Assessment of Muscle Quality and Quantity for the Diagnosis of Sarcopenia Using Mid-Thigh Computed Tomography : A Cohort Study

Abstract BackgroundPreviously, sarcopenia was diagnosed based on walking speed, grip strength, and muscle mass. However, recent consensus has proposed a concern regarding the use of muscle mass measurement for sarcopenia diagnosis due to lack of accuracy; therefore, new assessment methods in clinical practice are required. We compared computed tomography (CT) with various motor function tests to determine the validity of CT as a potential diagnostic method for sarcopenia.MethodsIn total, 214 patients who were examined at our center during the study period (2016–2017) were included in the study. Single-slice CT scan of the mid-thigh region was performed, from which cross-sectional area (CSA) and CT attenuation value (CTV) of quadriceps femoris were evaluated for each subject. Other assessments included skeletal mass index, muscle strength and physical performance. Furthermore, subjects were classified into four groups: normal, low muscle mass (low mass), poor muscle function/strength (poor function), and sarcopenia.ResultsCSA and muscle strength exhibited the strongest correlation. Some physical performance tests showed the strongest correlation with CTV. CSA was significantly reduced both in men and women with low mass and sarcopenia group (p < 0.01), whereas CTV was significantly lower in men with sarcopenia group and in women with poor function and sarcopenia group (p < 0.01).ConclusionsCSA mostly reflects muscle strength, whereas CTV mostly reflects physical performance. CT with measurements of CSA and CTV enables the evaluation of muscle mass and quality simultaneously. Thus, CT is thought to be useful for the assessment of motor function and diagnosis of sarcopenia.

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Evaluation of muscle quality and quantity for the assessment of sarcopenia using mid-thigh computed tomography: a cohort study

10.21203/rs.3.rs-64471/v2 ◽

2021 ◽

Author(s):

Hiroki Oba ◽

Yasumoto Matsui ◽

Hidenori Arai ◽

Tsuyoshi Watanabe ◽

Hiroki Iida ◽

...

Keyword(s):

Computed Tomography ◽

Muscle Strength ◽

Muscle Mass ◽

Physical Performance ◽

Motor Function ◽

Mass Measurement ◽

Muscle Quality ◽

Cross Sectional ◽

Men And Women ◽

Ct Attenuation Value

Abstract BackgroundPreviously, sarcopenia was diagnosed based on walking speed, grip strength and muscle mass. However, recent consensus has proposed a concern regarding the use of muscle mass measurement for sarcopenia diagnosis due to lack of accuracy; therefore, new assessment methods in clinical practice are required. We investigated the correlation between computed tomography (CT) and various motor function tests to assess the utility of CT as a potential diagnostic method for sarcopenia.MethodsIn total, 214 patients who were examined at our center during the study period (2016–2017) were included in the study. Single-slice CT scan of the mid-thigh region was performed, from which cross-sectional area (CSA) and CT attenuation value (CTV) of quadriceps femoris were evaluated for each subject. Other assessments included skeletal muscle mass index, muscle strength and physical performance. Furthermore, subjects were classified into four groups as per the Asia Working Group of Sarcopenia (AWGS) 2019 criteria as those with: normal, poor muscle function/strength (poor function), sarcopenia and severe sarcopenia.ResultsCSA and muscle strength exhibited the strongest correlation. Some physical performance tests showed the strongest correlation with CTV. The CSA was significantly lower in women with sarcopenia group and in both men and women with severe sarcopenia (all p < 0.01); furthermore, the CTV was significantly lower in women with poor-function and in both men and women with severe sarcopenia group (all p < 0.01).ConclusionsCSA mostly correlated with muscle strength, whereas CTV mostly correlated with physical performance. CT with measurements of CSA and CTV enables the evaluation of muscle mass and quality simultaneously. CT is believed to be useful in inferring evaluation of motor function and assessment of sarcopenia.

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Evaluation of muscle quality and quantity for the assessment of sarcopenia using mid-thigh computed tomography: a cohort study

BMC Geriatrics ◽

10.1186/s12877-021-02187-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Hiroki Oba ◽

Yasumoto Matsui ◽

Hidenori Arai ◽

Tsuyoshi Watanabe ◽

Hiroki Iida ◽

...

