Value of conventional ultrasound and shear wave elastography in the assessment of muscle mass and function in elderly people with type 2 diabetes

ObjectivesWe assessed muscle mass and function using ultrasound (US) and shear wave elastography (SWE) for sarcopenia in elderly patients with type 2 diabetes.MethodsThere were 84 patients with type 2 diabetes enrolled in this study; of these, 30 had sarcopenia and 54 did not. We measured appendicular skeletal muscle mass index (ASMI), handgrip strength, calf circumference, 6-m walking speed, and 5-time chair stand test. All patients were in the supine position with their knees in straight and bent poses in turn. The US-derived thickness (T-straight, T-bent), cross-sectional area (CSA(straight), CSA(bent)), and SWE (SWEstraight, SWEbent) of the rectus femoris muscle (RFM) were measured and the differences (Delta T, Delta CSA, Delta SWE) were calculated. We assessed the correlations of clinical indicators with US and SWE features. We then compared the clinical indicators and US and SWE features between patients with and without sarcopenia to determine independent predictors. Diagnostic models were established based on these independent predictors.ResultsThe ASMI was correlated with T-bent (r = 0.57, p < 0.001) and CSA(bent) (r = 0.50, p < 0.001). Handgrip strength was correlated with T-bent (r = 0.53, p < 0.001) and CSA(bent) (r = 0.51, p < 0.001). Between patients with and without sarcopenia, the indicators of age, Delta CSA, and Delta SWE were statically different (all p <= 0.001). Based on these results, a diagnostic model for sarcopenia was established with 83.3% sensitivity, 83.3% specificity, and 83.3% accuracy.ConclusionsIn elderly people with type 2 diabetes, sarcopenia patients had smaller muscle CSA and less stiffness than non-sarcopenia patients. US and SWE might be useful to screen them.

Automated summary

This study assessed muscle mass and function in elderly patients with type 2 diabetes using ultrasound and shear wave elastography. Various clinical indicators were measured, and the thickness, cross-sectional area, and shear wave elastography values of the rectus femoris muscle were also measured. The study found independent predictors for sarcopenia and established a diagnostic model with high accuracy.