Subcutaneous Thigh Fat Assessment: A Comparison of Skinfold Calipers and Ultrasound Imaging

Abstract Context: Skinfold calipers (SC) typically are used to determine subcutaneous fat thicknesses. Identifying the exact separation of muscle and fat can complicate measurements. Ultrasound imaging (USI) might provide a better technique for analyzing subcutaneous fat thicknesses. Objective: To compare measurements from SC and USI in assessing subcutaneous thigh fat thickness. Design: Descriptive laboratory study. Setting: Laboratory. Patients and Other Participants: Twenty healthy adults (13 men, 7 women; age = 26.9 ± 5.4 years, height = 173.9 ± 7.3 cm, mass = 77.4 ± 16.1 kg) participated. Intervention(s): Participants were seated in 90° of knee flexion and 85° of trunk extension. A standardized template was used to identify measurement sites over the vastus medialis obliquus (VMO), distal rectus femoris (dRF), proximal rectus femoris (pRF), and vastus lateralis (VL). Three measurements at each of the 4 sites were made in random order and were averaged for each measurement tool by the same investigator. Main Outcome Measure(s): Fat thickness was measured in millimeters with SC and USI. Measurements at each site were compared using Pearson product moment correlations and Bland-Altman plots. Results: Strong correlations between measures were found at the VMO (r = .90, P < .001), dRF (r = .93, P < .001), pRF (r = .93, P < .001), and VL (r = .91, P < .001). Mean differences between measures ranged from 1.7 ± 2.4 mm (dRF) to 3.7 ± 2.6 mm (pRF), indicating that the SC resulted in larger thicknesses compared with USI. Limits of agreement, as illustrated by the Bland-Altman plots, were fairly wide at each site: from −3.38 mm to 7.74 mm at the VMO, from −3.04 mm to 6.52 mm at the dRF, from −1.53 mm to 8.87 mm at the pRF, and from −3.73 mm to 8.15 mm at the VL. All plots except for the VL demonstrated increasing overestimation via the SC as fat thicknesses increased. Conclusions: We found strong correlations between the SC and USI; however, the large limits of agreement and increasing mean differences with larger fat thicknesses were a concern in terms of using this tool. When measuring subcutaneous fat thickness of the thigh, SC tended to overestimate thickness in individuals with higher fat values.

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Age-, sex-, and region-specific differences in skeletal muscle size and quality

Applied Physiology Nutrition and Metabolism ◽

10.1139/apnm-2020-0114 ◽

2020 ◽

Vol 45 (11) ◽

pp. 1253-1260 ◽

Cited By ~ 3

Author(s):

Matt S. Stock ◽

Dustin J. Oranchuk ◽

Adam M. Burton ◽

David C. Phan

Keyword(s):

Vastus Lateralis ◽

Subcutaneous Fat ◽

Rectus Femoris ◽

Older Men ◽

Muscle Size ◽

Cross Sectional ◽

Proximal Site ◽

Younger Men ◽

Subcutaneous Fat Thickness ◽

Fat Thickness

Ultrasonography-derived cross-sectional area (CSA) and echo intensity (EI) are increasingly utilized by investigators to study muscle size and quality, respectively. We sought to examine age, sex, and region (proximal, middle, distal) differences in vastus lateralis and rectus femoris CSA and EI, and determine whether correction for subcutaneous fat thickness influences the magnitude of EI differences. Fifteen younger men (mean age = 23 years), 15 younger women (aged 21 years), 11 older men (aged 74 years), and 15 older women (aged 70 years) participated. Clear differences were observed among age, sex, and region for vastus lateralis CSA (p ≤ 0.013, d = 0.38–0.73), whereas rectus femoris CSA was only different between younger and older participants at the proximal region (p = 0.017, d = 0.65). Uncorrected EI was greatest at the distal region of both muscles (p < 0.001, d = 0.59–1.38), with only the younger men having significantly lower EI values than the other groups (p ≤ 0.043, d = 0.37–0.63). Subcutaneous fat correction resulted in a marked increase in the magnitude of sex-specific EI differences (p ≤ 0.032, d ≥ 0.42). Additionally, subcutaneous fat correction increased the uniformity of EI throughout the thigh. These findings highlight considerable region-specific differences in muscle size and quality among younger and older men and women and highlight the need to correct for subcutaneous fat thickness when examining EI. Novelty Rectus femoris CSA is similar between younger and older adults except at the most proximal site evaluated. Age- and sex-specific differences in uncorrected EI are nonuniform across the thigh. Correction for subcutaneous fat thickness substantially increased EI in women, resulting in greater sex differences.