Keyword(s):

Computed Tomography ◽

Muscle Strength ◽

Muscle Mass ◽

Physical Performance ◽

Motor Function ◽

Working Group ◽

Assessment Tool ◽

Muscle Quality ◽

Men And Women ◽

European Working

Abstract Background For the diagnosis of Sarcopenia, European Working Group on Sarcopenia in Older People (EWGSOP) revised the algorisms in 2019, where they added computed tomography (CT) as an assessment tool not only for quantity but also for quality in research purpose. However, the evidence for clinical appreciation of CT has been lacking. Therefore, we investigated the correlation between CT and various motor function tests to assess the utility of CT as a potential diagnostic tool for sarcopenia. Methods In total, 214 patients who were examined at our center during the study period (2016–2017) were included in the study. Single-slice CT scan of the mid-thigh region was performed, from which cross-sectional area (CSA) and CT attenuation value (CTV) of quadriceps femoris were evaluated for each subject. Other assessments included skeletal muscle mass index by DXA and BIA, muscle strength and physical performance. Furthermore, subjects were classified into four groups as per the Asia Working Group of Sarcopenia (AWGS) 2019 criteria as those with: normal, poor muscle function/strength (poor function), sarcopenia and severe sarcopenia. Results Knee muscle strength correlated with CSA (r = 0.60) and the correlation was significantly greater than that with DXA and BIA. For physical performance, standing-up test correlated with CSA (r = − 0.20) and CTV (r = − 0.40) and walking speed with CTV (r = 0.43), which was significantly greater than that with DXA and BIA. The CSA was significantly lower in women with sarcopenia group and in both men and women with severe sarcopenia (all p < 0.01). Furthermore, CTV was significantly lower in women with poor-function and in both men and women with severe sarcopenia group (all p < 0.01). Conclusions CSA mostly correlated with muscle strength, whereas CTV mostly correlated with physical performance. CT with measurements of CSA and CTV enables the evaluation of muscle mass and quality simultaneously. CT is believed to be useful in inferring evaluation of motor function and assessment of sarcopenia.

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Testosterone but not estradiol level is positively related to muscle strength and physical performance independent of muscle mass: a cross-sectional study in 1489 older men

Acta Endocrinologica ◽

10.1530/eje-10-0952 ◽

2011 ◽

Vol 164 (5) ◽

pp. 811-817 ◽

Cited By ~ 55

Author(s):

Tung Wai Auyeung ◽

Jenny Shun Wah Lee ◽

Timothy Kwok ◽

Jason Leung ◽

Claes Ohlsson ◽

...

Keyword(s):

Muscle Strength ◽

Grip Strength ◽

Muscle Mass ◽

Physical Performance ◽

Older Men ◽

Community Dwelling ◽

Sex Hormone ◽

Sex Hormone Binding Globulin ◽

Cross Sectional ◽

Skeletal Mass

ObjectiveTo examine the relationship between different measures of testosterone and estradiol (E2), muscle mass, muscle strength, and physical performance; and to test whether the association of sex hormone level with muscle strength and physical performance was independent of muscle mass.Design and methodsA cross-sectional survey on 1489 community-dwelling men older than 64 years of age. Serum levels of testosterone and E2were measured by mass spectrometry, and sex hormone-binding globulin (SHBG) levels were measured by immunoradioassay. Muscle mass was examined by dual-energy X-ray absorptiometry and physical performance was assessed by hand-grip strength, gait speed, step length and chair-stand test.ResultsAppendicular skeletal mass (ASM) was positively associated with total testosterone (TT;P<0.001), free testosterone (FT;P<0.001), and total E2(P<0.001) but not with free E2(P=0.102). After adjustment for age, serum SHBG and relative ASM, both TT and FT were significantly associated with grip strength, narrow-walk speed and the composite neuromuscular score. Higher total E2, but not free E2was associated with lower grip strength (P<0.05) after adjustment for age, FT, SHBG and relative ASM.ConclusionsTestosterone level was related to both muscle mass, strength and physical performance. Total E2level, though related to muscle mass positively, affected muscle strength adversely in older men.

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Intracellular Water Content in Lean Mass as an Indicator of Muscle Quality in an Older Obese Population

Journal of Clinical Medicine ◽

10.3390/jcm9051580 ◽

2020 ◽

Vol 9 (5) ◽

pp. 1580

Author(s):

Mateu Serra-Prat ◽

Isabel Lorenzo ◽

Mònica Papiol ◽

Elisabet Palomera ◽

Maria Bartolomé ◽

...

