Abstract
Objectives
There is increasing evidence that muscle volume and mass are poor predictors of muscle
strength and physical performance. Other assessments of muscle quality such as skeletal
muscle density measured by computed tomography (CT) may be more important. The aim
of this study was to explore associations of muscle size and density with handgrip
strength (HGS) and the Timed Up and Go test (TUG). We also hypothesized that the strength
of these associations would depend on the specific muscle of muscle group, namely
trunk, hip, and mid-thigh muscles.
Design
Cross-sectional study.
Setting and Participants
University hospital; 316 volunteers aged 59 to 85 years.
Methods
HGS, TUG, and quantitative CT imaging of the lumber, hip, and mid-thigh were performed
in volunteers. From the CT images, cross-sectional area and attenuation were determined
for the gluteus muscle, trunk muscle at vertebrae L2 level, and mid-thigh muscle.
Results
In men and women, associations of muscle area with TUG were insignificant after adjustment
for age, height, and weight. Associations with HGS were only significant in men for
the gluteus maximus and the mid-thigh but slopes were rather low (β < 0.20). Associations
between muscle density and TUG/HGS were more pronounced, in particular for HGS. After
adjustment, associations with TUG were significant in women for the gluteus maximus
and trunk muscle even (β −0.06, P .001 and β −0.07, P .031, respectively).
Conclusions and Implications
Muscle density is more strongly associated with muscle strength than muscle size andin
women muscle density was also more strongly associated than muscle size with physical
performance. Therefore, muscle density may represent a more clinically meaningful
surrogate of muscle performance than muscle size. Muscle density measurements of trunk
and gluteus muscles can be easily obtained from routine CT scan and, therefore, may
become an important measurement to diagnose and screen for sarcopenia.
Keywords
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Article info
Publication history
Published online: August 05, 2020
Footnotes
This work was supported in part by the National Natural Science Foundation of China (Grant no. 81901718; 81971617; 81771831), the Beijing Natural Science Foundation-Haidian Primitive Innovation Joint Fund (grant no. L172019), and the Beijing Municipal Administration of Hospitals Clinical Medicine Development of Special Funding Support (code: XMLX201843).
Klaus Engelke is a part time employee of BioClinica, Inc. The other authors declare no conflict of interest.
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© 2020 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