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Variability of regional quadriceps echo intensity in active young men with and without subcutaneous fat correction

Applied Physiology Nutrition and Metabolism ◽

10.1139/apnm-2019-0601 ◽

2020 ◽

Vol 45 (7) ◽

pp. 745-752 ◽

Cited By ~ 6

Author(s):

Dustin J. Oranchuk ◽

Matt S. Stock ◽

André R. Nelson ◽

Adam G. Storey ◽

John B. Cronin

Keyword(s):

Vastus Lateralis ◽

Intraclass Correlation ◽

Subcutaneous Fat ◽

Rectus Femoris ◽

Muscle Quality ◽

Echo Intensity ◽

Vastus Intermedius ◽

Subcutaneous Fat Thickness ◽

Fat Thickness ◽

Myotendinous Junctions

Quantifying echo intensity (EI), a proposed measure of muscle quality, is becoming increasingly popular. Additionally, much attention has been paid to regional differences in other ultrasonically evaluated measures of muscle morphology and architecture. However, the variability of regional (proximal, middle, distal) EI of the vastus lateralis, rectus femoris, and lateral and anterior vastus intermedius has yet to be determined. Twenty participants (40 limbs), were evaluated on 3 occasions, separated by 7 days. Intersession variability of EI with and without subcutaneous fat correction was quantified. Furthermore, the interchangeability of corrected EI across regions was evaluated. Variability of regional quadriceps EI was substantially lower with subcutaneous fat correction (intraclass correlation coefficient (ICC) = 0.81–0.98, coefficient of variation (CV) = 4.5%–16.8%, typical error of measure (TEM) = 0.13–0.49) versus raw values (ICC = 0.69–0.98, CV = 7.7%–42.7%, TEM = 0.14–0.68), especially when examining the vastus intermedius (ICC = 0.81–0.95, CV = 7.1%–16.8%, TEM = 0.23–0.49 vs. ICC = 0.69–0.92, CV = 22.9%–42.7%, TEM = 0.31–0.68). With the exception of the rectus femoris and vastus intermedius (p ≥ 0.143, effect size (ES) ≤ 0.18), corrected EI was greater for proximal and distal regions when compared with the midpoint (p ≤ 0.038, ES = 0.38–0.82). Researchers and practitioners should utilize subcutaneous fat thickness correction to confidently evaluate EI at all regions of the quadriceps. Regional EI cannot be used interchangeably for the vastus muscles, likely because of an increase in fibrous content towards the myotendinous junctions. Novelty Regional quadriceps echo intensity was reliable with and without correction for subcutaneous fat thickness. Intersession variability of regional quadriceps echo intensity was substantially improved following subcutaneous fat correction. Quadriceps echo intensity increased towards myotendinous junctions in the vastus muscles.

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Neuromuscular Strategies in Stretch–Shortening Exercises with Increasing Drop Heights: The Role of Muscle Coactivation in Leg Stiffness and Power Propulsion

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17228647 ◽

2020 ◽

Vol 17 (22) ◽

pp. 8647

Author(s):

Riccardo Di Giminiani ◽

Aldo Giovannelli ◽

Lorenzo Capuano ◽

Pascal Izzicupo ◽

Andrea Di Blasio ◽

...

Keyword(s):

Vastus Lateralis ◽

Reaction Force ◽

Rectus Femoris ◽

Random Order ◽

Biceps Femoris ◽

Drop Height ◽

Drop Jump ◽

Contact Phase ◽

Leg Stiffness ◽

Braking Phase

When applying drop jump exercises, knowing the magnitude of the stimulus is fundamental to stabilize the leg joints and to generate movements with the highest power. The effects of different drop heights on leg muscles coactivation, leg stiffness and power propulsion were investigated in fifteen sport science students. Drop jumps from heights of 20, 30, 40, 50, and 60 cm in a random order were performed on a force platform. During each drop jump, the ground reaction force, knee angle displacement, and synchronized surface-electromyography root-mean-square (sEMGRMS) activity (vastus lateralis, VL; vastus medialis, VM; rectus femoris, RF; biceps femoris, BF; tibialis anterior, TA and lateral gastrocnemius, LG) were recorded. The coactivation in the pre-contact phase, between VL and BF, VM and BF as well as RF and BF, was dependent on the drop height (p < 0.01; effect size (ES) ranged from 0.45 to 0.90). Leg stiffness was dependent on the drop height (p < 0.001; ES = 0.27–0.28) and was modulated by the coactivation of VM–BF (p = 0.034) and RF–BF (p = 0.046) during the braking phase. Power propulsion was also dependent on the drop height (p < 0.001; ES = 0.34); however, it was primarily modulated by the coactivation of LG–TA during the braking phase (p = 0.002). The coactivation of thigh muscles explains leg stiffness adjustments at different drop heights. On the contrary, the coactivation of shank muscles is mostly responsible for the power propulsion.

