Increase in echo intensity and extracellular-to-intracellular water ratio is independently associated with muscle weakness in elderly women
- 493 Downloads
The changes in muscle composition and its heterogeneity during aging are associated with muscle weakness in elderly persons independent of decreases in muscle mass or muscle thickness (MT). Both the assessment of echo intensity (EI) with ultrasound imaging and the evaluation of the extracellular water/intracellular water (ECW/ICW) ratio with segmental bioelectrical impedance spectroscopy (BIS) are non-invasive and convenient methods and seem valuable for muscle quality determination. However, no previous study has evaluated both EI and the ECW/ICW ratio simultaneously to investigate their relationship to muscle strength. The purpose of the present study was to investigate whether both EI and the ECW/ICW ratio are independently associated with muscle strength in elderly women.
A total of 179 elderly women with a mean age of 74.1 ± 4.9 years, living independently in the community, were enrolled. The MT and EI of the quadriceps femoris were measured using transverse ultrasound imaging. The ECW/ICW ratio in the upper thigh was calculated from segmental BIS. The maximum knee extensor strength and the presence of knee pain were also assessed.
Knee extensor strength showed a significant positive correlation with MT, and significant negative correlations with EI, the ECW/ICW ratio, and age. Stepwise regression analysis revealed that knee extensor strength in elderly women was predicted by MT, EI, and the ECW/ICW ratio.
This study suggests that the simultaneous application of EI and the ECW/ICW ratio is useful in assessing muscle strength, and accurately estimates the changes in muscle quality related to muscle weakness.
KeywordsMuscle strength Muscle quality Echo intensity Extracellular water Muscle thickness
Bioelectrical impedance spectroscopy
Body mass index
The authors would like to thank Nishimura T, Watanabe A, Kaihara C, Iwane K, and Shoji Y for their practical and technical assistance. The authors also thank all individuals who participated in the study. This study was not funded by any institutions, agencies, or companies.
Compliance with ethical standards
Conflict of interest
The authors have no conflicts of interest to disclose.
- Cadore EL, Izquierdo M, Conceicao M, Radaelli R, Pinto RS, Baroni BM, Vaz MA, Alberton CL, Pinto SS, Cunha G, Bottaro M, Kruel LF (2012) Echo intensity is associated with skeletal muscle power and cardiovascular performance in elderly men. Exp Gerontol 47:473–478. doi: 10.1016/j.exger.2012.04.002 CrossRefPubMedGoogle Scholar
- Cruz-Jentoft AJ, Baeyens JP, Bauer JM, Boirie Y, Cederholm T, Landi F, Martin FC, Michel JP, Rolland Y, Schneider SM, Topinkova E, Vandewoude M, Zamboni M, European Working Group on Sarcopenia in Older People (2010) Sarcopenia: European consensus on definition and diagnosis: Report of the European Working Group on Sarcopenia in Older People. Age Ageing 39:412–423. doi: 10.1093/ageing/afq034 CrossRefPubMedPubMedCentralGoogle Scholar
- Fukumoto Y, Ikezoe T, Tateuchi H, Tsukagoshi R, Akiyama H, So K, Kuroda Y, Yoneyama T, Ichihashi N (2012a) Muscle mass and composition of the hip, thigh and abdominal muscles in women with and without hip osteoarthritis. Ultrasound Med Biol 38:1540–1545. doi: 10.1016/j.ultrasmedbio.2012.04.016 CrossRefPubMedGoogle Scholar
- Fukumoto Y, Ikezoe T, Yamada Y, Tsukagoshi R, Nakamura M, Mori N, Kimura M, Ichihashi N (2012b) Skeletal muscle quality assessed from echo intensity is associated with muscle strength of middle-aged and elderly persons. Eur J Appl Physiol 112:1519–1525. doi: 10.1007/s00421-011-2099-5 CrossRefPubMedGoogle Scholar
- Hirani V, Naganathan V, Blyth F, Le Couteur DG, Seibel MJ, Waite LM, Handelsman DJ, Cumming RG (2016) Longitudinal associations between body composition, sarcopenic obesity and outcomes of frailty, disability, institutionalisation and mortality in community-dwelling older men: the Concord Health and Ageing in Men Project. Age Ageing. doi: 10.1093/ageing/afw214 PubMedGoogle Scholar
- Pillen S, Tak RO, Zwarts MJ, Lammens MM, Verrijp KN, Arts IM, van der Laak JA, Hoogerbrugge PM, van Engelen BG, Verrips A (2009) Skeletal muscle ultrasound: correlation between fibrous tissue and echo intensity. Ultrasound Med Biol 35:443–446. doi: 10.1016/j.ultrasmedbio.2008.09.016 CrossRefPubMedGoogle Scholar
- Reid KF, Pasha E, Doros G, Clark DJ, Patten C, Phillips EM, Frontera WR, Fielding RA (2014) Longitudinal decline of lower extremity muscle power in healthy and mobility-limited older adults: influence of muscle mass, strength, composition, neuromuscular activation and single fiber contractile properties. Eur J Appl Physiol 114:29–39. doi: 10.1007/s00421-013-2728-2 CrossRefPubMedPubMedCentralGoogle Scholar
- Rice J, Keogh JWL (2009) Power training: can it improve functional performance in older adults? A systematic review. Int J Exerc Sci 2:131–151Google Scholar
- Yamada Y, Watanabe Y, Ikenaga M, Yokoyama K, Yoshida T, Morimoto T, Kimura M (2013) Comparison of single- or multifrequency bioelectrical impedance analysis and spectroscopy for assessment of appendicular skeletal muscle in the elderly. J Appl Physiol 115:812–818. doi: 10.1152/japplphysiol.00010.2013 CrossRefPubMedGoogle Scholar
- Yamada Y, Buehring B, Krueger D, Anderson R, Schoeller D, Binkley N (2016a) Electrical properties assessed by segmental bioelectrical impedance spectroscopy as biomarkers of age-related loss of skeletal muscle quantity and quality. J Gerontol A Biol Sci Med Sci. doi: 10.1093/gerona/glw125 Google Scholar
- Yamada Y, Yoshida T, Yokoyama K, Watanabe Y, Miyake M, Yamagata E, Yamada M, Kimura M, Kyoto-Kameoka S (2016b) The extracellular to intracellular water ratio in upper legs is negatively associated with skeletal muscle strength and gait speed in older people. J Gerontol A Biol Sci Med Sci. doi: 10.1093/gerona/glw125 Google Scholar
- Yoshimura N, Muraki S, Oka H, Mabuchi A, En-Yo Y, Yoshida M, Saika A, Yoshida H, Suzuki T, Yamamoto S, Ishibashi H, Kawaguchi H, Nakamura K, Akune T (2009) Prevalence of knee osteoarthritis, lumbar spondylosis, and osteoporosis in Japanese men and women: the research on osteoarthritis/osteoporosis against disability study. J Bone Miner Metab 27:620–628. doi: 10.1007/s00774-009-0080-8 CrossRefPubMedGoogle Scholar