Comparabilidade da medida de circunferência da panturrilha em pacientes hospitalizados por meio de medidas repetidas em diferentes posições

Abstract

Calf circumference (CC) is an anthropometric measure recognized as a muscle mass marker. However, discrepancies exist in the literature regarding the individual`s position (orthostatic, sitting, or supine) during measurement. This study aimed to evaluate agreement among CC measurements in different positions and suggest adjustments if we observed variations. This cross-sectional study was conducted with hospitalized patients (≥ 18 years). CC was measured at the largest circumference of the right calf in orthostatic (standing) (CCort), sitting (CCsit), and supine (CCsup) positions. The repeated-measures Analysis of Variance (RM-ANOVA) and the Tukey Honestly Significant Difference post hoc tests were applied. Bland–Altman plots and linear regression adjusted for sex, body mass index, and age were also used, with CCort as the dependent variable and the other positions as independent variables. A total of 193 patients were evaluated with a mean age of 57.7 ± 15.0 years (52.8% females). CCsit (34.4 ± 4.8 cm) had the highest mean values, with statistically significant differences from CCort (+0.39 cm; p < 0.05) and CCsup (+0.33 cm; p < 0.05). CCsit was higher than CCort in both sexes, while CCsup was higher only in females. As the cutoff values for our population were obtained from CCort (≤ 33.3 cm and ≤ 34.3 cm, for females and males, respectively), linear regressions generated equivalent CC values when the measurements were obtained from other positions. For CCsit, the equivalent cutoffs would be ≤ 33.3 cm and ≤ 34.3 cm for females and males, respectively. For CCsup, the corresponding cutoffs would be ≤33.2 cm and ≤ 34.0 cm for females and males, respectively. The CC measurement taken at standing, sitting, and supine position are not interchangeable, and significant higher values were obtained in the sitting position. These results suggest that equivalent cutoff values should be used when CC is measured in different position from the one the cutoff was originally established.