Normative Data for Lean Mass Using FNIH Criteria in an Australian Setting
Recommendations from the FNIH Sarcopenia Project are that appendicular lean mass (ALM, kg) adjusted for body mass index (BMI, kg/m2) be used for identifying low lean mass, with ALM/BMI cutpoints of < 0.789 m2 for men and < 0.512 m2 for women. We report normative ALM/BMI values for Australian adults, and compare the performance of cutpoints derived from reference values for this population with FNIH values for identifying low lean mass. Body composition was measured by DXA (Lunar) for 1411 men and 960 women, aged 20–93 years, from the Geelong Osteoporosis Study, a population-based study in Australia. Sex-stratified means and standard deviations for DXA-derived ALM/BMI were generated for each age-decade, and cutpoints equivalent to T-scores of − 2.0 were derived using reference data for 374 men and 308 women aged 20–39 years. Mean ALM/BMI values were greater for men than women, and decreased with age in both sexes. Cutpoints for ALM/BMI corresponding to T-scores of − 2.0 were 0.827 m2 for men and 0.518 m2 for women. For individuals aged 65+ years, cross-classification of low lean mass according to FNIH criteria (ALM/BMI < 0.789 m2 men and < 0.512 m2 women) in comparison with our cutpoints for ALM/BMI showed overall agreement of 94.6% for men and 99.0% for women (κ 0.73 and 0.89, respectively). We report good agreement for low ALM indexed to BMI, particularly for women, between classifications based on recommendations from the FNIH Sarcopenia Project for identifying clinically significant weakness, with low values identified within our population distribution of ALM/BMI.
KeywordsAppendicular lean mass Body composition Muscle mass Sarcopenia Reference data
The authors acknowledge the men and women who participated in the study.
The Geelong Osteoporosis Study (GOS) was funded by the National Health and Medical Research Council (NHMRC) Australia (Projects 299831, 251638, 628582). The funding organisations played no role in the design or conduct of the study, in the collection, management, analysis and interpretation of the data, nor in the preparation, review and approval of the manuscript. SXS, MCT and PGR were supported by Deakin Postgraduate Scholarships and KLH-K was supported by an Alfred Deakin Postdoctoral Research Fellowship.
Compliance with Ethical Standards
Conflict of interest
Julie A. Pasco, Kara L. Holloway-Kew, Monica C. Tembo, Sophia X. Sui, Kara B. Anderson, Pamela Rufus-Membere, Natalie K. Hyde, Lana J. Williams, Mark A. Kotowicz have declared that no competing interests exist.
The study was approved by Barwon Health’s Human Research Ethics Committee.
Human and Animal Rights and Informed Consent
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. Informed consent was obtained from all individual participants included in the study.
- 2.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 (2010) Sarcopenia: European consensus on definition and diagnosis: report of the European Working Group on Sarcopenia in older people. Age Ageing 39:412–423CrossRefPubMedGoogle Scholar
- 6.Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyere 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 (2018) Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. https://doi.org/10.1093/ageing/afy169 (Epub ahead of print)Google Scholar
- 7.Studenski SA, Peters KW, Alley DE, Cawthon PM, McLean RR, Harris TB, Ferrucci L, Guralnik JM, Fragala MS, Kenny AM, Kiel DP, Kritchevsky SB, Shardell MD, Dam TT, Vassileva MT (2014) The FNIH sarcopenia project: rationale, study description, conference recommendations, and final estimates. J Gerontol A 69:547–558CrossRefGoogle Scholar
- 8.Cawthon PM, Peters KW, Shardell MD, McLean RR, Dam TT, Kenny AM, Fragala MS, Harris TB, Kiel DP, Guralnik JM, Ferrucci L, Kritchevsky SB, Vassileva MT, Studenski SA, Alley DE (2014) Cutpoints for low appendicular lean mass that identify older adults with clinically significant weakness. J Gerontol A 69:567–575CrossRefGoogle Scholar