Correlation Between Bioelectrical Impedance Analysis and Chest CT-Measured Erector Spinae Muscle Area: A Cross-Sectional Study

Diagnostic performance of various radiological modalities in the detection of sarcopenia within Asian populations: a systematic review

PURPOSE

Diagnosing sarcopenia necessitates the measurement of skeletal muscle mass. However, guidelines lack a standardized imaging modality with thresholds validated among Asians. This systematic review compared ultrasonography, computed tomography (CT), magnetic resonance imaging (MRI), and bioelectrical impedance analysis (BIA)/body composition monitoring in the detection of sarcopenia within Asian populations.

METHODS

PubMed and Embase were systematically searched for studies analyzing ultrasonography, CT, MRI, and BIA in diagnosing sarcopenia among Asians. Study quality was assessed using the Newcastle-Ottawa scale.

RESULTS

Pooled findings from 21,598 patients across 25 studies were examined. In receiver operating characteristic analysis, ultrasound displayed a pooled mean area under the curve (AUC) of 0.767 (95% confidence interval [CI], 0.709-0.806), with mean sensitivity of 81.1% (95% CI, 0.744-0.846) and specificity of 73.1% (95% CI, 0.648-0.774), for detecting sarcopenia in Asian populations. CT exhibited an AUC of 0.720 (sensitivity, 54.0%; specificity, 92.0%). MRI demonstrated an AUC of 0.839 (sensitivity, 67.0%; specificity, 66.0%). BIA displayed an AUC of 0.905 (95% CI, 0.842-0.968), 80.7% sensitivity (95% CI, 0.129-0.679), and 82.4% specificity (95% CI, 0.191-0.633).

CONCLUSIONS

Various modalities aid in diagnosing sarcopenia, and selection should be individualized. Although only BIA and dual-energy x-ray absorptiometry are recommended by the Asian Working Group for Sarcopenia and the European Working Group on Sarcopenia in Older People, ultrasound imaging may hold diagnostic value for sarcopenia in the Asian population. In certain groups, diagnostic use of CT and MRI is warranted. Future research can standardize and validate modality-specific thresholds and protocols within Asian populations.

The chest CT perspective on sarcopenia: Exploring reference values for muscle mass quantity/quality and its application in elderly adults

OBJECTIVE

To determine reference values for diagnosing sarcopenia through chest CT scans and evaluate their suitability for use among the Chinese elderly population.

METHODS

Chest CT scans were obtained from 500 healthy individuals aged 19-39. Skeletal muscle mass was assessed on chest CT at the level of T4 by the skeletal muscle area (T4SMA), skeletal muscle index (T4SMI), T12 erector spinae muscle area (T12ESMA), and T12 skeletal muscle index (T12SMI), as well as skeletal muscle density (SMD) at T4 and T12 levels. The diagnostic threshold for sarcopenia was defined as a gender-specific value below 2 SD of the mean value in the young group. These cutoff values were then applied to a group of older adults aged 65 and over.

RESULTS

Diagnostic thresholds for low skeletal muscle in men were 110.05 cm², 36.01 cm²/m², 29.56 cm², and 9.65 cm²/m² for T4SMA, T4SMI, T12ESMA, and T12SMI, respectively. For women, the thresholds were: 69.93 cm², 26.51 cm²/m², 17.84 cm²/m², and 6.87 cm²/m², respectively. Diagnostic thresholds for low SMD were 38.63HU in men, 34.74 HU for women at T4 level. At T12 level, the cutoff values were 40.94 HU for men and 36.63 HU for women. Sarcopenia prevalence in men, defined by T4SMA, T4SMI, T12ESMA, and T12SMI cutoffs, was 35.6%, 18.9%, 36.7%, and 23.7%, respectively. In women, sarcopenia prevalence was 5.1%, 3.2%, 3.2%, and 1.9%, respectively.

