Radiographic Thigh Muscle Measurements Are a Reliable Predictor of Psoas Area and Sarcopenia.


Journal

The Journal of bone and joint surgery. American volume
ISSN: 1535-1386
Titre abrégé: J Bone Joint Surg Am
Pays: United States
ID NLM: 0014030

Informations de publication

Date de publication:
10 Apr 2024
Historique:
medline: 10 4 2024
pubmed: 10 4 2024
entrez: 10 4 2024
Statut: aheadofprint

Résumé

Sarcopenia is associated with falls, fractures, postoperative complications such as periprosthetic joint infections and dislocations, and early mortality. Although cross-sectional imaging is currently used to diagnose sarcopenia, inexpensive and widely available screening tests are needed. The goal of this study was to investigate whether measurements of thigh muscles made on radiographs can predict psoas muscle area and the presence of sarcopenia as determined on computed tomography (CT) scans. A retrospective radiographic review was performed to measure thigh muscle area in the coronal and sagittal planes using the differential in soft-tissue attenuation. Psoas muscle area on CT at L3 and L4 served as the gold standard for the diagnosis of sarcopenia. The correlation between thigh muscle and psoas muscle areas was determined, and multivariable models were developed to identify predictors of psoas muscle area and sarcopenia. Four hundred and fourteen patients (252 male, 162 female) were identified. Seventy-six (18.4%) of the patients had an L4 psoas muscle area below the sex-specific cutoff value for sarcopenia. Patients with sarcopenia on abdominal CT had significantly smaller thigh muscle measurements on all radiographic views. The mean and standard deviation of the thigh muscle measurements were determined for the entire cohort and for patients with sarcopenia, as well as for adults aged 18 to 40 years without sarcopenia to provide normative reference values. The intraclass correlation coefficients were >0.8 for all radiographic measurements. The anteroposterior-view measurement of thigh muscle width and lateral-view measurement of quadriceps height were identified as independent predictors of both psoas muscle area and sarcopenia. Measurements of thigh muscle size made on radiographs can predict both psoas muscle area and sarcopenia. These measurements are a reliable and readily available screening tool to aid in the diagnosis and treatment of sarcopenia in the orthopaedic population. Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

Sections du résumé

BACKGROUND BACKGROUND
Sarcopenia is associated with falls, fractures, postoperative complications such as periprosthetic joint infections and dislocations, and early mortality. Although cross-sectional imaging is currently used to diagnose sarcopenia, inexpensive and widely available screening tests are needed. The goal of this study was to investigate whether measurements of thigh muscles made on radiographs can predict psoas muscle area and the presence of sarcopenia as determined on computed tomography (CT) scans.
METHODS METHODS
A retrospective radiographic review was performed to measure thigh muscle area in the coronal and sagittal planes using the differential in soft-tissue attenuation. Psoas muscle area on CT at L3 and L4 served as the gold standard for the diagnosis of sarcopenia. The correlation between thigh muscle and psoas muscle areas was determined, and multivariable models were developed to identify predictors of psoas muscle area and sarcopenia.
RESULTS RESULTS
Four hundred and fourteen patients (252 male, 162 female) were identified. Seventy-six (18.4%) of the patients had an L4 psoas muscle area below the sex-specific cutoff value for sarcopenia. Patients with sarcopenia on abdominal CT had significantly smaller thigh muscle measurements on all radiographic views. The mean and standard deviation of the thigh muscle measurements were determined for the entire cohort and for patients with sarcopenia, as well as for adults aged 18 to 40 years without sarcopenia to provide normative reference values. The intraclass correlation coefficients were >0.8 for all radiographic measurements. The anteroposterior-view measurement of thigh muscle width and lateral-view measurement of quadriceps height were identified as independent predictors of both psoas muscle area and sarcopenia.
CONCLUSIONS CONCLUSIONS
Measurements of thigh muscle size made on radiographs can predict both psoas muscle area and sarcopenia. These measurements are a reliable and readily available screening tool to aid in the diagnosis and treatment of sarcopenia in the orthopaedic population.
LEVEL OF EVIDENCE METHODS
Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

Identifiants

pubmed: 38598605
doi: 10.2106/JBJS.23.01177
pii: 00004623-990000000-01069
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2024 by The Journal of Bone and Joint Surgery, Incorporated.

