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Validity of mid-arm muscular area measured by anthropometry in nonobese patients with increased muscle atrophy and variation of subcutaneous fat thickness

Abstract

Background:

The anthropometric measurement of mid-arm muscular area (MAMA) involves overestimation because of various assumptions, this overestimation being progressive with increasing adiposity. However, the effects of muscle atrophy and variation of the subcutaneous fat thickness have remained uncertain.

Objectives:

The validity of MAMA estimated by anthropometry was examined by comparing with MAMA measured by computed tomography (CT) in a nonobese population. The effects of muscle atrophy and variation of the subcutaneous fat thickness on the validity of MAMA were examined by new indices.

Subjects/Methods:

The relative MAMA was compared between the anthropometric and CT methods in 45 patients. New indices were introduced for assessing muscle deformity (muscle deformity index, MDI) and subcutaneous fat variation (SFVI). The effects of MDI, SFVI and age on the difference of MAMA between the anthropometric and CT methods were investigated.

Results:

MDIs were positively correlated with age in males (r=0.47, P<0.05) and females (r=0.66, P<0.001). SFVI was positively correlated with age only in females (r=0.54, P<0.01). Even in these patients, the relative MAMA estimated by anthropometry was significantly associated with that measured by CT (r=0.85, P<0.0001 in males and r=0.90, P<0.0001 in females). A Bland–Altman plot indicated that the difference between both methods was relatively small, although increased adiposity might be a source of overestimation for anthropometric MAMA measurement.

Conclusions:

MAMA estimated by anthropometry was a reliable indicator of muscle mass in patients with muscle atrophy and varying thickness of subcutaneous fat in lean patients.

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Acknowledgements

This study was supported by a grant from the COE (Center of Excellence) Program in the 21st Century at the University of Shizuoka.

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Correspondence to H Kumagai.

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Appendix A

Appendix A

MDI defined by a simple model calculation

The progression of muscle deformity can be regarded by a simple approximation from a circle to an ellipse. In this simple geometrical model, a candidate for the deformity index is

where a is the shorter radius and b is the longer radius of the ellipsec.

Parameter r, however, is rather difficult to calculate because the center of the irregularly shaped arm muscle cannot be easily found. We thus introduce MDI in this study as

where MAMC is the mid-arm muscular circumference and MAMA is the mid-arm muscular area.

The validity of this equation can be easily demonstrated. In equations (1) and (2), the quantities of both r and MDI should be independent of the scaling of the body size, so a scale transformation or Weyl transformation (Jackiw, 1972) is performed.

where ew is the scale factor (a positive number; w=0 is the identical transformation).

MDI is expressed as,

where L (a, b) is the circumference of an ellipse, E (k2) is the complete elliptical integral of the second kind and S (a, b) is the area of an ellipse. MDI depends only on scale invariant parameter r=b/a, hence manifesting their scale invariance.

MDI shows a positive association with r in the range of 1r5.

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Saito, R., Ohkawa, S., Ichinose, S. et al. Validity of mid-arm muscular area measured by anthropometry in nonobese patients with increased muscle atrophy and variation of subcutaneous fat thickness. Eur J Clin Nutr 64, 899–904 (2010). https://doi.org/10.1038/ejcn.2010.87

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  • DOI: https://doi.org/10.1038/ejcn.2010.87

Keywords

  • MAMA
  • anthropometry
  • CT
  • MDI
  • SFVI

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