Evaluation of Appendicular Muscle Mass in Sarcopenia in Older Adults Using Ultrasonography: A Systematic Review and Meta-Analysis

Zhao, Ruina; Li, Xuelan; Jiang, Yuxin; Su, Na; Li, Jianchu; Kang, Lin; Zhang, Yewei; Meng, Yonggang

doi:10.1159/000525758

Cited by 32 publications

(18 citation statements)

References 78 publications

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“…It was reported that ultrasonography evaluation validated the quantitative assessment of appendicular skeletal muscle mass in older adults. 42 To the best of our knowledge, this is the first study to demonstrate that MT can determine skeletal muscle mass better and conveniently than ASMI.…”

Section: Discussionmentioning

confidence: 84%

The Muscle Thickness Assessment Using Ultrasonography is a Useful Alternative to Skeletal Muscle Mass by Bioelectrical Impedance Analysis

Isaka¹,

Sugimoto²,

Akasaka³

et al. 2022

CIA

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Purpose Muscle mass, a key index for the diagnosis of sarcopenia, is currently assessed using the appendicular skeletal muscle mass index (ASMI) by bioelectrical impedance analysis (BIA). Muscle thickness (MT) assessed by ultrasonography (US) may be a better determinant and/or predictor of muscle condition than ASMI. Thus, we compared it to the ASMI determined by the BIA. Patients and Methods Our study included 165 ambulatory older adults (84 males, 81 females, mean age: 76.82 years). The ASMI by the BIA method, MT by US, and the distribution of body mass index (BMI) and body fat percentage (BFP) were examined using defined values for men and women. These were used as the basis for examining the association of MT and ASMI with handgrip strength (HGS), leg muscle strength (LMS), gait speed (GS), and echo intensity (EI). We compared HGS, LMS, GS, and EI for high and low ASMI among lower BMI or BFP. The same was also done for MT assessed by US. Results MT, as well as ASMI, was strongly associated with HGS and LMS. There was a correlation between MT and GS and EI but not between ASMI and GS and EI. There were significant differences in the prevalence between high ASMI and high MT or low ASMI and low MT in those with lower BMI or BFP. In non-overweight participants, HGS, LMS, GS, and EI were significantly higher in those with high MT than in those with low MT; however, there were no significant differences in them between those with high and low ASMI. Conclusion In the non-overweight group, the MT assessment by US showed a stronger relationship to muscle strength and muscle quality than the ASMI assessment by BIA. The MT assessment using US is a useful alternative to BIA-assessed ASMI, especially in non-overweight participants.

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Section: Discussionmentioning

confidence: 84%

The Muscle Thickness Assessment Using Ultrasonography is a Useful Alternative to Skeletal Muscle Mass by Bioelectrical Impedance Analysis

Isaka¹,

Sugimoto²,

Akasaka³

et al. 2022

CIA

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“…However, the clinical use of US is narrow due to the lack of a standardized protocol and validated cutoff points. Several new ultrasonic techniques for diagnosing muscle diseases have emerged in recent years, such as elastosonography and artificial intelligence ( 69 ).…”

Section: Discussionmentioning

confidence: 99%

The agreement of different techniques for muscle measurement in diagnosing sarcopenia: a systematic review and meta-analysis

