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Value of ultrasound assessment of sarcopenia in patients with diffuse large B-cell lymphoma: a prospective study

Teng Liu

Teng Liu

  • Department of Ultrasound, Qilu Hospital of Shandong UniversityJinan, China
  • Shandong Key Laboratory Cardiovascular ProteomicsJinan, China
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Liu, Teng
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Junjun Wan

Junjun Wan

  • Department of Respiratory Medicine, the Second Hospital of Shandong UniversityJinan, China
  • Shandong Key Laboratory Cardiovascular ProteomicsJinan, China
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Wan, Junjun
, 
Yangyang Liu

Yangyang Liu

  • Department of Ultrasound, the People’s Hospital of YinanLinyi, China
  • Shandong Key Laboratory Cardiovascular ProteomicsJinan, China
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Liu, Yangyang
, 
Jing Zhuo

Jing Zhuo

  • Department of Ultrasound, Qilu Hospital of Shandong UniversityJinan, China
  • Shandong Key Laboratory Cardiovascular ProteomicsJinan, China
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Zhuo, Jing
 y 
Weijiang Fu

Weijiang Fu

  • Department of Geriatric Medicine, Qilu Hospital of Shandong UniversityJinan, China
  • Shandong Key Laboratory Cardiovascular ProteomicsJinan, China
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Fu, Weijiang
  
08 jul 2025
Value of ultrasound assessment of sarcopenia in patients with diffuse large B-cell lymphoma: a prospective study's Cover Image
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Categoría del artículo: Research Article
Publicado en línea: 08 jul 2025
Páginas: 301 - 310
Recibido: 18 dic 2024
Aceptado: 11 abr 2025
DOI: https://doi.org/10.2478/raon-2025-0036
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© 2025 Teng Liu et al., published by Sciendo
This work is licensed under the Creative Commons Attribution 4.0 International License.

Figure 1.

Participant flow chart for study. A total of 167 cases were eventually recruited into the sarcopenia (n = 88) and non-sarcopenia (n = 79) groups for analysis.
Participant flow chart for study. A total of 167 cases were eventually recruited into the sarcopenia (n = 88) and non-sarcopenia (n = 79) groups for analysis.

Figure 2.

Muscle thickness and cross-sectional area of the extremity muscles. (A) Muscle thickness of biceps brachii (BB) and brachialis, cross-sectional area of BB; (B) Muscle thickness of radial anterior (RA) muscle and ulnar anterior (UA) muscle; (C) Muscle thickness and cross-sectional area of rectus femoris (RF), muscle thickness of vastus intermedius (VI); (D) Muscle thickness of tibialis posterior (TP) and fibula posterior (FP).
Muscle thickness and cross-sectional area of the extremity muscles. (A) Muscle thickness of biceps brachii (BB) and brachialis, cross-sectional area of BB; (B) Muscle thickness of radial anterior (RA) muscle and ulnar anterior (UA) muscle; (C) Muscle thickness and cross-sectional area of rectus femoris (RF), muscle thickness of vastus intermedius (VI); (D) Muscle thickness of tibialis posterior (TP) and fibula posterior (FP).

Figure 3.

ROC analysis for the prediction of sarcopenia from extremity muscle thickness and cross-sectional area. (A) The predictive value of extremity muscle thickness. (B) The predictive value of extremity muscle cross-sectional area. BB = biceps brachii; CSA = cross-sectional area; MT = muscle thickness; PP = psoas posterior; RA = radial anterior; RF = rectus femoris; QF = quadriceps femoris; TP = tibialis posterior; UA = ulnar anterior; VI = vastus intermedius
ROC analysis for the prediction of sarcopenia from extremity muscle thickness and cross-sectional area. (A) The predictive value of extremity muscle thickness. (B) The predictive value of extremity muscle cross-sectional area. BB = biceps brachii; CSA = cross-sectional area; MT = muscle thickness; PP = psoas posterior; RA = radial anterior; RF = rectus femoris; QF = quadriceps femoris; TP = tibialis posterior; UA = ulnar anterior; VI = vastus intermedius

Patient clinical characteristics at diagnosis and comparison between patients with or without sarcopenia

