Reference Values for Skeletal Muscle Mass at the Third Lumbar Vertebral Level Measured by Computed Tomography in a Healthy Korean Population

Abstract

Background Sarcopenia is defined as the loss of skeletal muscle mass and is associated with negative clinical outcomes. This study aimed to establish sex-specific cutoff values for the skeletal muscle area (SMA) and skeletal muscle index (SMI) at the third lumbar vertebral (L3) level using computed tomography (CT) imaging to identify sarcopenia in healthy Korean liver donors. Methods This retrospective study included 659 healthy liver donors (408 men and 251 women) aged 20 to 60 years who had undergone abdominal CT examinations between January 2017 and December 2018. Assessment of body composition was performed with an automated segmentation technique using a deep-learning system. Sex-specific SMA and SMI distributions were assessed, and cutoff values for determining sarcopenia were defined as values at either two standard deviations (SDs) below the mean reference value or below the fifth percentile. Results Using the SD definition, cutoff values for SMA and SMI were 117.04 cm 2 and 39.33 cm 2 /m 2 , respectively, in men and 71.39 cm 2 and 27.77 cm 2 /m 2 , respectively, in women. Using the fifth percentile definition, cutoff values for SMA and SMI were 126.88 cm 2 and 40.96 cm 2 /m 2 , respectively, in men and 78.85 cm 2 and 30.60 cm 2 /m 2 , respectively, in women. Conclusion Our data provide sex-specific cutoff values for the SMA and SMI at the L3 level measured by CT imaging in a healthy Korean population, which may be applicable for identifying sarcopenia in this population.

The effect of biological agent on body composition in patients with Crohn’s disease

“…CT-based studies in Korean patients also vary from the cutoffs presented. [33,34] We defined sarcopenia by Korean specific cut-off values for the SMI of 49 cm 2 /m 2 for men and 31 cm 2 /m 2 for women, which was used in several previous studies which included Korean population. [21,35] Additional research is needed to consensus on the definition of sarcopenia in the future.…”

Validity of computed tomography defined body composition as a prognostic factor for functional outcome after kidney transplantation

“…Fourth, the lack of a set time frame for preoperative imaging means that the CT scans used for skeletal muscle measurement could range in age, leading to potential over‐ or underestimation of skeletal muscle mass at the time of transplantation, which is particularly significant in dialysis patients given the significant correlation between dialysis vintage and development of sarcopenia 17 . Fifth, there is a lack of consensus on cut‐off values for CT skeletal muscle mass measurements, with variation in reported values due to differences in populations studied and the failure to account for age, sex, and BMI as potential confounders 32–35 . Our group has emphasized the need for consensus on cut‐off values.…”

“… 17 Fifth, there is a lack of consensus on cut‐off values for CT skeletal muscle mass measurements, with variation in reported values due to differences in populations studied and the failure to account for age, sex, and BMI as potential confounders. 32 , 33 , 34 , 35 Our group has emphasized the need for consensus on cut‐off values. In this study, we utilized age and gender specific cut‐off values for SMI determined in a large cohort of living kidney donors.…”

The Association between the L3 Skeletal Muscle Index Derived from Computed Tomography and Clinical Outcomes in Patients with Urinary Tract Infection in the Emergency Department

“…Non-normally distributed data were assessed using the Mann-Whitney U test and expressed as the median and interquartile range. Sex-specific cutoff values for SMI at the L3 level measured by CT imaging in a healthy Korean population were used in this study [7]. Multivariate binary logistic regression analysis was used to assess independent predictors of critical events.…”