CONCLUSION

This study established reference values for sarcopenia diagnosis through chest CT scans among the Chinese population, highlighting the importance of utilizing chest CT scans for sarcopenia detection and muscle health monitoring in older adults.

Unveiling the Knowledge Frontier: A Scientometric Analysis of COPD with Sarcopenia

Objective

Numerous articles and reviews addressing the intersection of Chronic Obstructive Pulmonary Disease (COPD) with sarcopenia have been documented. However, a significant gap exists in the literature concerning scientometric analysis in this field. This study aimed to concentrate on recent research and elucidate emerging research areas through the examination of COPD with sarcopenia.

Methods

Articles in the field were systematically retrieved from the Web of Science Core Collections (WoSCC) spanning from 2003 to 2022. The analysis employed scientometric and keyword analyses through specialized software, including VOSviewer, CiteSpace, and Origin.

Results

A comprehensive analysis of 758 articles and reviews in the field of COPD with sarcopenia revealed the United States as the leading contributor in terms of publications and overall influence. Maastricht University emerged as the most prolific institution, with Schols Annemie M. W. J. being identified as the most influential scholar in this field. The International Journal of Chronic Obstructive Pulmonary Disease emerged as the most prolific journal. Notably, COPD with sarcopenia exhibits frequent associations with other diseases, underscoring the complexity of the topic and emphasizing the necessity for comprehensive treatment. Mechanistic and diagnostic aspects, particularly computed tomography, are pivotal in this research field. Osteoporosis emerges as a prospective avenue for future research, encompassing both COPD and sarcopenia. Furthermore, nutrition and physical activity are integral components for managing COPD patients with sarcopenia.

Conclusion

This study delineates the distribution of fields, the knowledge structure, and the evolution of major research topics related to COPD with sarcopenia. The identification of keyword hotspots enhances the understanding of the occurrence, development, and future study trends associated with the topic.

Prevalence of sarcopenia in patients with COPD through different musculature measurements: An updated meta-analysis and meta-regression

Aim

Chronic obstructive pulmonary disease (COPD) patients vary widely in terms of the prevalence of sarcopenia, which is partially attributed to differences in diagnostic criteria and disease severity. There are several different musculature measurements that are used to quantify sarcopenia. This study included published literature for meta-analysis to assess the sarcopenia prevalence in COPD patients and correlate the disease with the clinical characteristics of such patients.

Methods

A comprehensive review of the English and Chinese literature on sarcopenia prevalence in COPD patients was conducted using electronic databases such as China National Knowledge Infrastructure (CNKI), Web of Science, Cochrane Library, EMBASE, PubMed, and Wanfang. Two researchers analyzed the studies for Newcastle-Ottawa Scale. The software Stata 11.0 was employed for the analysis of the acquired data. The standard mean differences method was utilized for the estimation and quantification of the effect size. Furthermore, a fixed- or random-effects model was employed for conducting a combined analysis.

Results

In total, 56 studies were included as per the specific inclusion criteria. The resulting data of the assessed COPD patients in this research indicated a 27% prevalence of sarcopenia. Further analysis of subgroups was executed per disease severity, ethnicity, diagnostic criteria, gender, and age. Per these findings, increased disease severity elevated the prevalence of sarcopenia. The Latin American and Caucasian populations indicated an increased prevalence of sarcopenia. In addition, the prevalence of sarcopenia was related to diagnostic criteria and definition. Male COPD patients had a higher prevalence of sarcopenia than female COPD patients. COPD patients with an average age greater than 65 had a slightly higher prevalence of sarcopenia. COPD patients with comorbid sarcopenia had poorer pulmonary function, activity tolerance, and clinical symptoms than patients with COPD alone.

Conclusion

Sarcopenia prevalence is high (27%) in COPD patients. In addition, these patients had worse pulmonary function and activity tolerance compared to patients without sarcopenia.

Systematic review registration

https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=367422, identifier CRD42022367422.