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Body composition, energy expenditure and physical activity

Computerised tomography skeletal muscle and adipose surface area values in a healthy Caucasian population

European Journal of Clinical Nutrition volume 74, pages 1276–1281 (2020)Cite this article

Subjects

Abstract

Background

The analysis of computerised tomography (CT) images to provide body composition data has grown exponentially. Despite this, there remains limited published data defining the normal range of skeletal muscle area and adipose tissue area using CT. The aim of this study was to determine age- and sex-specific body composition values using CT at the level of the third lumbar vertebrae, in a Caucasian population with a healthy body mass index (BMI). In addition, we sought to develop threshold values for low skeletal muscle mass using these data.

Methods

We included 107 healthy Caucasian patients (46 males; 61 females) with a healthy BMI (18–25 kg/m2) for analysis. Body composition data were obtained from a single transverse CT image at the mid-third lumbar vertebrae using ImageJ software. Tissue segmentation was performed using Hounsfield unit thresholds of −29 to +150 for muscle and −190 to −30 for adipose tissue.

Results

The mean age of the study cohort was 47.8 ± 11.0 years (range 21–73) with a median BMI of 23.7 kg/m2 (interquartile range 22.3–24.8). Patients were sub-divided into age above or below 50 years. Cut-offs for low muscle quantity, representing two standard deviations below the young healthy population mean values, were 43.5 cm2/m2 for males and 30.0 cm2/m2 for females.

Conclusions

Our data provide an insight into the distribution of skeletal muscle and adipose tissue surface area values measured on CT from a healthy Caucasian population. Our CT-derived cut-offs for low muscle quantity, based on international guidelines, are much lower than those previously suggested.

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Fig. 1: Comparison of computed tomography (CT) skeletal muscle index (SMI) in age- and sex-specific groups.

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Acknowledgements

The authors would like to acknowledge the statistical advice provided by Dr Anne Bernard.

Funding

AJW received a project grant from the Royal Australasian College of Physicians and is a recipient of the Princess Alexandra Hospital Research Support Scheme Postgraduate Scholarship. SEK is supported by a National Health and Medical Research Council (NHMRC) Early Career Fellowship.

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Authors and Affiliations

  1. School of Medicine, The University of Queensland, Brisbane, QLD, Australia

    Aidan J. Woodward & Graeme A. Macdonald

  2. Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, QLD, Australia

    Aidan J. Woodward & Graeme A. Macdonald

  3. Department of Radiology, Princess Alexandra Hospital, Brisbane, QLD, Australia

    Allan Avery

  4. Centre for Research on Exercise, Physical Activity and Health (CRExPAH), School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia

    Shelley E. Keating & Jeff S. Coombes

  5. School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, QLD, Australia

    Leigh C. Ward

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Contributions

AJW, LCW, JCW and GAM were responsible for the study design; AJW was responsible for data collection and image analysis; AA provided radiological expertise and assisted with protocol design; SEK provided assistance with image analysis; AJW, LCW, JSC and GAM contributed to the analysis and interpretation of data. AJW, AA, SEK, LCW, JSC and GAM contributed to the manuscript preparation and revisions.

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Correspondence to Aidan J. Woodward.

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Conflict of interest

AA and SEK have no personal or funding interests to disclose. AJW has received funding to speak on behalf of Janssen-Cilag for unrelated work. LCW consults to ImpediMed Ltd. JSC has received an unrestricted research grant from Coca Cola and funding from Renew Corp, Pfizer, Cyanotech, Terumo, Gatorade, Numico, Northfields and Baxter for unrelated work. JSC has also received honorariums to present at meetings from Novartis, Amgen and Roche. GAM is on an advisory board for AbbVie and has received funding to speak on behalf of MSD and Gilead for unrelated work.

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Woodward, A.J., Avery, A., Keating, S.E. et al. Computerised tomography skeletal muscle and adipose surface area values in a healthy Caucasian population. Eur J Clin Nutr 74, 1276–1281 (2020). https://doi.org/10.1038/s41430-020-0628-1

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