Déclaration de conflit d'intérêts

Disclosure: No external funding was received for this work. The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJS/H963).

Références

Oliveira A, Vaz C. The role of sarcopenia in the risk of osteoporotic hip fracture. Clin Rheumatol. 2015 Oct;34(10):1673-80.
Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyère O, Cederholm T, Cooper C, Landi F, Rolland Y, Sayer AA, Schneider SM, Sieber CC, Topinkova E, Vandewoude M, Visser M, Zamboni M; Writing Group for the European Working Group on Sarcopenia in Older People 2 (EWGSOP2), and the Extended Group for EWGSOP2. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019 Jul 1;48(4):601.
Cruz-Jentoft AJ, Baeyens JP, Bauer JM, Boirie Y, Cederholm T, Landi F, Martin FC, Michel JP, Rolland Y, Schneider SM, Topinková E, Vandewoude M, Zamboni M; European Working Group on Sarcopenia in Older People. Sarcopenia: European consensus on definition and diagnosis: Report of the European Working Group on Sarcopenia in Older People. Age Ageing. 2010 Jul;39(4):412-23.
Han A, Bokshan SL, Marcaccio SE, DePasse JM, Daniels AH. Diagnostic Criteria and Clinical Outcomes in Sarcopenia Research: A Literature Review. J Clin Med. 2018 Apr 8;7(4):70.
González-Montalvo JI, Alarcón T, Gotor P, Queipo R, Velasco R, Hoyos R, Pardo A, Otero A. Prevalence of sarcopenia in acute hip fracture patients and its influence on short-term clinical outcome. Geriatr Gerontol Int. 2016 Sep;16(9):1021-7.
Yu S, Appleton S, Adams R, Chapman I, Wittert G, Visvanathan T, Visvanathan R. The impact of low muscle mass definition on the prevalence of sarcopenia in older Australians. Biomed Res Int. 2014;2014:361790.
Santilli V, Bernetti A, Mangone M, Paoloni M. Clinical definition of sarcopenia. Clin Cases Miner Bone Metab. 2014 Sep;11(3):177-80.
Su H, Ruan J, Chen T, Lin E, Shi L. CT-assessed sarcopenia is a predictive factor for both long-term and short-term outcomes in gastrointestinal oncology patients: a systematic review and meta-analysis. Cancer Imaging. 2019 Dec 3;19(1):82.
Steihaug OM, Gjesdal CG, Bogen B, Kristoffersen MH, Lien G, Ranhoff AH. Sarcopenia in patients with hip fracture: A multicenter cross-sectional study. PLoS One. 2017 Sep 13;12(9):e0184780.
Boutin RD, Bamrungchart S, Bateni CP, Beavers DP, Beavers KM, Meehan JP, Lenchik L. CT of Patients With Hip Fracture: Muscle Size and Attenuation Help Predict Mortality. AJR Am J Roentgenol. 2017 Jun;208(6):W208-15.
Joglekar S, Nau PN, Mezhir JJ. The impact of sarcopenia on survival and complications in surgical oncology: A review of the current literature. J Surg Oncol. 2015 Oct;112(5):503-9.
Babu JM, Kalagara S, Durand W, Antoci V, Deren ME, Cohen E. Sarcopenia as a Risk Factor for Prosthetic Infection After Total Hip or Knee Arthroplasty. J Arthroplasty. 2019 Jan;34(1):116-22.
Chang K, Albright JA, Testa EJ, Balboni AB, Daniels AH, Cohen E. Sarcopenia is associated with an increased risk of postoperative complications following total hip arthroplasty for osteoarthritis. Biology (Basel). 2023 Feb 13;12(2):295.
