Frontiers in physiology · 2025
Age- and sex-specific reference values for CT-based low skeletal muscle quantity and quality in healthy living kidney donors.
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Martin David, Dolce Paola, Hübner Martin, Zingg Tobias, Fuks David, Venetz Jean-Pierre, Maier Damien, Matter Maurice, Becce Fabio
Аннотация
BACKGROUND: Computed tomography (CT) imaging is a useful tool for assessing skeletal muscle mass and quality. The present study aimed to determine age- and sex-specific reference values for CT-based skeletal muscle markers in a healthy population, and to correlate them with serum creatinine and 24-h urinary creatinine excretion (24h-UCE).
METHODS: Skeletal muscle index (SMI) - a marker of muscle mass/quantity - and skeletal muscle radiation attenuation (SMRA) and intermuscular adipose tissue index (IMATI) - markers of muscle quality/myosteatosis - were determined using a deep-learning-based method from axial CT images at the level of the 3rd lumbar vertebra in living kidney donors assessed between 01/2005 and 05/2023. Age- and sex-specific reference values were determined by the 5th percentile, and correlation was tested with the Pearson correlation coefficient.
RESULTS: CT scans of 394 healthy individuals were included. The mean age was 53 years (SD 12), mean BMI was 25.2 kg/m2 (SD 3.9), and 130 patients (33%) were male. The reference values for low skeletal muscle mass (SMI) in males were 43.7 cm2/m2 (20-39 years), 44.9 cm2/m2 (40-59 years), and 39.7 cm2/m2 (≥60 years). In females, the corresponding values were 33.8 cm2/m2 (20-39 years), 34.8 cm2/m2 (40-59 years), and 31.2 cm2/m2 (≥60 years). SMI showed a moderate correlation with serum creatinine (r = 0.452, p < 0.001) but a weak correlation with 24h-UCE (r = 0.188, p = 0.003). Correlations were all weak for SMRA (creatinine: r = 0.220, p < 0.001; 24h-UCE: r = 0.177, p = 0.006) and IMATI (creatinine: r = -0.101, p = 0.054; 24h-UCE, r = -0.108, p = 0.093).
CONCLUSION: The age- and sex-specific reference values reported here could be used in clinical practice and future studies to identify patients at risk of muscle decline.
METHODS: Skeletal muscle index (SMI) - a marker of muscle mass/quantity - and skeletal muscle radiation attenuation (SMRA) and intermuscular adipose tissue index (IMATI) - markers of muscle quality/myosteatosis - were determined using a deep-learning-based method from axial CT images at the level of the 3rd lumbar vertebra in living kidney donors assessed between 01/2005 and 05/2023. Age- and sex-specific reference values were determined by the 5th percentile, and correlation was tested with the Pearson correlation coefficient.
RESULTS: CT scans of 394 healthy individuals were included. The mean age was 53 years (SD 12), mean BMI was 25.2 kg/m2 (SD 3.9), and 130 patients (33%) were male. The reference values for low skeletal muscle mass (SMI) in males were 43.7 cm2/m2 (20-39 years), 44.9 cm2/m2 (40-59 years), and 39.7 cm2/m2 (≥60 years). In females, the corresponding values were 33.8 cm2/m2 (20-39 years), 34.8 cm2/m2 (40-59 years), and 31.2 cm2/m2 (≥60 years). SMI showed a moderate correlation with serum creatinine (r = 0.452, p < 0.001) but a weak correlation with 24h-UCE (r = 0.188, p = 0.003). Correlations were all weak for SMRA (creatinine: r = 0.220, p < 0.001; 24h-UCE: r = 0.177, p = 0.006) and IMATI (creatinine: r = -0.101, p = 0.054; 24h-UCE, r = -0.108, p = 0.093).
CONCLUSION: The age- and sex-specific reference values reported here could be used in clinical practice and future studies to identify patients at risk of muscle decline.