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April 15, 2026Scientific Reports0 citationsOpen Access

Identification of ultrasound predictors and development of a diagnostic scoring system for sarcopenia using LASSO regression: a cross-sectional study

BLByung Chan LeeJLJuhyun LeeKCKang Hee Cho

Key Points

  • To evaluate the diagnostic value of ultrasound-derived muscle parameters and develop a scoring system for sarcopenia.
  • Cross-sectional design involving 145 community-dwelling women aged 65–80 years.
  • Assessment of eight ultrasound-derived quadriceps muscle parameters.
  • Correlation analysis between ultrasound parameters, handgrip strength, and skeletal muscle mass.
  • Application of LASSO regression to identify key predictors for sarcopenia.
  • Development of a scoring system based on identified parameter cutoff values.
  • Sarcopenia diagnosed in 5.5% of participants.
  • Significant weak-to-moderate correlations between most ultrasound parameters and handgrip strength.
  • LASSO regression identified quadriceps femoris thickness, vastus lateralis thickness, and rectus femoris cross-sectional area as top predictors.
  • Proposed scoring system with a cutoff score of ≥ 3 showed high diagnostic performance (AUC 0.914, sensitivity 0.875, specificity 0.861).

Abstract

Ultrasound-based muscle assessment has emerged as a practical and noninvasive tool for evaluating sarcopenia; however, the relative diagnostic value of individual ultrasound-derived muscle parameters and their integration into a simple scoring system remain unclear. This cross-sectional study included 145 community-dwelling women aged 65–80 years. Eight ultrasound-derived quadriceps muscle parameters were evaluated: rectus femoris thickness, cross-sectional area, and echo intensity; vastus intermedius thickness; vastus lateralis thickness, fascicle length, and pennation angle; and quadriceps femoris thickness, defined as the combined thickness of the rectus femoris and vastus intermedius. Sarcopenia was diagnosed in 8 participants (5.5%). Most ultrasound parameters demonstrated significant weak-to-moderate correlations with handgrip strength and skeletal muscle mass index. Least absolute shrinkage and selection operator regression identified quadriceps femoris thickness, vastus lateralis thickness, and rectus femoris cross-sectional area as the most informative predictors. Based on these variables, a simple preliminary ultrasound-based scoring system was developed using parameter-specific cutoff values. A cutoff score of ≥ 3 demonstrated high diagnostic performance, with an area under the receiver operating characteristic curve of 0.914, sensitivity of 0.875, and specificity of 0.861. This exploratory ultrasound-based scoring system may suggest a feasible approach for sarcopenia screening in older women, although further validation in larger populations is warranted.

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Cite This Study

Lee et al. (2026) studied this question.

synapsesocial.com/papers/69df2bece4eeef8a2a6b0cf7https://doi.org/10.1038/s41598-026-47400-1
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