Albright JA, Chang K, Alsoof D, McDonald CL, Diebo BG, Daniels AH. Sarcopenia and Postoperative Complications, Cost of Care, and All-Cause Hospital Readmission Following Lumbar Spine Arthrodesis: A Propensity Matched Cohort Study. World Neurosurg. 2023 Jan;169:e131-40.
Bokshan SL, Han AL, DePasse JM, Eltorai AE, Marcaccio SE, Palumbo MA, Daniels AH. Effect of sarcopenia on postoperative morbidity and mortality after thoracolumbar spine surgery. Orthopedics. 2016 Nov 1;39(6):e1159-64.
Schweitzer L, Geisler C, Pourhassan M, Braun W, Glüer CC, Bosy-Westphal A, Müller MJ. What is the best reference site for a single MRI slice to assess whole-body skeletal muscle and adipose tissue volumes in healthy adults? Am J Clin Nutr. 2015 Jul;102(1):58-65.
Kara M, Kaymak B, Ata AM, Özkal Ö, Kara Ö, Baki A, Şengül Ayçiçek G, Topuz S, Karahan S, Soylu AR, Çakır B, Halil M, Özçakar L. STAR—sonographic thigh adjustment ratio: a golden formula for the diagnosis of sarcopenia. Am J Phys Med Rehabil. 2020 Oct;99(10):902-8.
Frontera WR, Reid KF, Phillips EM, Krivickas LS, Hughes VA, Roubenoff R, Fielding RA. Muscle fiber size and function in elderly humans: a longitudinal study. J Appl Physiol (1985). 2008 Aug;105(2):637-42.
Maden-Wilkinson TM, Degens H, Jones DA, McPhee JS. Comparison of MRI and DXA to measure muscle size and age-related atrophy in thigh muscles. J Musculoskelet Neuronal Interact. 2013 Sep;13(3):320-8.
Abe T, Sakamaki M, Yasuda T, Bemben MG, Kondo M, Kawakami Y, Fukunaga T. Age-related, site-specific muscle loss in 1507 Japanese men and women aged 20 to 95 years. J Sports Sci Med. 2011 Mar 1;10(1):145-50.
Aitken SA. Normative Values for Femoral Length, Tibial Length, and the Femorotibial Ratio in Adults Using Standing Full-Length Radiography. Osteology. 2021;1(2):86-91.
Derstine BA, Holcombe SA, Ross BE, Wang NC, Su GL, Wang SC. Skeletal muscle cutoff values for sarcopenia diagnosis using T10 to L5 measurements in a healthy US population. Sci Rep. 2018 Jul 27;8(1):11369.
Tomov M, Alvi MA, Elminawy M, Currier B, Yaszemski M, Nassr A, Huddleston P, Sebastian A, Bydon M, Freedman B. An objective and reliable method for identifying sarcopenia in lumbar spine surgery patients: using morphometric measurements on computed tomography imaging. Asian Spine J. 2020 Dec;14(6):814-20.
Ito K, Ookawara S, Imai S, Kakuda H, Bandai Y, Fueki M, Yasuda M, Kamimura T, Kiryu S, Wada N, Hamashima Y, Shindo M, Kobayashi T, Sanayama H, Kaku Y, Tanno K, Ohnishi Y, Iino N, Dezaki K, Kakei M, Tabei K, Morishita Y. Muscle mass evaluation using psoas muscle mass index by computed tomography imaging in hemodialysis patients. Clin Nutr ESPEN. 2021 Aug;44:410-4.
Derstine BA, Holcombe SA, Goulson RL, Ross BE, Wang NC, Sullivan JA, Su GL, Wang SC. Quantifying sarcopenia reference values using lumbar and thoracic muscle areas in a healthy population. J Nutr Health Aging. 2017;21(10):180-5.
Batista AFR, Petty D, Fairhurst C, Davies S. Psoas muscle mass index as a predictor of long-term mortality and severity of complications after major intra-abdominal colorectal surgery - A retrospective analysis. J Clin Anesth. 2023 Feb;84:110995.
Iannuzzi-Sucich M, Prestwood KM, Kenny AM. Prevalence of sarcopenia and predictors of skeletal muscle mass in healthy, older men and women. J Gerontol A Biol Sci Med Sci. 2002 Dec;57(12):M772-7.
