{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T20:42:25Z","timestamp":1790455345596,"version":"4.1.0"},"reference-count":13,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T00:00:00Z","timestamp":1747180800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["aspenjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nut in Clin Prac"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Although calf circumference (CC) may be used to distinguish body composition, methods applying adjustment coefficients based on body mass index (BMI) and edema have been reported. This study evaluated whether malnutrition assessed using BMI\u2010 and edema\u2010adjusted CC predicts mortality in hospitalized adult patients compared with unadjusted CC across cutoff values.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort study used the medical records of patients aged \u226518 years hospitalized between December 2017 and March 2022 and at risk for nutrition disorders through nutrition screening. Low muscle mass was defined using CC cutoff values of 34\u201330\u2009cm for men and 33\u201329\u2009cm for women.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The data of 11,606 patients were analyzed. The mean age was 71.2\u2009\u00b1\u200916.3 years, and 5949 patients (51.3%) were women. No significant difference was observed compared with the unadjusted state, regardless of sex, cutoff value, or adjustment method (male: unadjusted hazard ratio [HR]: 2.13 to 2.30 vs adjusted HR: 2.11 to 2.36; memale: unadjusted HR 1.75: to 2.59 vs adjusted HR: 1.75 to 3.00). Furthermore, even when edema was adjusted, no significant difference was observed in the HR for mortality compared with the unadjusted state, regardless of sex, cutoff value, or adjustment method (male: unadjusted HR: 2.13 to 2.30 vs adjusted HR: 2.23 to 2.52; female: unadjusted HR: 1.75 to 2.59 vs adjusted HR: 2.02 to 3.57).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>When assessing low muscle mass using lower CC, we found that adjusting for BMI and edema did not result in a significant mortality difference compared with unadjusted actual measurements.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ncp.11316","type":"journal-article","created":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T06:49:21Z","timestamp":1747205361000},"page":"187-197","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Assessing mortality and malnutrition using calf circumference adjusted for body mass index and edema as muscle mass reduction indicators within the Global Leadership Initiative on Malnutrition criteria: A retrospective study"],"prefix":"10.1002","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3684-3240","authenticated-orcid":false,"given":"Yuria","family":"Ishida","sequence":"first","affiliation":[{"name":"Department of Nutrition Aichi Medical University Hospital Nagakute Japan"},{"name":"Department of Palliative and Supportive Medicine, Graduate School of Medicine Aichi Medical University Nagakute Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7132-7818","authenticated-orcid":false,"given":"Keisuke","family":"Maeda","sequence":"additional","affiliation":[{"name":"Department of Nutrition Aichi Medical University Hospital Nagakute Japan"},{"name":"Department of Palliative and Supportive Medicine, Graduate School of Medicine Aichi Medical University Nagakute Japan"},{"name":"Nutrition Therapy Support Center Aichi Medical University Hospital Nagakute Japan"},{"name":"Department of Geriatric Medicine Hospital, National Center for Geriatrics and Gerontology Obu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akio","family":"Shimizu","sequence":"additional","affiliation":[{"name":"Department of Palliative and Supportive Medicine, Graduate School of Medicine Aichi Medical University Nagakute Japan"},{"name":"Department of Rehabilitation Medicine Mie University Graduate School of Medicine Tsu 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