Proposal for new diagnostic criteria for low skeletal muscle mass based on computed tomography imaging in Asian adults.
OBJECTIVE
Low skeletal muscle, referred to as sarcopenia, has been shown to be an independent predictor of lower overall survival in various kinds of diseases. Several studies have evaluated the low skeletal muscle mass using computed tomography (CT) imaging. However, the cutoff values based on CT imaging remain undetermined in Asian populations.


METHODS
Preoperative plain CT imaging at the third lumbar vertebrae level was used to measure the psoas muscle mass index (PMI, cm(2)/m(2)) in 541 adult donors for living donor liver transplantation (LDLT). We analyzed PMI distribution according to sex or donor age, and determined the sex-specific cutoff values of PMI to define low skeletal muscle mass.


RESULTS
PMI in men was significantly higher than observed in women (8.85 ± 1.61 cm(2)/m(2) versus 5.77 ± 1.21 cm(2)/m(2); P < 0.001). PMI was significantly lower in individuals ≥50 y than in younger donors in both men and women (P < 0.001 and P < 0.001, respectively). On the basis of the younger donor data, we determined the sex-specific cutoff values for the low skeletal muscle mass were 6.36 cm(2)/m(2) for men and 3.92 cm(2)/m(2) for women (mean - 2 SD).


CONCLUSIONS
Data from healthy young Asian adults were used to establish new criteria for low skeletal muscle mass that would be applicable for defining sarcopenia in Asian populations.
Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Yuhei
Y
Hamaguchi
Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan. Electronic address: kaido@kuhp.kyoto-u.ac.jp.
Toshimi
T
Kaido
Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Shinya
S
Okumura
Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Atsushi
A
Kobayashi
Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan; Department of Surgery, Mansoura University, Mansoura, Egypt.
Ahmed
A
Hammad
Department of Metabolism and Clinical Nutrition, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Yumiko
Y
Tamai
Department of Metabolism and Clinical Nutrition, Graduate School of Medicine, Kyoto University, Kyoto, Japan; Department of Diabetes, Endocrinology and Nutrition, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Nobuya
N
Inagaki
Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Shinji
S
Uemoto
D000328:Adult; D000367:Age Factors; D044466:Asian People; D005260:Female; D006801:Humans; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000033:anatomy & histology / Q000000981:diagnostic imaging* / Q000473:pathology; D016658:Psoas Muscles / Q000033:anatomy & histology / Q000000981:diagnostic imaging / Q000473:pathology; D012016:Reference Values; D055948:Sarcopenia / Q000175:diagnosis / Q000000981:diagnostic imaging*; D012727:Sex Characteristics; D014057:Tomography, X-Ray Computed
Computed tomography; Cutoff value; Healthy young population; Living donor liver transplantation; Psoas muscle mass index; Sarcopenia