Diagnostic ultrasound estimates of muscle mass and muscle quality discriminate between women with and without sarcopenia

Abstract

Introduction: Age-related changes in muscle mass and muscle tissue composition contribute to diminished strength in older adults. The objectives of this study are to examine if an assessment method using mobile diagnostic ultrasound augments well-known determinants of lean body mass (LBM) to aid sarcopenia staging, and if a sonographic measure of muscle quality is associated with muscle performance.Methods: Twenty community-dwelling female subjects participated in the study (age = 43.4 ± 20.9 years; BMI: 23.8, interquartile range: 8.5). Dual energy X-ray absorptiometry (DXA) and diagnostic ultrasound morphometry were used to estimate LBM. Muscle tissue quality was estimated via the echogenicity using grayscale histogram analysis. Peak force was measured with grip dynamometry and scaled for body size. Bivariate and multiple regression analyses were used to determine the association of the predictor variables with appendicular lean mass (aLM/ht2), and examine the relationship between scaled peak force values and muscle echogenicity. The sarcopenia LBM cut point value of 6.75 kg/m2 determined participant assignment into the Normal LBM and Low LBM subgroups.Results: The selected LBM predictor variables were body mass index (BMI), ultrasound morphometry, and age. Although BMI exhibited a significant positive relationship with aLM/ht2 (adj. R2 = 0.61, p < 0.001), the strength of association improved with the addition of ultrasound morphometry and age as predictor variables (adj. R2 = 0.85, p < 0.001). Scaled peak force was associated with age and echogenicity (adj. R2 = 0.53, p < 0.001), but not LBM. The Low LBM subgroup of women (n = 10) had higher scaled peak force, lower BMI, and lower echogenicity values in comparison to the Normal LBM subgroup (n = 10; p < 0.05).Conclusions: Diagnostic ultrasound morphometry values are associated with LBM, and improve the BMI predictive model for aLM/ht2 in women. In addition, ultrasound proxy measures of muscle quality are more strongly associated with strength than muscle mass within the study sample.

Pediatric Sarcopenia: A Paradigm in the Overall Definition of Malnutrition in Children?

“…It is easy to carry out in infants and toddlers; however, the high cost and labor intensity for analyses are the disadvantages. Although total body potassium is a simple method to accurately evaluate muscle mass through body cell mass measurement, this technique requires specialized and costly equipment and human resource support, which may not be routinely available in acute care settings . Emerging evidence in adults suggests ultrasound might be used as a practical bedside approach to quadriceps muscle thickness, which potentially may be a good surrogate of overall SMM .…”

“…[40][41][42][43] Emerging evidence in adults suggests ultrasound might be used as a practical bedside approach to quadriceps muscle thickness, which potentially may be a good surrogate of overall SMM. 41 However, in children, this methodology has not been well validated as a measure of overall SMM and warrants further investigation. 42 The selection of body composition techniques to determine sarcopenia prevalence should be based on careful considerations of the targeted clinical group, feasibility, accuracy, and limitations of each method.…”

Quantitative Sonographic Assessment of the Quadriceps Femoris Muscle in Healthy Japanese Adults

“…Measures of muscle echogenicity have been shown to be significantly associated with intramuscular adipose tissue, rather than fibrotic tissue, based on the biochemical analysis of biopsied tissue samples from 82 people with muscle disorders . Recently, several investigators have used computer‐aided echo intensity analysis (histogram analysis) to evaluate the quality of skeletal muscle . We have also reported a positive correlation between sonography and magnetic resonance imaging in the assessment of supraspinatus muscle fatty infiltration .…”

“…5 Recently, several investigators have used computer-aided echo intensity analysis (histogram analysis) to evaluate the quality of skeletal muscle. [6][7][8][9][10] We have also reported a positive correlation between sonography and magnetic resonance imaging in the assessment of supraspinatus muscle fatty infiltration. 11 Watanabe et al 12 reported that muscle thickness and muscle quality assessed from echo intensity measured by sonography independently contributed to isometric knee extension strength in elderly men (65-91 years).…”

Clinical Assessment of Fatigability in Multiple Sclerosis: A Shift from Perception to Performance

“…Importantly, diminished muscle cross-sectional area and greater levels of intramuscular adipose tissue are associated with poor performance with repeated or sustained functional tasks (34). While methods to characterize skeletal muscle are often invasive or difficult to implement in rehabilitation settings (32, 35), alternative approaches involving ultrasound have shown that proxy measures of muscle tissue composition are also associated with impaired performance (36, 37). Further study regarding muscle morphology using clinically viable methods may advance our understanding of the state variables of fatigability in MS.…”