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Background: Sarcopenic obesity (SO) is the coexistence of sarcopenia and obesity in an individual. The present study is designed to define the usefulness of skeletal muscle ultrasonography (US) in the definition of SO. Methods: Eighty-nine participants aged ≥65 whose body mass index (BMI, kg/m 2) was ≥30 were consecutively enrolled in an outpatient clinic of geriatric medicine. All underwent comprehensive geriatric assessment. US measurements were obtained in 6 different muscles consisting of core and limb muscles. We defined SO as the presence of low muscle function (defined by a handgrip strength < 27 kg in males and <16 kg in females) and high BMI (≥30). Results: The median age of the participants was 72 (65-85) years; 81% were female, and 35% (n = 31) had SO. Anthropometric parameters that estimate muscle mass were lower in the sarcopenic group, but estimations of muscle mass with bioelectrical impedance analysis (BIA) did not differ between groups. All US estimations of muscle mass were lower in sarcopenic obese participants, albeit not all significantly. RF muscle cross-sectional area (RF CSA) and abdominal subcutaneous fat thickness were most strongly correlated with grip strength (r = 0.477 and r = −508, respectively). Receiver operating characteristic analysis suggested that the optimum cutoff point of RF CSA for SO was ≤5.22 cm 2 , with 95.8% sensitivity and 46.7% specificity (area under the curve: 0.686). Conclusions: US evaluation of muscle mass may be more accurate than BIA-derived skeletal muscle index assessment for the diagnosis of SO.

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Background Diagnostic accuracy of fine‐needle aspiration cytology (FNAC) in large and subcentimeter nodules is still debated. We aimed to evaluate the impact of nodule size on efficacy of the ultrasound‐guided FNAC. Methods B‐mode grayscale ultrasound (US), US‐guided FNAC according to Bethesda system and histopathological data of 514 nodules from 371 patients, who underwent thyroidectomy were examined retrospectively. Nodules were grouped by maximal diameter; group A nodules were smaller than 10 mm (n = 59), group B nodules were between 10 and 29 mm (n = 218), and group C nodules were 30 mm or greater (n = 130). Results Sensitivity, specificity, and accuracy of FNAC was 92.0%, 100%, and 95.1% in group A, 80.7%, 99.1%, and %92.9 in group B, 70.0%, 98.9%, and 95.8% in group C nodules, respectively. The prevalence of papillary thyroid cancer (PTC) and incidental PTC were 44.2% (n = 164) and 6.4% (n = 24), respectively. Malignancy rate was more frequent in group A when compared to groups B and C (P < 0.01). Nodule size was positively associated with follicular cancer risk (P = 0.009). The thyroid stimulating hormone level was positively associated with malignancy (P = 0.02) and optimal cut‐off value was 0.96 mIU/L. False‐negative rate was 8.0%, 19.3%, and 30.0% in groups A, B, and C nodules, respectively. Conclusions Although the malignancy rate was low in nodules ≥30 mm, diagnostic surgery for large nodules should be considered because of decreased reliability of FNAC, ineffectiveness of clinical and sonographic criteria. False‐negative rate was relatively low and malignancy rate was high in subcentimeter nodules, supporting the accuracy of FNAC.