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PURPOSE: The Achilles tendon (AT) is the largest and strongest tendon in the human body, and its elasticity is known to be affected by the aging process. However, the relation between AT stiffness and frailty in older individuals remains uncertain. This study aims to explore the potential of Achilles tendon shear wave elastography (AT-SWE) as a tool for assessing physical frailty in older adults. METHODS: A total of 148 patients aged 65 years and over were included in this cross-sectional study. Patients with heart failure, AT injury, stroke history, active malignancy, and claudication were excluded. All patients underwent a comprehensive geriatric assessment. Physical frailty assessment was performed with the fried frailty phenotype. Achilles tendon elastography was measured by ultrasound. RESULTS: The mean age of the participants was 73.8 years and 62.2% were female. 30.4% of the participants were defined as frail. Achilles tendon shear wave elastography measurements were statistically lower in the frail group (p < 0.05). In the multivariate regression analysis, AT-SWE demonstrated a statistically significant association with frailty independent of confounding factors (OR 0.982, 95% CI 0.965-0.999, p value = 0.038). In the ROC curve analysis, the area under the curve for AT-SWE was 0.647 (95% CI, 0.564-0.724, p < 0.01) and the optimum cut-off point was 124.1 kilopascals. CONCLUSION: These findings highlight the value of AT-SWE as a non-invasive and objective tool for predicting frailty in older adults.
RESUMEN
PURPOSE: To evaluate the efficacy of attenuation measurement function (ATT), a newly developed quantitative ultrasonography(US) method based on measurement of the attenuation coefficient, using unenhanced computerized tomography(CT) attenuation values as a reference standard, for the detection and measurement of hepatosteatosis. MATERIAL AND METHODS: A total of 98 patients were analyzed. The diagnostic ability of ATT was evaluated using receiver operating characteristic (ROC) curve analysis, and the correlation between liver attenuation index (LAI), the liver-to-spleen attenuation ratio (CTL/S), liver attenuation value (CTL), and ATT was determined. RESULTS: ATT is negatively correlated with LAI (r = -0.571, p < 0.001), CTL/S (r = -0.532, p < 0.001), and mean CTL (r = -0.50, p < 0.001). A significant difference was found between ATT values of patients with different grades of hepatosteatosis (p < 0.001). A significant difference was found between ATT values of patients with LAI < -10 and LAI > -10, CTL < 40 and CTL > 40, and CTL/S < 1 and CTL/S > 1 (p < 0.001). An ATT ≥ 0.665 showed a sensitivity of 100% and a specificity of 90% in diagnosing moderate-severe steatosis. The corresponding area under the ROC curve(AUROC) was 0.935. The intraclass correlation coefficient for the interobserver variability of ATT was 0.907 (95% CI, 0.85-0.95). CONCLUSION: In conclusion, ATT values for evaluation of hepatosteatosis was closely correlated with the degree of hepatosteatosis and liver fat content. It can be used as a noninvasive method in the diagnosis and follow-up.