Arm lean mass determined by Dual-energy X-ray absorptiometry is superior to characterize skeletal muscle and predict sarcopenia-related mortality in cirrhosis

Introduction: Sarcopenia worsens survival in patients with advanced liver disease including cirrhosis. In this study we aimed to characterize skeletal muscle status by Dual-energy X-ray Absorptiometry (DXA) in patients with cirrhosis and examine the association between different skeletal muscle compartments and mortality. Methods: We included 231 men and 84 women (Child A, B, and C) with cirrhosis and 315 healthy matched controls (231 men and 84 women). Body composition was assessed with DXA. Appendicular skeletal muscle index (ASMI), arms index (AI), and legs index (LI) was calculated by normalizing lean mass to height squared. Low ASMI was defined as ASMI < 7.0 kg/m2 in men and < 5.5 kg/m2 in women. Biochemical and hemodynamic data were recorded for cirrhotic patients and mortality data retrieved from registers. Results: Low ASMI was more prevalent in both men (49%) and women (43%) with cirrhosis compared to healthy men (8%) and women (5%) (p<0.001). ASMI and LI were lowest in Child B, whereas AI decreased gradually with advancing Child Class. ASMI was inversely associated to mortality in men (HR = 0.74 [0.59-0.93], p <0.01), and this was mainly driven by AI (HR = 0.37 [0.18-0.71], p <0.01). Conclusion: AI showed closer association than ASMI or LI to both the severity of liver disease and to mortality, which may be due to increasing prevalence of leg edema with disease progression in this population. Determination of arm lean mass may add information on survival in patients with cirrhosis.

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Role of the Appendicular Skeletal Muscle Index for Predicting the Recurrence-Free Survival of Head and Neck Cancer

Diagnostics ◽

10.3390/diagnostics11020309 ◽

2021 ◽

Vol 11 (2) ◽

pp. 309

Author(s):

Kun-Yun Yeh ◽

Hang Huong Ling ◽

Shu-Hang Ng ◽

Cheng-Hsu Wang ◽

Pei-Hung Chang ◽

...

Keyword(s):

Skeletal Muscle ◽

Body Composition ◽

Head And Neck Cancer ◽

Mass Loss ◽

Lean Mass ◽

Recurrence Free Survival ◽

Skeletal Muscle Index ◽

Free Survival ◽

Prognostic Predictor ◽

Appendicular Skeletal Muscle

Background: This study investigates whether the appendicular skeletal muscle index (ASMI) was an independent prognostic predictor for patients with locally advanced head and neck cancer (LAHNC) receiving concurrent chemoradiotherapy (CCRT) and whether there were any differences in lean mass loss in different body regions during CCRT. Methods: In this prospective study, we analyzed the clinicopathological variables and the total body composition data before and after treatment. The factors associated with the 2-year recurrence-free survival rate (RFSR) were analyzed via logistic regression analysis. Results: A total of 98 patients were eligible for analysis. The body weight, body mass index, and all parameters of body composition significantly decreased after CCRT. The pretreatment ASMI was the only independent prognostic factor for predicting the 2-year RFSR (hazard ratio, 0.235; 95% confidence interval, 0.062–0.885; p = 0.030). There was at least 5% reduction in total lean and fat mass (p < 0.001); however, the highest lean mass loss was observed in the arms (9.5%), followed by the legs (7.2%), hips (7.1%), waist (4.7%), and trunk (3.6%). Conclusions: The pretreatment ASMI was the only independent prognostic predictor for the 2-year RFSR of LAHNC patients undergoing CCRT. Asynchronous loss of lean mass may be observed in different body parts after CCRT.

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Ultrasound-Derived Abdominal Muscle Thickness Better Detects Metabolic Syndrome Risk in Obese Patients than Skeletal Muscle Index Measured by Dual-Energy X-Ray Absorptiometry

PLoS ONE ◽

10.1371/journal.pone.0143858 ◽

2015 ◽

Vol 10 (12) ◽

pp. e0143858 ◽

Cited By ~ 8

Author(s):

Ayumi Ido ◽

Yuki Nakayama ◽

Kojiro Ishii ◽

Motoyuki Iemitsu ◽

Koji Sato ◽

...

Keyword(s):

Skeletal Muscle ◽

Metabolic Syndrome ◽

Muscle Thickness ◽

Abdominal Muscle ◽

Dual Energy ◽

Obese Patients ◽

Skeletal Muscle Index ◽

X Ray

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Prepubertal Asians have less limb skeletal muscle

Journal of Applied Physiology ◽

10.1152/japplphysiol.01066.2001 ◽

2002 ◽

Vol 92 (6) ◽

pp. 2285-2291 ◽

Cited By ~ 18

Author(s):

Mi-Yeon Song ◽

Jaehee Kim ◽

Mary Horlick ◽

Jack Wang ◽

Richard N. Pierson ◽

...

