Simple Age Specific Cutoff Value for Sarcopenia Evaluated by Computed Tomography

Abstract

Objective: Until now, cutoff values of low skeletal muscle mass using computed tomography (CT) were driven by optimal stratification to predict mortality in cancer patients. The aim of the present study was to investigate the simple, age-specific, cutoff value of low skeletal muscle mass by CT in healthy adults. Design: This is a retrospective, observational, single-center study. Setting: This study was performed in the health screening department of a university-affiliated hospital during a 10-year period. Patients: Medical records of 1,422 patients presenting to the health screening department were reviewed. Cross-sectional area of psoas muscle at the level of the third lumbar vertebra on abdominal CT was measured and adjusted by height (mm²/m²). This value (psoas muscle index [PMI]) was assumed to represent whole skeletal muscle mass. We divided the patients according to age, sex, and defined cutoff value of low skeletal muscle mass as 2 SDs below the mean. Intervention: None. Measurements and Main Results: Among 1,422 patients, 550 patients (38.6%) were male. The mean PMI was 896.60 (mm²/m²) for men and 570.54 (mm²/m²) for women. Cutoff values of PMI for men were 592.3 mm²/m² for 20-39 years, 474.0 mm²/m² for 40-49 years, 422.2 mm²/m² for 50-59 years, 374.4 mm²/m² for 60-69 years, and 331.5 mm²/m² for 70-89 years. The values for women were 399.9 mm²/m² for 20-39 years, 287.7 mm²/m² for 40-49 years, 242.5 mm²/m² for 50-59 years, 220.4 mm²/m² for 60-69 years, and 147.6 mm²/m² for 70-89 years. Conclusions: Cutoff values of low skeletal muscle mass using CT differed in healthy adults as age increased. Further studies on the effect of sarcopenia intervention using this cutoff value are needed.

Quantitative analysis of skeletal muscle by computed tomography imaging—State of the art

“…Later definitions of sarcopenia included impaired muscle strength and/or physical performance [82] , [83] , [84] , [85] . None of these definitions is based on CT, although specific thresholds of the muscle size assessed by CT have been proposed for the diagnosis of sarcopenia [86] . Yet, the controversy on which imaging modality should be preferred is still ongoing [87] , [88] .…”

Standardization of PSOAS Muscle Index Measurements Using Computed Tomography

“…The present study revealed that mean psoas muscle index varied with varying age group. 12,13 The mean psoas muscle index decreased as the age increased mirroring the fact that the skeletal muscle mass decreases with aging. [14][15][16] It was observed that mean psoas muscle index decreased significantly with increasing age (Ref: table 2, table 3).…”

“…[14][15][16] It was observed that mean psoas muscle index decreased significantly with increasing age (Ref: table 2, table 3). As per Asian Working Group for Sarcopenia (AWGS) recommendations and other previous studies sarcopenia is defined as two standard deviations less than the normal value [12][13][14] which has been applied in this study (table4,table5). Moreover, it was observed that mean psoas muscle index in female population was comparatively less than mean psoas muscle index in male population ( figure-1).…”

Radiology methods of the sarcopenia diagnosis

“…Ограничение плотности жировой ткани в диапазоне между -190 и -30 HU позволяет достоверно дифференцировать ее от мышечной массы на аксиальном срезе и активно использовать КТ для диагностики саркопении и ассоциированных с ней состояний. Возросшая доступность метода КТ с возможностью оценки структуры тела человека на любом анатомическом уровне привели к каскаду исследований мышечной массы с использованием совершенно различных индикаторных показателей [11][12][13][14].…”

“…По результатам исследования они определили нижнюю границу нормативных значений данного показателя. Для мужчин в возрасте 50-59 лет она составила 422 мм 2 /м 2 , для женщин -242 мм 2 /м 2 [12].…”