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Nutritional Status Assessment in ICU Patients Using Ultrasound Imaging of Muscles and Subcutaneous Fat

General Reanimatology ◽

10.15360/1813-9779-2020-5-13-21 ◽

2020 ◽

Vol 16 (5) ◽

pp. 13-21

Author(s):

R. E. Lakhin ◽

M. V. Nikitin ◽

E. Yu. Strukov ◽

A. A. Emelyanov ◽

A. G. Klimov ◽

...

Keyword(s):

Sodium Chloride ◽

Nutritional Status ◽

Ultrasound Imaging ◽

Tibialis Anterior ◽

Chloride Solution ◽

Sodium Chloride Solution ◽

Biceps Brachii ◽

Subcutaneous Fat ◽

Rectus Femoris ◽

Ultrasound Assessment

Ultrasound imaging of muscles and subcutaneous fat has been used in recent years to assess the nutritional status, but there are no common approaches for selecting muscles for it.The aim of the study was to examine the variability of thickness of different muscles and subcutaneous fat using ultrasonography to identify optimal cutaneous and muscle landmarks for the assessment of nutritional status.Materials and methods. It was a prospective observational study with participation of 14 patients. All patients underwent ultrasound examination of thickness of the following muscles: m. rectus femoris; m. tibialis anterior; m. biceps brachii; m. deltoideus and m. sternocleidomastoideus, as well as the thickness of skin and subcutaneous fat over the muscles. The ultrasound assessment was done on admission to ICU, on days 7, 14, 21, 28, 42. On days 7, 14 and 21 the intravenous load test of 1000 ml of 0.9% sodium chloride solution was performed. On days 5 and 10 the test with the patients in the lateral decubitus position was carried out.Results. We found that m. tibialis anterior changed its size when patients were turned laterally by 2%, m. deltoideus by 6%, m. sternocleidomastoideus by 10%, m. rectus femoris by 20.5%, and m. biceps brachii by 26%. After infusion of 1,000 ml of 0,9% sodium chloride solution, the variability of m. tibialis anterior size was 2%, m. deltoideus 2%, m. sternocleidomastoideus 6%, m. biceps brachii 8%, m. rectus femoris 12%.The thickness of subcutaneous fat over m. biceps brachii and m. rectus femoris changed more than the anteroposterior size of the muscles (P<0.05).Conclusion. The m. deltoideus and m. tibialis anterior are optimal for ultrasound assessment of the nutritional status because their size is less affected by the patient's positioning and infusion therapy. Intravenous fluid infusion increases the variability of subcutaneous fat thickness.

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Ultrasound assessment of sarcopenia in patients with rheumatoid arthritis

Modern Rheumatology ◽

10.1093/mr/roab049 ◽

2021 ◽

Author(s):

Takeshi Yoshida ◽

Yoshitaka Kumon ◽

Naoko Takamatsu ◽

Taiki Nozaki ◽

Masataka Inoue ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Biceps Brachii ◽

Vastus Lateralis ◽

Subcutaneous Fat ◽

Rectus Femoris ◽

Receiver Operating Curve ◽

Cross Sectional ◽

Discriminative Performance ◽

Receiver Operating Curve Analysis ◽

Ultrasound Assessment

ABSTRACT Objectives To evaluate the efficacy of ultrasound (US) as a diagnostic tool for sarcopenia in patients with rheumatoid arthritis (RA). Methods Female RA patients aged >50 years and matched controls were cross-sectionally assessed. Sarcopenia was diagnosed based on the 2019-updated Asian Working Group for Sarcopenia definition. The cross-sectional area (CSA) and echo intensity (EI) of the biceps brachii, rectus femoris, and EI of the vastus lateralis were examined bilaterally. Correction for subcutaneous fat and calculation of the recorrected EI (rcEI) were performed. We performed logistic regression using both muscle rcEI and CSA with receiver operating curve analysis to evaluate the discriminative performance per muscle group. Results Seventy-eight consecutive RA patients and 15 age-and sex-matched controls were assessed. Sarcopenia was diagnosed in 34 RA patients (43.6%). The rcEI of examined muscles were significantly higher, whereas CSA were significantly lower in sarcopenic RA patients than in non-sarcopenic patients and matched controls. The combined discriminative performance of rcEI and CSA was superior to those of rcEI or CSA alone. Conclusions This study suggests the use of US for the diagnosis of sarcopenia in RA patients. The diagnostic performance increases when both echogenicity and CSA are considered together rather than individually.

