Open AccessReference values of skeletal muscle area for diagnosis of sarcopenia using chest computed tomography in Asian general population
Author(s) -
Moon Sung Woo,
Lee Sang Hoon,
Woo Ala,
Leem Ah Young,
Lee Su Hwan,
Chung Kyung Soo,
Kim Eun Young,
Jung Ji Ye,
Kang Young Ae,
Park Moo Suk,
Kim Young Sam,
Kim Chang Oh,
Kim Song Yee
Publication year - 2022
Publication title -
journal of cachexia, sarcopenia and muscle
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.803
H-Index - 66
eISSN - 2190-6009
pISSN - 2190-5991
DOI - 10.1002/jcsm.12946
Subject(s) - sarcopenia , medicine , cutoff , pectoralis major muscle , population , pectoralis muscle , computed tomography , radiology , surgery , physics , environmental health , quantum mechanics
Background Diagnostic cutoff points for sarcopenia in chest computed tomography (CT) have not been established although CT is widely used for investigating skeletal muscles. This study aimed to determine reference values for sarcopenia of thoracic skeletal muscles acquired from chest CT scans and to analyse variables related to sarcopenia using the cutoff values determined in a general Asian population. Methods We retrospectively reviewed chest CT scans of 4470 participants (mean age 54.8 ± 9.9 years, 65.8% male) performed at a check‐up centre in South Korea (January 2016–August 2017). To determine cutoffs, 335 participants aged 19–39 years (mean age 35.2 ± 3.6 years, 75.2% male) were selected as the healthy and younger reference group, and 4135 participants aged ≥40 years (mean age 56.4 ± 8.4 years, 65.1% male) were selected as the study group. We measured the following: cross‐sectional area (CSA) of the pectoralis, intercostalis, paraspinal, serratus, and latissimus muscles at the 4 th vertebral region (T4 CSA ); T4 CSA divided by height 2 (T4MI); pectoralis muscle area (PM CSA ); and PM CSA divided by height 2 (PMI) at the 4 th vertebral region. Sarcopenia cutoff was defined as sex‐specific values of less than −2 SD below the mean from the reference group. Results In the reference group, T4 CSA , T4MI, PM CSA , and PMI cutoffs for sarcopenia were 100.06cm 2 , 33.69cm 2 /m 2 , 29.00cm 2 , and 10.17cm 2 /m 2 in male, and 66.93cm 2 , 26.01cm 2 /m 2 , 18.29cm 2 , and 7.31cm 2 /m 2 in female, respectively. The prevalence of sarcopenia in the study group measured with T4 CSA , T4MI, PM CSA and PMI cutoffs were 11.4%, 8.7%, 8.5%, and 10.1%, respectively. Correlations were observed between appendicular skeletal mass divided by height 2 measured by bioelectrical impedance analysis (BIA) and T4 CSA ( r = 0.82; P < 0.001)/T4MI ( r = 0.68; P < 0.001), and ASM/ height 2 measured by BIA and PM CSA ( r = 0.72; P < 0.001)/PMI ( r = 0.63; P < 0.001). In the multivariate logistic regression models, sarcopenia defined by T4 CSA /T4MI were related to age [odds ratio (95% confidence interval), P ‐values: 1.09 (1.07–1.11), <0.001/1.05 (1.04–1.07), <0.001] and diabetes [1.60 (1.14–2.25), 0.007/1.47 (1.01–2.14), 0.043]. Sarcopenia defined by PM CSA /PMI were related to age [1.09 (1.08–1.10), <0.001/1.05 (1.03–1.06), <0.001], male sex [0.23 (0.18–0.30), <0.001/0.47 (0.32–0.71), <0.001], diabetes [2.30 (1.73–3.05), <0.001/1.63 (1.15–2.32), 0.007], history of cancer [2.51 (1.78–3.55), <0.001/1.61 (1.04–2.48), 0.033], and sufficient physical activity [0.67 (0.50–0.89), 0.007/0.74 (0.56–0.99), 0.042]. Conclusions The reference cutoff values of a general population reported here will enable sex‐specific standardization of thoracic muscle mass quantification and sarcopenia assessment.