Skeletal muscle cutoff values for sarcopenia diagnosis using T10 to L5 measurements in a healthy US population

Abstract Measurements of skeletal muscle cross-sectional area, index, and radiation attenuation utilizing clinical computed tomography (CT) scans are used in assessments of sarcopenia, the loss of skeletal muscle mass and function associated with aging. To classify individuals as sarcopenic, sex-spe...

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Autores principales:	Brian A. Derstine, Sven A. Holcombe, Brian E. Ross, Nicholas C. Wang, Grace L. Su, Stewart C. Wang
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2018
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/ae3541d683554e7a8b5df972fbd85be5
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spelling	oai:doaj.org-article:ae3541d683554e7a8b5df972fbd85be52021-12-02T15:08:13ZSkeletal muscle cutoff values for sarcopenia diagnosis using T10 to L5 measurements in a healthy US population10.1038/s41598-018-29825-52045-2322https://doaj.org/article/ae3541d683554e7a8b5df972fbd85be52018-07-01T00:00:00Zhttps://doi.org/10.1038/s41598-018-29825-5https://doaj.org/toc/2045-2322Abstract Measurements of skeletal muscle cross-sectional area, index, and radiation attenuation utilizing clinical computed tomography (CT) scans are used in assessments of sarcopenia, the loss of skeletal muscle mass and function associated with aging. To classify individuals as sarcopenic, sex-specific cutoffs for ‘low’ values are used. Conventionally, cutoffs for skeletal muscle measurements at the level of the third lumbar (L3) vertebra are used, however L3 is not included in several clinical CT protocols. Non-contrast-enhanced CT scans from healthy kidney donor candidates (age 18–40) at Michigan Medicine were utilized. Skeletal muscle area (SMA), index (SMI), and mean attenuation (SMRA) were measured at each vertebral level between the tenth thoracic (T10) and the fifth lumbar (L5) vertebra. Sex-specific means, standard deviations (s.d.), and sarcopenia cutoffs (mean-2 s.d.) at each vertebral level were computed. Associations between vertebral levels were assessed using Pearson correlations and Tukey’s difference test. Classification agreement between different vertebral level cutoffs was assessed using overall accuracy, specificity, and sensitivity. SMA, SMI, and SMRA L3 cutoffs for sarcopenia were 92.2 cm2, 34.4 cm2/m2, and 34.3 HU in females, and 144.3 cm2, 45.4 cm2/m2, and 38.5 HU in males, consistent with previously reported cutoffs. Correlations between all level pairs were statistically significant and high, ranging from 0.65 to 0.95 (SMA), 0.64 to 0.95 (SMI), and 0.63 to 0.95 (SMRA). SMA peaks at L3, supporting its use as the primary site for CT sarcopenia measurements. However, when L3 is not available alternative levels (in order of preference) are L2, L4, L5, L1, T12, T11, and T10. Healthy reference values reported here enable sarcopenia assessment and sex-specific standardization of SMA, SMI, and SMRA in clinical populations, including those whose CT protocols do not include L3.Brian A. DerstineSven A. HolcombeBrian E. RossNicholas C. WangGrace L. SuStewart C. WangNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 8, Iss 1, Pp 1-8 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Brian A. Derstine Sven A. Holcombe Brian E. Ross Nicholas C. Wang Grace L. Su Stewart C. Wang Skeletal muscle cutoff values for sarcopenia diagnosis using T10 to L5 measurements in a healthy US population
description	Abstract Measurements of skeletal muscle cross-sectional area, index, and radiation attenuation utilizing clinical computed tomography (CT) scans are used in assessments of sarcopenia, the loss of skeletal muscle mass and function associated with aging. To classify individuals as sarcopenic, sex-specific cutoffs for ‘low’ values are used. Conventionally, cutoffs for skeletal muscle measurements at the level of the third lumbar (L3) vertebra are used, however L3 is not included in several clinical CT protocols. Non-contrast-enhanced CT scans from healthy kidney donor candidates (age 18–40) at Michigan Medicine were utilized. Skeletal muscle area (SMA), index (SMI), and mean attenuation (SMRA) were measured at each vertebral level between the tenth thoracic (T10) and the fifth lumbar (L5) vertebra. Sex-specific means, standard deviations (s.d.), and sarcopenia cutoffs (mean-2 s.d.) at each vertebral level were computed. Associations between vertebral levels were assessed using Pearson correlations and Tukey’s difference test. Classification agreement between different vertebral level cutoffs was assessed using overall accuracy, specificity, and sensitivity. SMA, SMI, and SMRA L3 cutoffs for sarcopenia were 92.2 cm2, 34.4 cm2/m2, and 34.3 HU in females, and 144.3 cm2, 45.4 cm2/m2, and 38.5 HU in males, consistent with previously reported cutoffs. Correlations between all level pairs were statistically significant and high, ranging from 0.65 to 0.95 (SMA), 0.64 to 0.95 (SMI), and 0.63 to 0.95 (SMRA). SMA peaks at L3, supporting its use as the primary site for CT sarcopenia measurements. However, when L3 is not available alternative levels (in order of preference) are L2, L4, L5, L1, T12, T11, and T10. Healthy reference values reported here enable sarcopenia assessment and sex-specific standardization of SMA, SMI, and SMRA in clinical populations, including those whose CT protocols do not include L3.
format	article
author	Brian A. Derstine Sven A. Holcombe Brian E. Ross Nicholas C. Wang Grace L. Su Stewart C. Wang
author_facet	Brian A. Derstine Sven A. Holcombe Brian E. Ross Nicholas C. Wang Grace L. Su Stewart C. Wang
author_sort	Brian A. Derstine
title	Skeletal muscle cutoff values for sarcopenia diagnosis using T10 to L5 measurements in a healthy US population
title_short	Skeletal muscle cutoff values for sarcopenia diagnosis using T10 to L5 measurements in a healthy US population
title_full	Skeletal muscle cutoff values for sarcopenia diagnosis using T10 to L5 measurements in a healthy US population
title_fullStr	Skeletal muscle cutoff values for sarcopenia diagnosis using T10 to L5 measurements in a healthy US population
title_full_unstemmed	Skeletal muscle cutoff values for sarcopenia diagnosis using T10 to L5 measurements in a healthy US population
title_sort	skeletal muscle cutoff values for sarcopenia diagnosis using t10 to l5 measurements in a healthy us population
publisher	Nature Portfolio
publishDate	2018
url	https://doaj.org/article/ae3541d683554e7a8b5df972fbd85be5
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_version_	1718388272475930624

Skeletal muscle cutoff values for sarcopenia diagnosis using T10 to L5 measurements in a healthy US population

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