Keyword(s):

Muscle Strength ◽

Water Content ◽

Muscle Mass ◽

Lean Mass ◽

Gait Speed ◽

Bioelectrical Impedance ◽

Intracellular Water ◽

Muscle Quality ◽

Timed Up And Go ◽

Cross Sectional

Background: In aged populations, muscle strength depends more on muscle quality than on muscle quantity, while all three are criteria for the diagnosis of sarcopenia. Intracellular water content (ICW) in lean mass (LM) has been proposed as an indicator of muscle quality related to muscle strength in older people. Objectives: To evaluate the relationship between the ICW/LM ratio, muscle strength and indicators of functional performance in obese older adults, and to assess the value of the ICW/LM ratio as an indicator of muscle quality. Methodology: Design: cross-sectional study. Population: persons aged 65–75 years with a body mass index of 30–39 kg/m2. ICW and LM were estimated by bioelectrical impedance. Hand grip, gait speed, unipedal stance test, timed up-and-go (TUG) test, Barthel score and frailty (Fried criteria) were assessed. Sarcopenia was established according to EWGSOP2 criteria. Results: Recruited were 305 subjects (66% women), mean age 68 years. The ICW/LM ratio correlated with the TUG test, gait speed and grip strength, and was also associated with sex, the unipedal stance test and frailty. Independently of age, sex and muscle mass, the ICW/LM ratio was related with gait speed, the TUG test and unipedal stance capacity. One person (0.3%) had sarcopenia defined as low muscle strength and low muscle mass, while 25 people (8.2%) had sarcopenia defined as low muscle strength and poor muscle quality (ICW/LM). With this last definition, sarcopenia was related to frailty, gait speed and the TUG test. Conclusions: ICW content in LM could be a useful muscle quality indicator for defining sarcopenia. However, more studies are required to confirm our findings for other populations.

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Association between Muscle Mass and Muscle Strength with Physical Performance in Elderly in Surabaya

Surabaya Physical Medicine and Rehabilitation Journal ◽

10.20473/spmrj.v2i1.2020.24-34 ◽

2020 ◽

Vol 2 (1) ◽

pp. 24

Author(s):

Titin Kristiana ◽

Novira Widajanti ◽

Rwahita Satyawati

Keyword(s):

Muscle Strength ◽

Muscle Mass ◽

Physical Performance ◽

Handgrip Strength ◽

Positive Association ◽

The Elderly ◽

Bivariate Analysis ◽

Weak Correlation ◽

Elderly Age ◽

Cross Sectional

ABSTRACTBackground: Sarcopenia is a decrease in muscle mass and strength that mostly happens in the elderly. Sarcopenia is a problem that is often found in the elderly who are at risk of disability, hospitalization and death. This data on muscle mass and strength with physical performance is expected to support the theory of sarcopenia and as a reference in promoting and preventing sarcopenia in elderly.Aims: To analyze the association between muscle mass and strength (handgrip strength) with physical performance assessed using Short Physical Performance Battery (SPPB) in an elderly community.Methods: This study was a cross-sectional observational analytic study involving 203 sample of elderly (age >60 years old). The subjects were categorized as the strong and weak muscle mass and muscle strength, also the high, moderate and low physical performance. We used Bioimpedance Analysis (BIA) and hand dynamometer to measure muscle mass and muscle strength (handgrip strength). SPPB was used to assess physical performance.The association between muscle mass and strength with physical performance was displayed in bivariate analysis with chi square.Result: Of all 203 subjects, 57 were males and 146 were females. Chi square test showed association between muscle strength (handgrip strength) with physical performance (SPPB) (p=0.001), with a weak correlation (r=0.26) and no association between muscle mass and physical performance (SPPB) (p=0.517).Conclusion: There is a positive association between muscle strength with physical performance, with a weak correlation and no association between muscle mass and physical performance in the elderly community in Surabaya.

