostic accuracy was assessed using sensitivity, specificity, and receiver operating characteristic (ROC) curve analysis, including area under the curve (AUC).

This study enrolled 330 older adults with type 2 diabetes, including 172 women and 158 men, with a mean age of 68.35 ± 6.32 years. Sarcopenia prevalence ranged from 7.58% to 27.27%. The Ishii Score showed the highest accuracy for screening sarcopenia in older patients with T2DM. Under the 2019 consensus of the Asian Working Group for Sarcopenia criteria, sensitivity ranged from 13.33% (SARC-F) to 80.00% (Ishii Score), and specificity ranged from 27.92% (MSRA-7) to 91.67% (SARC-F). AUCs ranged from 0.51 (MSRA-5) to 0.79 (Ishii Score). In subgroup analyses, the Ishii Score also demonstrated the highest AUC values in men (0.79) and in women (0.83). The performance of tools varied against other three golden standards, with sensitivity (8.00%-98.04%), specificity (27.21%-91.67%), and AUC (0.51-0.88).

The Ishii score demonstrated the highest overall diagnostic accuracy for sarcopenia screening. CC may be ideal for rapid screening, while SARC-F suits confirmatory testing. Further validation of these tools in diverse settings is needed.