ULTRASONIC EVALUATION OF SOFT TISSUES OF THE RIGHT THIGH IN THE DIAGNOSIS OF SARCOPENIA IN PATIENTS WITH ARTERIAL HYPERTENSION AND OBESITY: FROM VISUALIZATION TO VERIFICATION

Purpose To evaluate the feasibility of ultrasound for determining muscle mass and diagnosing sarcopenia in working-age patients with arterial hypertension (AH) and obesity.

Materials and Methods. A cross-sectional (comparative) single-center study was conducted, including 160 patients (96 men and 64 women) with stage I–II AH and obesity, aged 30 to 64 years. The average age of the study participants was 47.8 ± 7.99 years. All patients underwent anthropometric measurements, assessment of skeletal muscle strength and function, and dual-energy X-ray absorptiometry (DXA) using a Lunar Prodigy GE (core Version 18.0, USA). Ultrasound examination of the rectus femoris, vastus intermedius, and subcutaneous fat was performed using an EPIQ expert-class ultrasound system manufactured by Philips Ultrasound Inc. (USA). Statistical analysis of the obtained data was performed using SPSS 27.0 (IBM, USA) and Statistica (version 10.0, StatSoft, Inc., USA). Results were interpreted as reliable, and differences between parameters were considered significant at p < 0.05.

Results. An inverse correlation was found between subcutaneous fat thickness and muscle mass and strength. Conversely, rectus femoris thickness was directly related to these parameters. The greater the subcutaneous fat thickness, the more pronounced the muscle dysfunction (the patient required more time to complete the 5-times chair stand and 4-meter walk tests). Conversely, the greater the thickness of the right rectus femoris and vastus intermedius muscles, the less time the patient required to complete these tests. AUROCs for US parameters of the thigh soft tissue, specifically subcutaneous fat thickness and right rectus femoris thickness, for identifying reduced skeletal muscle mass (according to the appendicular skeletal muscle mass to body weight ratio, DXA) in patients with obesity and hypertension were 0.752 (0.639–0.864)/0.604 (0.487–0.720) and 0.628 (0.490–0.766)/ 0.669 (0.525–0.812) in men and women, respectively. The AUROC for the total thickness of the rectus femoris and vastus intermedius muscles according to US data in determining sarcopenia was 0.633 (95 % CI: 0.532–0.733).

Conclusion. Ultrasound assessment of the thigh soft tissue (subcutaneous fat and muscle thickness) is a promising method for screening for sarcopenia in patients with AH and obesity. Verification of muscle loss using ultrasound imaging of the thigh muscles in this patient population can be used as an alternative to DXA for detecting sarcopenia in its early stages.

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