Turkish Calf Circumference Cut-offs Derived from Normative Values of Young Reference Population

Objective: Calf circumference (CC) is used as a simple and practical anthropometric measure for evaluating skeletal muscle mass (SMM). CC cutoffs to indicate the presence of low SMM were determined through calculation of CC values that predicted low SMM with receiver operating characteristic analyses. Also, to date CC cut-off points were obtained from older adults. Very recently, the determination of CC cut-off values derived from normative values of young reference population with normal body mass index [using one and two standard deviations (SDs) below the mean] has been suggested as an alternative CC cut-off designation method. Here, we aimed to determine the sex-specific Turkish CC cut-offs by this new CC cut-off designation method. Materials and Methods: We included healthy young participants aged between 18 and 39, with body mass index between 18.5 kg/[m.sup.2]-24.9 kg/ [m.sup.2] who were free from any chronic disease or drug use. CC was measured at the widest circumference of the calf with a non-elastic tape on the non-dominant leg while the subjects were standing and CC cut-off points were calculated as one and two SDs below the mean for moderately low or severely low CC values, respectively in each sex. Results: There were 164 participants (mean age, 25.7 [+ or -] 4.4 years; 50% male, 50% female). Mean CC was 35.5 [+ or -] 2.1 cm and 34.2 [+ or -] 2.1 cm in males and females, respectively. The rounded cut-off values for moderately and severely low CC were calculated as 33 cm in males and 32 cm in females and 31 cm in males 30 cm in females, respectively. Conclusion: This study reported CC cut-offs derived from normative values of the Turkish young reference population which can be used as a marker for the muscle mass assessment. The success of these cut-offs in prediction of SMM adequacy should be assessed in further studies. Keywords: Calf circumference, cut-off, Turkish, normative, young reference, body mass index