Muscle Area and Density Assessed by Abdominal Computed Tomography in Healthy Adults: Effect of Normal Aging and Derivation of Reference Values

Marco, Davide De; Mamane, Samuel; Choo, W.; Mullie, Louis; Xue, Xin; Afilalo, Marc; Afilalo, Jonathan

doi:10.1007/s12603-022-1746-3

Cited by 8 publications

(4 citation statements)

References 31 publications

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“…The mean ± SD PMAs were 18.55 ± 3.45 cm 2 in men and 13.52 ± 2.80 in women (p = 0.0001), and the cutoff values for sarcopenia, calculated as mean − 2 SDs were 11.64 for men and 7.92 for women. 14 The PMAs observed in the present study were slightly higher than those observed in patients from Turkey, 15 but significantly lower than those observed in patients from France 16 and Canada 17 ( Table 12 ), differences that may be associated with race, age, comorbidities, BMI, or method of determining cutoff value. Muscle mass generally increases with BMI, 18 but BMI was not evaluated in the Canadian study.…”

Section: Discussioncontrasting

confidence: 67%

Cutoff Value of Psoas Muscle Area as Reduced Muscle Mass and Its Association with Acute Pancreatitis in China

Fu¹,

Li²,

Xing³

et al. 2023

IJGM

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Objective The Global Leadership Initiative on Malnutrition (GLIM) has proposed criteria for the diagnosis of malnutrition, one of which is reduced muscle mass. Computed tomography (CT) assessment of psoas muscle area (PMA) has been used to estimate muscle mass in patients, including those with acute pancreatitis (AP). The present study aimed to define the cutoff value of PMA indicative of reduced muscle mass in patients with AP and to assess the impact of reduced muscle mass on the severity and early complications of AP. Methods Clinical data of 269 patients with AP were analyzed retrospectively. The severity of AP was determined according to the revised Atlanta classification. PMA was evaluated by CT and used to calculate the psoas muscle index (PMI). Cutoff values for reduced muscle mass were calculated and validated. Logistic regression analysis was performed to assess the relationship between PMA and the severity of AP. Results PMA was a better indicator of reduced muscle mass than PMI, with cutoff values of 11.50 cm 2 for men and 8.22 cm 2 for women. Rates of local complications, splenic vein thrombosis, and organ failure were significantly higher in AP patients with low than high PMA (all p < 0.05). PMA showed good ability to predict splenic vein thrombosis in women, with an area under the receiver operating characteristic curve of 0.848 (95% confidence interval 0.768–0.909, sensitivity 100%, specificity 83.64%). Multivariate logistic regression revealed that PMA was an independent risk factor for moderately severe plus severe AP (odds ratio 5.639, p = 0.001) and severe AP (odds ratio 3.995, p = 0.038). Conclusion PMA is a good predictor of the severity and complications of AP. The PMA cutoff value is a good indicator of reduced muscle mass.

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Section: Discussioncontrasting

confidence: 67%

Cutoff Value of Psoas Muscle Area as Reduced Muscle Mass and Its Association with Acute Pancreatitis in China

Fu¹,

Li²,

Xing³

et al. 2023

IJGM

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“…Muscle mass was represented by the cross-sectional psoas muscle area (PMA) on axial CT images acquired before TAVR. The L4 vertebral level was chosen for PMA measurements given the extensive prognostic data and published normative reference values at this level, with low PMA defined as less than 22 cm 2 for men and less than 12 cm 2 for women . This level was specified as the axial image immediately below the anterior-superior aspect of the bright vertebral end plate of L4, corroborated by a multiplanar reconstruction of the sagittal view.…”

Section: Methodsmentioning

confidence: 99%

“…The L4 vertebral level was chosen for PMA measurements given the extensive prognostic data and published normative reference values at this level, with low PMA defined as less than 22 cm 2 for men and less than 12 cm 2 for women. 13 This level was specified as the axial image immediately below the anterior-superior aspect of the bright vertebral end plate of L4, corroborated by a multiplanar reconstruction of the sagittal view. Using CoreSlicer version 1 web-based software (CoreSlicer.com), 14 2 trained observers segmented the left and right psoas muscles with a smart paintbrush tool that had a programmed threshold range of 30 to 150 HU (Figure 1) designed to isolate muscle-density tissue.…”

Section: Muscle Assessmentmentioning

confidence: 99%

Osteosarcopenia and Mortality in Older Adults Undergoing Transcatheter Aortic Valve Replacement

