Nutrition · Sep 19, 2025
Sex-specific ultrasound thresholds of rectus femoris assessment in disease-related malnutrition: A cross-sectional analysis
By Vidal-Casariego A, Cadahía-Lema S, Palacios-Paíno N et al.
OBJECTIVES: Disease-related malnutrition (DRM) frequently results in loss of muscle mass and function, increasing morbidity and mortality risk. Nutritional ultrasound is a promising, noninvasive tool for assessing muscle composition; however, sex-specific cut-off values for diagnosing myopenia remain unclear. BACKGROUND: In this retrospective cross-sectional study, we evaluated adult DRM patients using the GLIM criteria. Rectus femoris (RF) ultrasound measurements (thickness, width, cross-sectional area [CSA]) and bioelectrical impedance analysis (BIA) were obtained. Muscle function was assessed via handgrip strength. Receiver operating characteristic (ROC) curves identified sex-specific ultrasound thresholds for myopenia. RESULTS: Eighty-four patients (mean age: 65.6 years; 57.1% male) were analyzed. Myopenia was present in 53.6% based on low ASMI. Optimal RF thresholds for males were 11.45 mm (thickness), 36.95 mm (width), and 2.92 cm² (CSA); for females, 9.40 mm, 34.55 mm, and 2.30 cm², respectively. Reduced RF values were significantly associated with lower phase angle, body cell mass, and handgrip strength. CONCLUSIONS: This study proposes novel, sex-specific ultrasound thresholds for rectus femoris assessment in DRM patients. Findings support ultrasound's role as a noninvasive, accessible method for diagnosing myopenia within a morphofunctional evaluation framework.