Cut-offs for calf circumference as a screening tool for low muscle mass: WASEDA'S Health Study

Ryoko Kawakami*, Motohiko Miyachi, Susumu S. Sawada, Suguru Torii, Taishi Midorikawa, Kumpei Tanisawa, Tomoko Ito, Chiyoko Usui, Kaori Ishii, Katsuhiko Suzuki, Shizuo Sakamoto, Mitsuru Higuchi, Isao Muraoka, Koichiro Oka

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

23 Citations (Scopus)


Aim: To re-evaluate the suitability of calf circumference as a surrogate marker of low muscle mass measured by both bioelectrical impedance analysis (BIA) and dual-energy X-ray absorptiometry (DXA). We also examined the effects of obesity and age on low muscle mass screening using calf circumference. Methods: In total, 1239 adults participated in this cross-sectional study. We measured the maximum calf circumference in a standing position and appendicular skeletal muscle mass (ASM) using BIA and DXA. We defined low muscle mass based on the Asian Working Group for Sarcopenia 2019 consensus. Results: Calf circumference was positively correlated with BIA-measured ASM/height2 (men: r = 0.81, women: r = 0.73) and DXA-measured ASM/height2 (men: r = 0.78, women: r = 0.76). In the subgroup analyses by obesity and age, calf circumference was also positively correlated with ASM/height2. The optimal calf circumference cut-offs for low muscle mass screening measured by BIA and DXA were 35 cm (sensitivity 91%, specificity 84%) and 36 cm (sensitivity 82%, specificity 80%) for men, and 33 cm (sensitivity 82%, specificity 84%) and 34 cm (sensitivity 85%, specificity 72%) for women, respectively. Conclusions: Calf circumference is positively correlated with BIA- and DXA-measured muscle mass regardless of obesity and age and is a simple and accurate surrogate marker of muscle mass for diagnosing sarcopenia. Geriatr Gerontol Int 2020; 20: 943–950.

Original languageEnglish
Pages (from-to)943-950
Number of pages8
JournalGeriatrics and Gerontology International
Issue number10
Publication statusPublished - 2020 Oct 1


  • anthropometry
  • bioelectrical impedance
  • body composition
  • dual-energy X-ray absorptiometry scan
  • sarcopenia

ASJC Scopus subject areas

  • Health(social science)
  • Gerontology
  • Geriatrics and Gerontology


Dive into the research topics of 'Cut-offs for calf circumference as a screening tool for low muscle mass: WASEDA'S Health Study'. Together they form a unique fingerprint.

Cite this