Solla-Suarez,

Arif,

Ahmad

et al. 2024

JAMA Cardiol

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ImportanceOsteosarcopenia is an emerging geriatric syndrome characterized by age-related deterioration in muscle and bone. Despite the established relevance of frailty and sarcopenia among older adults undergoing transcatheter aortic valve replacement (TAVR), osteosarcopenia has yet to be investigated in this setting.ObjectiveTo determine the association between osteosarcopenia and adverse outcomes following TAVR.Design, Setting, and ParticipantsThis is a post hoc analysis of the Frailty in Aortic Valve Replacement (FRAILTY-AVR) prospective multicenter cohort study and McGill extension that enrolled patients aged 70 years or older undergoing TAVR from 2012 through 2022. FRAILTY-AVR was conducted at 14 centers in Canada, the United States, and France between 2012 and 2016, and patients at the McGill University–affiliated center in Montreal, Québec, Canada, were enrolled on an ongoing basis up to 2022.ExposureOsteosarcopenia as measured on computed tomography (CT) scans prior to TAVR.Main Outcomes and MeasuresClinically indicated CT scans acquired prior to TAVR were analyzed to quantify psoas muscle area (PMA) and vertebral bone density (VBD). Osteosarcopenia was defined as a combination of low PMA and low VBD according to published cutoffs. The primary outcome was 1-year all-cause mortality. Secondary outcomes were 30-day mortality, hospital length of stay, disposition, and worsening disability. Multivariable logistic regression was used to adjust for potential confounders.ResultsOf the 605 patients (271 [45%] female) in this study, 437 (72%) were octogenarian; the mean (SD) age was 82.6 (6.2) years. Mean (SD) PMA was 22.1 (4.5) cm2 in men and 15.4 (3.5) cm2 in women. Mean (SD) VBD was 104.8 (35.5) Hounsfield units (HU) in men and 98.8 (34.1) HU in women. Ninety-one patients (15%) met the criteria for osteosarcopenia and had higher rates of frailty, fractures, and malnutrition at baseline. One-year mortality was highest in patients with osteosarcopenia (29 patients [32%]) followed by those with low PMA alone (18 patients [14%]), low VBD alone (16 patients [11%]), and normal bone and muscle status (21 patients [9%]) (P &lt; .001). Osteosarcopenia, but not low VBD or PMA alone, was independently associated with 1-year mortality (odds ratio [OR], 3.18; 95% CI, 1.54-6.57) and 1-year worsening disability (OR, 2.11; 95% CI, 1.19-3.74). The association persisted in sensitivity analyses adjusting for the Essential Frailty Toolset, Clinical Frailty Scale, and geriatric conditions such as malnutrition and disability.Conclusions and RelevanceThe findings suggest that osteosarcopenia detected using clinical CT scans could be used to identify frail patients with a 3-fold increase in 1-year mortality following TAVR. This opportunistic method for osteosarcopenia assessment could be used to improve risk prediction, support decision-making, and trigger rehabilitation interventions in older adults.

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“… 2 In this regard, abdominal muscle radiodensity, measured in Hounsfield Units (HU), reflects the quality of muscle tissue and the degree of fat infiltration/fibrosis. 3 Of note, growing evidence suggests that abdominal muscle radiodensity is inversely associated with cardiovascular events and mortality in men. 2 …”

Section: Introductionmentioning

confidence: 99%

Sex Hormones and Abdominal Muscle Area and Radiodensity in Men: The Multi-Ethnic Study of Atherosclerosis

Osmancevic,

Allison,

Miljkovic

et al. 2024

Preprint

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Information on the associations of testosterone levels with abdominal muscle volume and quality in men is limited, while the role of estradiol and SHBG on these muscle characteristics are unclear. To investigate the association between fasting serum sex hormones and CT-derived abdominal muscle area and radiodensity in adult men. Cross sectional observational study using data from the Multi-Ethnic Study of Atherosclerosis. A community-based sample of 907 men aged 45–84 years; 878 men with complete data were included in the analysis. CT scans of the abdomen were interrogated for muscle characteristics. Multivariable linear regressions were used to test the associations. After adjustment, higher levels of both total testosterone and estradiol were associated with higher abdominal muscle area (1.79, 0.1–3.4, & 1.79, 0.4–3.2, respectively). In the final analyses, levels of total testosterone showed a positive association, while an inverse relationship was observed for SHBG with abdominal muscle radiodensity (0.3, 0.0–0.6, & -0.34, -0.6 - -0.1, respectively). Our results indicate a complex association between sex hormones and abdominal muscle characteristics in men. Specifically, total testosterone and estradiol were associated with abdominal muscle area, while only total testosterone was associated with muscle radiodensity and SHBG was inversely associated with muscle radiodensity.

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Muscle Area and Density Assessed by Abdominal Computed Tomography in Healthy Adults: Effect of Normal Aging and Derivation of Reference Values

Cited by 8 publications

References 31 publications

Cutoff Value of Psoas Muscle Area as Reduced Muscle Mass and Its Association with Acute Pancreatitis in China

Cutoff Value of Psoas Muscle Area as Reduced Muscle Mass and Its Association with Acute Pancreatitis in China

Osteosarcopenia and Mortality in Older Adults Undergoing Transcatheter Aortic Valve Replacement

Sex Hormones and Abdominal Muscle Area and Radiodensity in Men: The Multi-Ethnic Study of Atherosclerosis

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