Li,

Xia,

Zeng

et al. 2024

Quant Imaging Med Surg

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Background The measurement or estimation of muscle mass plays an important role in the diagnosis of sarcopenia. Beside dual-energy X-ray absorptiometry (DXA), several modalities, including bioelectrical impedance analysis (BIA), ultrasound (US), computed tomography (CT), and magnetic resonance imaging (MRI), have helped to provide imaging or electrical biomarkers for muscle mass. This study was aimed at summarizing the diagnostic performance of different techniques on muscle assessment for sarcopenia. Methods Studies on the assessment of muscle mass by different techniques (compared with DXA), published from inception to 12 October, 2023 were retrieved from 4 electronic databases: the Cochrane Library, Embase, PubMed, and Web of Science. The quality assessment of included studies was conducted using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2). The sensitivity, specificity, Cohen’s kappa coefficient (κ), and Pearson correlation coefficient (r) with 95% confidence intervals (CIs) were pooled and presented via forest plots. The area under the curve (AUC) with 95% CI was pooled and presented via summary receiver operating characteristic (sROC) curve. Results A total of 28 studies involving 4,926 participants were included. Compared with DXA, the pooled sensitivity and specificity, AUC, and Cohen’s κ were 0.79 (95% CI: 0.71–0.86, P<0.001), 0.95 (95% CI: 0.82–0.99, P<0.001), and 0.88 (95% CI: 0.85–0.90), and 0.61 (95% CI: 0.51–0.72) for BIA. The pooled r value between DXA and BIA or US or MRI was 0.94 (95% CI: 0.92–0.96, P<0.001), 0.69 (95% CI: 0.54–0.80, P<0.001), and 0.96 (95% CI: 0.95–0.97, P=0.21), respectively. No qualified original study in relation to CT was included. Conclusions BIA, US, and MRI would provide acceptable diagnostic accuracy for sarcopenia by evaluating muscle mass in terms of sensitivity, specificity, accuracy, and their higher correlations with DXA. Further investigation is required to elucidate the value of CT in diagnosing sarcopenia.

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“…Firstly, it is important to highlight that this study makes an important advance in scientific knowledge with the implementation of a training/qualification program for health professionals with different backgrounds. Studies have requested that training programs should be structured to enhance the reliability of US muscle assessment, as there is still no training program or standardized protocols for training health professionals and students [8,19,20,29,30]. In addition, it is also suggested that studies should report data regarding reliability and training, not considering that these are already established in the literature [20].…”

Section: Discussionmentioning

confidence: 99%

Inter-Examiner and Intra-Examiner Reliability of Quantitative and Qualitative Ultrasonography Assessment of Peripheral and Respiratory Muscles in Critically Ill Patients

Barbosa

Santos

Alves

et al. 2023

IJERPH

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ICU patients are exposed to several factors that can lead to muscle structural and functional changes, and ultrasonography can identify them. Although several studies have analyzed the reliability of muscle ultrasonography assessment, a protocol with more muscle assessments becomes a challenge. The aim of this study was to analyze the inter and intra-examiner reliability of peripheral and respiratory muscle ultrasonography assessment in critically ill patients. The sample size was 10 individuals aged ≥ 18 years who were admitted to the ICU. Practical training of four health professionals from different backgrounds was performed. After training, each examiner acquired three images to assess the thickness and echogenicity of the muscle groups: biceps brachii, forearm flexor group, quadriceps femoris, tibialis anterior and diaphragm. For the reliability analysis, an intraclass correlation coefficient was performed. Six hundred US images were analyzed for muscle thickness and 150 for echogenicity. Excellent intra-examiner reliability for echogenicity (ICC: 0.867–0.973) and inter-examiner reliability for thickness were found in all muscle groups (ICC: 0.778–0.942). For muscle thickness intra-examiner reliability, excellent results were found (ICC: 0.798–0.988), with a “good” correlation in one diaphragm assessment (ICC: 0.718). Excellent inter- and intra-examiner reliability of the thickness assessment and intra-examiner echogenicity of all muscles analyzed were found.

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Evaluation of Appendicular Muscle Mass in Sarcopenia in Older Adults Using Ultrasonography: A Systematic Review and Meta-Analysis

Cited by 32 publications

References 78 publications

The Muscle Thickness Assessment Using Ultrasonography is a Useful Alternative to Skeletal Muscle Mass by Bioelectrical Impedance Analysis

The Muscle Thickness Assessment Using Ultrasonography is a Useful Alternative to Skeletal Muscle Mass by Bioelectrical Impedance Analysis

The agreement of different techniques for muscle measurement in diagnosing sarcopenia: a systematic review and meta-analysis

Inter-Examiner and Intra-Examiner Reliability of Quantitative and Qualitative Ultrasonography Assessment of Peripheral and Respiratory Muscles in Critically Ill Patients

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