Melton LJ 3rd, Khosla S, Crowson CS, O’Connor MK, O’Fallon WM, Riggs BL. Epidemiology of sarcopenia. J Am Geriatr Soc. 2000 Jun;48(6):625-30.
Schmidt AF, Finan C. Linear regression and the normality assumption. J Clin Epidemiol. 2018 Jun;98:146-51.
Casson RJ, Farmer LD. Understanding and checking the assumptions of linear regression: a primer for medical researchers. Clin Exp Ophthalmol. 2014 Aug;42(6):590-6.
Lewis-Beck C, Lewis-Beck M. Applied regression: An introduction. Sage; 2015.
Koo TK, Li MY. A guideline of selecting and reporting intraclass correlation coefficients for reliability research. J Chiropr Med. 2016 Jun;15(2):155-63.
Leach RE, Gregg T, Siber FJ. Weight-bearing radiography in osteoarthritis of the knee. Radiology. 1970 Nov;97(2):265-8.
Kan H, Arai Y, Kobayashi M, Nakagawa S, Inoue H, Hino M, Komaki S, Ikoma K, Ueshima K, Fujiwara H, Kubo T. Radiographic measurement of joint space width using the fixed flexion view in 1,102 knees of Japanese patients with osteoarthritis in comparison with the standing extended view. Knee Surg Relat Res. 2017 Mar 1;29(1):63-8.
Willey MC, Owen EC, Miller A, Glass N, Kirkpatrick T, Fitzpatrick D, et al. Substantial Loss of Skeletal Muscle Mass Occurs After Femoral Fragility Fracture. J Bone Joint Surg Am. 2023;105(22):1777-85.
Baumgartner RN, Wayne SJ, Waters DL, Janssen I, Gallagher D, Morley JE. Sarcopenic obesity predicts instrumental activities of daily living disability in the elderly. Obes Res. 2004 Dec;12(12):1995-2004.
Gill S, McBurney H. Reliability of performance-based measures in people awaiting joint replacement surgery of the hip or knee. Physiother Res Int. 2008 Sep;13(3):141-52.
Bahl JS, Nelson MJ, Taylor M, Solomon LB, Arnold JB, Thewlis D. Biomechanical changes and recovery of gait function after total hip arthroplasty for osteoarthritis: a systematic review and meta-analysis. Osteoarthritis Cartilage. 2018 Jul;26(7):847-63.
Lee K, Shin Y, Huh J, Sung YS, Lee IS, Yoon KH, Kim KW. Recent Issues on Body Composition Imaging for Sarcopenia Evaluation. Korean J Radiol. 2019 Feb;20(2):205-17.

Auteurs

Benjamin Lurie (B)

Department of Orthopaedic Surgery, Kirk Kerkorian School of Medicine, University of Nevada Las Vegas, Las Vegas, Nevada.
Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California.

Karen Nelson (K)

Department of Orthopaedic Surgery, Kirk Kerkorian School of Medicine, University of Nevada Las Vegas, Las Vegas, Nevada.

Janel Pietryga (J)

Department of Orthopaedic Surgery, Kirk Kerkorian School of Medicine, University of Nevada Las Vegas, Las Vegas, Nevada.

Daniel Urness (D)

Department of Orthopaedic Surgery, Kirk Kerkorian School of Medicine, University of Nevada Las Vegas, Las Vegas, Nevada.

Michael Daubs (M)

Department of Orthopaedic Surgery, Kirk Kerkorian School of Medicine, University of Nevada Las Vegas, Las Vegas, Nevada.

Erik Kubiak (E)

Department of Orthopaedic Surgery, Kirk Kerkorian School of Medicine, University of Nevada Las Vegas, Las Vegas, Nevada.

Jeff Surina (J)

Department of Orthopaedic Surgery, Kirk Kerkorian School of Medicine, University of Nevada Las Vegas, Las Vegas, Nevada.

Classifications MeSH