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Prevalence of sarcopenia in an elderly population in rural South India: a cross-sectional study

F1000Research ◽

10.12688/f1000research.22580.1 ◽

2020 ◽

Vol 9 ◽

pp. 175

Author(s):

Nishat Shaikh ◽

R Harshitha ◽

Madhavi Bhargava

Keyword(s):

Muscle Strength ◽

Muscle Mass ◽

Rural Areas ◽

Large Scale ◽

Elderly Population ◽

South India ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Skeletal Mass ◽

European Working

Background: Sarcopenia is a condition common in the elderly characterized by progressive and generalized loss of skeletal muscle mass and strength leading to poor quality of life. According to a working definition proposed by the European Working Group on Sarcopenia in Older People (EWGSOP), the criteria for a diagnosis of sarcopenia is based on documentation of low muscle mass with either poor muscle strength or low physical performance. The objective of the present study was to determine the prevalence of sarcopenia in the rural elderly population of South India. Methods: We conducted a cross-sectional survey of 240 elderly people, 60 years and above, 118 men and 122 women, in rural areas of Dakshina Kannada district. We measured their height, weight, gait speed (using an 8-feet walk test) and muscle strength (using a handgrip dynamometer). Appendicular skeletal mass was calculated using height and weight adjusted for sex and Asian people using the Lee formula. Results: Sarcopenia was found in 34 (14.2%) participants. Of all those having sarcopenia, 27 (79.4%) were ≤75 years, 30 (88.2%) were women, 27 (79.4%) were married, 23 (67.6%) had below poverty line status. Conclusions: The prevalence of sarcopenia found in the present study was 14.2% in an elderly population more than 60 years of age and was found to be more in women. Large-scale multi-centric community-based surveys will help determine the actual burden of sarcopenia in India.

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Prevalence of sarcopenia in community-dwelling older adults in Ireland: comparison of EWGSOP1 and EWGSOP2 definitions

Proceedings of The Nutrition Society ◽

10.1017/s0029665120001093 ◽

2020 ◽

Vol 79 (OCE2) ◽

Author(s):

Caoileann Murphy ◽

Aoibheann McMorrow ◽

Ellen Flanagan ◽

Helen Cummins ◽

Sinead McCarthy ◽

...

Keyword(s):

Older Adults ◽

Muscle Strength ◽

Muscle Mass ◽

Physical Performance ◽

Clinical Investigation ◽

Community Dwelling ◽

Muscle Disease ◽

Cross Sectional ◽

European Working ◽

Community Dwelling Older Adults

AbstractSarcopenia is a muscle disease rooted in adverse muscle changes that accrue across a lifetime. It is an independent risk factor for numerous adverse health outcomes. In 2010, the European Working Group on Sarcopenia in Older People (EWGSOP) published a definition for the identification of people with sarcopenia (EWGSOP1). In 2018, this definition was updated based on the newest evidence (EWGSOP2), with the focus now on low muscle strength rather than low muscle quantity as the key characteristic of sarcopenia. In addition, EWGSOP2 provides clear cut-off points for measurements of variables that identify sarcopenia. The aim of this study was to determine the prevalence of sarcopenia among community-dwelling older adults in Ireland for the first time and to assess agreement between the EWGSOP1 and EWGSOP2 definitions. In a cross-sectional analysis, 490 community-dwelling adults (age 78.4 ± 8.0 y, body mass index 27.6 ± 5.1 kg/m2) were assessed. Skeletal muscle mass was estimated using bioelectrical impedance analysis, muscle strength was measured via handgrip dynamometry and physical performance via the Short Physical Performance Battery. Sarcopenia was defined according to both the 2010 criteria (EWGSOP1) and the updated 2018 criteria (EWGSOP2). Using the EWGSOP1 criteria, the prevalence of sarcopenia was 7.1% (2.6% sarcopenia, 4.5% severe sarcopenia) and 3.6% were classified as pre-sarcopenic (low muscle mass without a decrement in strength or physical performance). Using the EWGSOP2 criteria, the prevalence of sarcopenia was 5.5% (1.6% sarcopenia, 3.9% severe sarcopenia) and 23.4 % were classified as having low strength but without a decrement in muscle mass. Five of the participants who were classified as sarcopenic (2 sarcopenia, 3 severe sarcopenia) by EWGSOP1 were classified as “normal” using the EWGSOP2 criteria. In conclusion, the prevalence of sarcopenia in community-dwelling older adults in Ireland is in line with the prevalence reported in other European countries using the EWGSOP1 criteria (3.3–11.4 %). To our knowledge this is the first study to compare the prevalence based on the EWGSOP1 and the EWGSOP2 criteria. We report a slightly lower prevalence using the EWGSOP2 definition compared to the EWGSOP1 definition. Importantly however, in contrast to EWGSOP1, the EWGSOP2 definition identified a substantial proportion of older adults with poor strength in the absence of overt sarcopenia (23.4%). These older adults represent a group who would benefit from further clinical investigation and intervention.