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Correlates of visceral and subcutaneous fat thickness in non-diabetic obese and morbidly obese patients

Endocrine Abstracts ◽

10.1530/endoabs.35.p753 ◽

2014 ◽

Author(s):

Ozen Oz Gul ◽

Murat Pekgoz ◽

Sumeyye Gullulu ◽

Soner Cander ◽

Ahmet Tutuncu ◽

...

Keyword(s):

Subcutaneous Fat ◽

Morbidly Obese ◽

Obese Patients ◽

Subcutaneous Fat Thickness ◽

Fat Thickness

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The Use of Ultrasonic Measurements on Subcutaneous Fat Thickness in Breeding of Japanese Shorthorn Cattle

Nihon Chikusan Gakkaiho ◽

10.2508/chikusan.59.335 ◽

1988 ◽

Vol 59 (4) ◽

pp. 335-343

Author(s):

Yoshitaka NAGAMINE ◽

Takashi HAYASHI ◽

Hiroshi SATO ◽

Akira NISHIDA ◽

Shigeki KOMATSU

Keyword(s):

Subcutaneous Fat ◽

Ultrasonic Measurements ◽

Subcutaneous Fat Thickness ◽

Fat Thickness

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Real-time measurement of rectus femoris muscle kinematics during drop jump using ultrasound imaging: A preliminary study

2012 Annual International Conference of the IEEE Engineering in Medicine and Biology Society ◽

10.1109/embc.2012.6347080 ◽

2012 ◽

Author(s):

A. Eranki ◽

N. Cortes ◽

Z. G. Ferencek ◽

J. J. Kim ◽

S. Sikdar

Keyword(s):

Real Time ◽

Ultrasound Imaging ◽

Rectus Femoris ◽

Time Measurement ◽

Drop Jump ◽

Real Time Measurement ◽

Preliminary Study ◽

Rectus Femoris Muscle ◽

Femoris Muscle

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Estimation of the carcass composition of different cattle breeds and crosses from fatness measurements and visual assessments

The Journal of Agricultural Science ◽

10.1017/s0021859600063802 ◽

1986 ◽

Vol 106 (2) ◽

pp. 223-237 ◽

Cited By ~ 15

Author(s):

A. J. Kempster ◽

J. P. Chadwick ◽

D. D. Charles

Keyword(s):

Subcutaneous Fat ◽

Visual Assessment ◽

Carcass Composition ◽

Beef Breed ◽

Percentage Unit ◽

Wide Range ◽

Fat Thickness ◽

Substantial Bias ◽

Visual Assessments ◽

Thickness Measurements

SUMMARYCarcass data for 1053 steers from the Meat and Livestock Commission's beef breed evaluation programme were used to examine the relative precision of alternative fatness assessments for predicting carcass lean percentage. The data were from four trials and comprised both dairy-bred and suckler-bred cattle by a wide range of sire breeds.A visual assessment of carcass subcutaneous fat content to the nearest percentage unit (SFe) was the single most precise predictor both overall (residual S.d. = 2·28) and within breed (residual S.d. = 2·05). Precision was improved by the addition in multiple regression of the percentage perinephric and retroperitoneal fat (KKCF) in carcass, a visual score of the degree of marbling in the m. longissimus and selected fat thickness measurements taken by calipers on cut surfaces (residual S.d. = 2·11 (overall) and 1·90 (within breed)).When the best overall equation was applied to the breed means, there was substantial bias (predicted – actual carcass lean percentage). Biases ranged from +2·5 (purebred Canadian Holstein and Luing) to – 1·3 (Limousin crosses).Breeds differed significantly in carcass lean content when compared at equal levels of fatness measurements. The differences depended both on the precision with which the measurements predicted carcass lean content and the observed differences in carcass composition that existed before adjustments to equal fatness were made.The robustness of prediction equations was examined by applying them to independent sets of data (a total of 334 carcasses) from four other trials involving steers, heifers, cows and young bulls. Equations were stable for cattle of the same breed, sex and similar levels of fatness but important bias was found between more extreme types of cattle.

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