Total (n = 167) Sarcopenia (n = 88) No sarcopenia (n = 79) P value
Age (years) 60 ± 14.15 63 ± 14.70 56 ± 12.65 0.002
Gender, n (%) < 0.001
Males 98 (59) 40 (46) 58 (73)
Females 69 (41) 48 (54) 21 (27)
Height (cm) 166.63 ± 8.55 164.69 ± 8.42 168.78 ± 8.23 0.002
Weight (kg) 66.24 ± 11.76 61.33 ± 10.61 71.71 ± 10.54 < 0.001
BMI (kg/m2) 23.79 ± 3.17 22.60 ± 3.08 25.12 ± 2.74 < 0.001
CC (cm) 33.50 ± 3.25 32.00 ± 2.69 35.18 ± 3.00 < 0.001
Handgrip strength (kg) 23.19 ± 10.00 18.50 ± 7.51 28.41 ± 9.88 < 0.001
Gait speed (m/s) 1.02 ± 0.29 0.92 ± 0.24 1.14 ± 0.29 < 0.001
SMA (cm2) 116.71 ± 27.89 98.86 ± 18.26 136.59 ± 22.89 < 0.001
SMI (cm2/m2) 41.63 ± 7.57 36.21 ± 4.73 47.67 ± 5.17 < 0.001
Upper arm SFT (cm) 0.30 ± 0.16 0.29 ± 0.14 0.32 ± 0.18 0.23
BB and brachialis MT (cm) 2.29 ± 0.46 2.02 ± 0.38 2.59 ± 0.34 < 0.001
BB CSA (cm2) 8.24 ± 2.68 6.67 ± 2.11 9.99 ± 2.10 < 0.001
Forearm SFT (cm) 0.36 ± 0.15 0.35 ± 0.17 0.37 ± 0.14 0.498
UA MT (cm) 3.55 ± 0.49 3.34 ± 0.46 3.79 ± 0.41 < 0.001
RA MT (cm) 1.63 ± 0.36 1.48 ± 0.32 1.79 ± 0.33 < 0.001
Thigh SFT (cm) 0.78 ± 0.36 0.78 ± 0.37 0.78 ± 0.35 0.989
RF MT (cm) 1.54 ± 0.33 1.36 ± 0.30 1.74 ± 0.23 < 0.001
VI MT (cm) 1.45 ± 0.41 1.22 ± 0.34 1.71 ± 0.33 < 0.001
QF MT (cm) 2.99 ± 0.70 2.58 ± 0.59 3.45 ± 0.51 < 0.001
RF CSA (cm2) 7.12 ± 1.93 6.01 ± 1.56 8.36 ± 1.51 < 0.001
Lower leg SFT (cm) 0.45 ± 0.19 0.45 ± 0.17 0.45 ± 0.21 0.844
TP MT (cm) 4.87 ± 0.74 4.49 ± 0.62 5.28 ± 0.63 < 0.001
FP MT (cm) 2.39 ± 0.71 2.10 ± 0.61 2.72 ± 0.67 < 0.001

ROC analysis results for the prediction of sarcopenia from ultrasonographically measured muscle thickness and cross-sectional area

AUC(95%CI) Cut-off Specificity Sensitivity Accuracy
BB and brachialis MT (cm) 86.87% (81.28% ~ 92.47%) 2.22 0.77 0.90 0.83
BB CSA(cm2) 86.82% (81.41% ~ 92.23%) 7.46 0.69 0.92 0.80
UA MT(cm) 77.13% (70.04% ~ 84.22%) 3.55 0.73 0.72 0.72
RA MT(cm) 77.44% (70.14% ~ 84.73%) 1.56 0.69 0.78 0.74
RF MT(cm) 85.34% (79.56% ~ 91.12%) 1.58 0.78 0.81 0.80
VI MT(cm) 84.07% (78.24% ~ 89.9%) 1.38 0.67 0.89 0.77
QF MT(cm) 87.46% (82.17% ~ 92.75%) 2.92 0.74 0.87 0.80
RF CSA(cm2) 87.59% (82.16% ~ 93.02%) 7.08 0.83 0.86 0.84
TP MT(cm) 81.77% (75.42% ~ 88.12%) 4.90 0.80 0.72 0.76
FP MT(cm) 75.75% (68.44% ~ 83.06%) 2.20 0.68 0.73 0.71

Odds ratios and 95% confidence intervals for the prediction of sarcopenia from ultrasound parameters

Non-adjusted Model I Model II
OR (95% CI) P value OR (95% CI) P value OR (95% CI) P value
BB and brachialis MT 28.32 (11.74~68.27) < 0.001 107.93 (12.01–970.38) < 0.001 126.27 (12.06–1321.54) < 0.001
BB CSA 26.07 (10.13–67.11) < 0.001 20.56 (5.85–72.29) < 0.001 16.55 (4.5–60.85) < 0.001
UA MT 6.91 (3.5–13.63) < 0.001 3.42 (1.42–8.22) 0.006 2.7 (1.04–6.99) 0.041
RA MT 7.42 (3.7–14.89) < 0.001 3.74 (1.65–8.46) 0.002 3.17 (1.35–7.45) 0.008
RF MT 15.49 (7.26–33.05) < 0.001 8.19 (3.55–18.93) < 0.001 6.28 (2.64–14.98) < 0.001
VI MT 13.61 (6–30.87) < 0.001 10.68 (4.13–27.58) < 0.001 9.52 (3.47–26.12) < 0.001
QF MT 19.5 (8.62–44.1) < 0.001 13.04 (5.25–32.38) < 0.001 11.08 (4.23–29.04) < 0.001
RF CSA 30.08 (12.92–70.05) < 0.001 15.06 (6.03–37.6) < 0.001 13.26 (5.11–34.43) < 0.001
TP MT 9.41 (4.64–19.08) < 0.001 4.58 (2–10.45) < 0.001 3.65 (1.53–8.73) 0.004
PP MT 5.62 (2.88–10.96) < 0.001 3.72 (1.66–8.34) 0.001 2.85 (1.23–6.6) 0.014
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