Keyword(s):

Skeletal Muscle ◽

Body Weight ◽

African Americans ◽

Muscle Mass ◽

Skeletal Muscle Mass ◽

Dual Energy ◽

X Ray ◽

Asian Children ◽

Appendicular Skeletal Muscle ◽

Prepubertal Girls

Skeletal muscle mass in prepubertal Asian children has not been examined previously. The aims of this study were to test the hypotheses that 1) prepubertal Asians have less appendicular skeletal muscle (ASM) mass compared with African-Americans and Caucasians, and 2) ASM is less in prepubertal Asian girls compared with Asian boys. ASM was estimated by using dual-energy X-ray absorptiometry in healthy prepubertal girls ( n = 170) and boys ( n= 166). The results showed that, after adjusting for age, height, and body weight, 1) Asian girls and boys had less amounts of ASM than African-Americans ( P < 0.001); 2) Asian girls had less amounts of ASM than Caucasian girls ( P = 0.004); 3) there was a trend towards less ASM in Asian compared with Caucasian boys ( P = 0.07); 4) and Asian girls had significantly less ASM than Asian boys ( P < 0.001). This study indicates that skeletal muscle mass as a fraction of body weight is smaller in Asian compared with African-American and Caucasian children.

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Comparison between Dual-Energy X-ray Absorptiometry and Bioelectrical Impedance Analyses for Accuracy in Measuring Whole Body Muscle Mass and Appendicular Skeletal Muscle Mass

Nutrients ◽

10.3390/nu10060738 ◽

2018 ◽

Vol 10 (6) ◽

pp. 738 ◽

Cited By ~ 23

Author(s):

Seo Lee ◽

Soyeon Ahn ◽

Young Kim ◽

Myoung Ji ◽

Kyoung Kim ◽

...

Keyword(s):

Skeletal Muscle ◽

Muscle Mass ◽

Skeletal Muscle Mass ◽

Bioelectrical Impedance ◽

Dual Energy ◽

Whole Body ◽

X Ray ◽

Body Muscle ◽

Appendicular Skeletal Muscle ◽

Appendicular Skeletal Muscle Mass

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BatchBMD as an Efficient and Accurate Dual-Energy X-ray Absorptiometry Report Generator

Diagnostics ◽

10.3390/diagnostics11122403 ◽

2021 ◽

Vol 11 (12) ◽

pp. 2403

Author(s):

Chun-Hsiang Chan ◽

Wen-Chi Huang ◽

Yi-Chien Lu ◽

Hsing-Fen Hsiao ◽

Wing P. Chan

Keyword(s):

Reporting System ◽

Dual Energy ◽

Mineral Density ◽

Web Based ◽

Skeletal Muscle Index ◽

X Ray ◽

Appendicular Skeletal Muscle ◽

Portable Software ◽

Clinical Purpose ◽

Current Systems

Dual-energy X-ray absorptiometry is the gold standard for evaluating Bone Mineral Density (BMD); however, a typical BMD report is generated in a time-inefficient manner and is prone to error. We developed a rule-based automated reporting system, BatchBMD, that accelerates DXA reporting while improving its accuracy over current systems. BatchBMD generates a structured report, customized to the specific clinical purpose. To compare BatchBMD to a Web-based Reporting (WBR) system for efficiency and accuracy, 500 examinations were randomly chosen from those performed at the Taipei Municipal Wanfang Hospital from January to March 2021. The final assessment included all 2326 examinations conducted from September 2020 to March 2021. The average reporting times were 6.7 and 10.8 minutes for BatchBMD and the WBR system, respectively, while accuracy was 99.4% and 98.2%, respectively. Most of the errors made by BatchBMD were digit errors in the appendicular skeletal muscle index. After correcting this, 100% accuracy across all 2326 examinations was validated. This automated and accurate BMD reporting system significantly reduces report production workload for radiologists and technicians while increasing productivity and quality. Additionally, the portable software, which employs a simple framework, can reduce deployment costs in clinical practice.

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Optimal Skeletal Muscle Mass Index Cut-Off Values for Presarcopenia Evaluated by Computed Tomography against Dual-Energy X-ray Absorptiometry in Patients with Chronic Liver Disease

Journal of Clinical Medicine ◽

10.3390/jcm10071419 ◽

2021 ◽

Vol 10 (7) ◽

pp. 1419

Author(s):

Kazuki Ohashi ◽

Toru Ishikawa ◽

Asami Hoshii ◽

Tamaki Hokari ◽

Hirohito Noguchi ◽

...

Keyword(s):

Computed Tomography ◽

Skeletal Muscle ◽

Liver Disease ◽

Chronic Liver Disease ◽

Muscle Mass ◽

Skeletal Muscle Mass ◽

Dual Energy ◽

Chronic Liver ◽

X Ray ◽

Skeletal Muscle Mass Index

Although dual-energy X-ray absorptiometry (DXA) and body impedance analysis are commonly used to measure skeletal muscle mass (SMM), a computed tomography (CT) scan is preferred in clinical practice. We aimed to propose the cut-off values of skeletal muscle mass index (SMI) calculated using CT scans, using DXA as the reference method. We retrospectively assessed 589 patients with chronic liver disease. The SMI was assessed using appendicular SMM by DXA and total muscle area at the level of the third lumbar vertebra (L3) calculated by CT. The cut-off value was determined with reference to the Asian Working Group for Sarcopenia criteria. DXA identified 251 (42.6%) patients as having presarcopenia. In men, the cut-off value of SMI for presarcopenia was determined to be 45.471 cm2/m2, with an area under the curve (AUC) of 0.863 (95% confidence interval (CI): 0.823 to 0.903), and in women, this value was determined to be 35.170 cm2/m2, with an AUC of 0.846 (95% CI: 0.800 to 0.892). Cohen’s kappa coefficient was 0.575 (95% CI: 0.485–0.665) in men and 0.539 (95% CI: 0.438–0.639) in women.

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