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Computed Tomography-Derived Skeletal Muscle Radiodensity Predicts Peak Weight-Corrected Jump Power in Older Adults: The Korean Urban Rural Elderly (KURE) Study

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Abstract

Computed tomography (CT)-derived skeletal muscle area (SMA) and skeletal muscle radiodensity (SMD) reflect distinctive quantitative and qualitative characteristics of skeletal muscles. However, data on whether CT-based muscle parameters, especially SMD, can predict muscle function is limited. In a prospective cohort, 1523 community-dwelling older adults who underwent abdominal CT scans and the countermovement two-legged jumping test on a ground reaction force platform were analyzed (mean age 74.7 years, 65.1% women). SMA and SMD were measured at third lumbar vertebra level (L3). Individuals with low jump power (peak weight-corrected jump power < 23.8 W/kg in men and < 19.0 W/kg in women using clinically validated threshold) were older; had lower SMA, SMD, and maximal grip strength values; and had lower chair rise test and timed up and go test performance than those without low jump power. SMD was positively associated with peak weight-corrected jump power (adjusted β = 0.33 and 0.23 per 1 HU increase in men and women, respectively, p < 0.001). One HU decrement in SMD was associated with 10% elevated odds of low jump power (adjusted OR [aOR] 1.10, p < 0.001) after adjusting for age, sex, height, inflammation, and insulin resistance markers, whereas the association of SMA with low jump power was attenuated (aOR 1.00, p = 0.721). SMD showed better discrimination for low jump power than SMA (AUC 0.699 vs. 0.617, p < 0.001), with additional improvement when added to SMA and conventional risk factors (AUC 0.745 to 0.773, p < 0.001). Therefore, CT-measured L3 SMD can be a sensitive surrogate marker for muscle function along with SMA in older adults, which merits further investigation.

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Acknowledgements

We thank Sung-Kil Lim Research Award (4-2018-1215) and 2020 Research fund of Department of Internal Medicine, Severance Hospital, Seoul, Korea for the data quality assurance and statistical assistance by the SENTINEL (Severance ENdocrinology daTa scIeNcE pLatform) team.

Funding

This research was funded by the Korea Centers for Disease Control and Prevention (2013-E63007-01, 2013-E63007-02, 2019-ER6302-01), and Internal Medicine.

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Author notes

  1. Heewon Choi and Namki Hong have contributed equally to this work.

Authors and Affiliations

  1. Yonsei University College of Medicine, Seoul, South Korea

    Heewon Choi

  2. Department of Internal Medicine, Severance Hospital, Endocrine Research Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea

    Namki Hong, Narae Park & Yumie Rhee

  3. Division of Geriatrics, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea

    Chang Oh Kim

  4. Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, South Korea

    Hyeon Chang Kim

  5. Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, South Korea

    Jin Young Choi

  6. Department of Sociology, Yonsei University College of Social Sciences, Seoul, South Korea

    Yoosik Youm

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Contributions

HC and NH participated in the study concept and design, analysis and interpretation of data, and preparation and revision of manuscript. Extraction of data was done by HC and NP. HCK, JYC, YY played a role in the preparation phase of the paper by performing subject recruitment and data collection. YR contributed in acquisition of subjects and data, interpretation, and revision and final approval of manuscript.

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Correspondence to Yumie Rhee.

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Conflict of interest

Heewon Choi, Namki Hong, Narae Park, Chang Oh Kim, Hyeon Chang Kim, Jin Young Choi, Yoosik Youm, and Yumie Rhee have no conflicts of interest to declare.

Ethical Approval

This study was approved by Institutional Review Board of Severance Hospital (IRB No. 4–2012-0172). All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committees and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Written informed consent was obtained from all participants prior to the study.

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Choi, H., Hong, N., Park, N. et al. Computed Tomography-Derived Skeletal Muscle Radiodensity Predicts Peak Weight-Corrected Jump Power in Older Adults: The Korean Urban Rural Elderly (KURE) Study. Calcif Tissue Int 108, 764–774 (2021). https://doi.org/10.1007/s00223-021-00812-9

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