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Computed Tomography-Derived Skeletal Muscle Radiodensity Is an Early, Sensitive Marker of Age-Related Musculoskeletal Changes in Healthy Adults

 Yeon Woo Jung  ;  Namki Hong  ;  Joon Chae Na  ;  Woong Kyu Han  ;  Yumie Rhee 
 Endocrinology and Metabolism (대한내분비학회지), Vol.36(6) : 1201-1210, 2021-12 
Journal Title
Endocrinology and Metabolism(대한내분비학회지)
Issue Date
Aging ; Computed tomography ; Diagnostic screening programs ; Osteoporosis ; Sarcopenia
Background: A decrease in computed tomography (CT)-derived skeletal muscle radiodensity (SMD) reflects age-related ectopic fat infiltration of muscle, compromising muscle function and metabolism. We investigated the age-related trajectory of SMD and its association with vertebral trabecular bone density in healthy adults.

Methods: In a cohort of healthy adult kidney donors aged 19 to 69 years (n=583), skeletal muscle index (SMI, skeletal muscle area/height2), SMD, and visceral-to-subcutaneous fat (V/S) ratio were analyzed at the level of L3 from preoperative CT scans. Low bone mass was defined as an L1 trabecular Hounsfield unit (HU) <160 HU.

Results: L3SMD showed constant decline from the second decade (annual change -0.38% and -0.43% in men and women), whereas the decline of L3SMI became evident only after the fourth decade of life (-0.37% and -0.18% in men and women). One HU decline in L3SMD was associated with elevated odds of low bone mass (adjusted odds ratio, 1.07; 95% confidence interval, 1.02 to 1.13; P=0.003), independent of L3SMI, age, sex, and V/S ratio, with better discriminatory ability compared to L3SMI (area under the receiver-operating characteristics curve 0.68 vs. 0.53, P<0.001). L3SMD improved the identification of low bone mass when added to age, sex, V/S ratio, and L3SMI (category-free net reclassification improvement 0.349, P<0.001; integrated discrimination improvement 0.015, P=0.0165).

Conclusion: L3SMD can be an early marker for age-related musculoskeletal changes showing linear decline throughout life from the second decade in healthy adults, with potential diagnostic value for individuals with low bone mass.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
Na, Joon Chae(나준채) ORCID logo https://orcid.org/0000-0003-4449-8472
Rhee, Yumie(이유미) ORCID logo https://orcid.org/0000-0003-4227-5638
Han, Woong Kyu(한웅규) ORCID logo https://orcid.org/0000-0002-2527-4046
Hong, Nam Ki(홍남기) ORCID logo https://orcid.org/0000-0002-8246-1956
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