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Body composition associations with muscle strength in older adults living in Auckland, New Zealand

PLoS ONE ◽

10.1371/journal.pone.0250439 ◽

2021 ◽

Vol 16 (5) ◽

pp. e0250439

Author(s):

Anne N. Hiol ◽

Pamela R. von Hurst ◽

Cathryn A. Conlon ◽

Owen Mugridge ◽

Kathryn L. Beck

Keyword(s):

Older Adults ◽

Body Composition ◽

Muscle Strength ◽

Grip Strength ◽

Muscle Mass ◽

Body Fat ◽

Muscle Quality ◽

Body Fat Percentage ◽

Fat Percentage ◽

Cross Sectional

Background Aging is associated with decreases in muscle strength and simultaneous changes in body composition, including decreases in muscle mass, muscle quality and increases in adiposity. Methods Adults (n = 369; 236 females) aged 65–74 years living independently were recruited from the cross-sectional Researching Eating Activity and Cognitive Health (REACH) study. Body fat percentage and appendicular skeletal muscle mass (ASM) (sum of lean mass in the arms and legs) were assessed using Dual-energy X-ray Absorptiometry (Hologic, QDR Discovery A). The ASM index was calculated by ASM (kilograms) divided by height (meters) squared. Isometric grip strength was measured using a hand grip strength dynamometer (JAMAR HAND). Results Linear regression analyses revealed that muscle strength was positively associated with the ASM index (R2 = 0.431, p < 0.001). When exploring associations between muscle strength and muscle mass according to obesity classifications (obesity ≥30% males; ≥40% females), muscle mass was a significant predictor of muscle strength in non-obese participants. However, in participants with obesity, muscle mass was no longer a significant predictor of muscle strength. Conclusions Body fat percentage should be considered when measuring associations between muscle mass and muscle strength in older adults.

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The Role of Serum Omega 3 Levels on Muscle Mass, Muscle Strength, and Physical Performance in the Elderly Community

BioScientia Medicina ◽

10.32539/bsm.v5i3.220 ◽

2021 ◽

Vol 5 (3) ◽

pp. 329-339

Author(s):

Welly Salutondok ◽

Nur Riviati ◽

Yulianto kusnadi ◽

Erial Bahar ◽

Nova Kuniati ◽

...

Keyword(s):

Muscle Strength ◽

Muscle Mass ◽

Physical Performance ◽

Significant Relationship ◽

The Elderly ◽

Mean Value ◽

Geriatric Syndrome ◽

Omega 3 ◽

Cross Sectional ◽

Geriatric Clinic

A B S T R A C TIntroduction. Old age is related to geriatric syndrome where there are several healthproblems that often occur related to a decrease in body function and an increase inthe inflammatory process. Decrease in muscle mass, muscle strength and physicalperformance will lead to a condition of sarcopenia and frailty syndrome in the elderly.The importance of prevention so that sarcopenia does not occur in the elderly byevaluating the factors that can cause it, one of which is controlling nutritional factors(macro and micro nutrients), such as in research, namely omega-3 macronutrients.The purpose of this study was to determine the correlation between serum omega-3levels with muscle mass, muscle strength, and physical performance in the elderlycommunity at Moehammad Hoesin Hospital Palembang. Methods. This research isan observational analytic study with a cross-sectional approach which wasconducted at the Integrated Geriatric Clinic Internal Medicine RSMH Palembangfrom November 2019 to November 2020. A sample of 21 people aged> 60 years wasexamined for muscle mass, muscle strength, physical performance and omega-levels. 3 serums. All data processing and analysis in this study used SPSS version25 for Windows. Results. Of the 21 subjects, it was found that women were 19people (90.5%) and 2 men (9.5%). The mean value of muscle mass was 37.65 ± 5.7,hand grip strength was 24.04 ± 5 kg, and walking speed was 6.72 ± 1.8 seconds per6 meters. There were 11 subjects with low serum omega-3 levels of 485.25 ± 110.19mg. There was a significant relationship between serum omega-3 levels and musclemass (p = 0.041) with moderate correlation strength (r = 0.448). Conclusion: Musclemass has a significant relationship with serum omega-3 levels in the elderly withmoderate strength. Meanwhile, muscle strength and physical performance did nothave a significant relationship.

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