Differences in muscle composition and functionality: Exploring CT anatomical points and SARC-F components

Abstract

PurposeOur study aimed to: i) investigate the differences of muscle parameters in relation to each SARC-F component/question; ii) to explore the relationship between SARC-F score with these muscle parameters using various landmarks derived from CT scans of patients with cancer. MethodsThis study is a cross-sectional analysis of a cohort comprising consecutive patients with cancer, displaying CT scans. SARC-F questionnaire was utilized as a proxy for muscle functionality, with a score ≥ 4 indicating a poor status. Muscle assessment via CT measurements was performed using single cross-sectional images at the level of the third lumbar vertebrae (L3) in the abdominal region, the thigh region, and the total gluteal region at the level of the second sacral vertebrae. Skeletal muscle (SM) cross-sectional area, skeletal muscle index (SMI, normalized to height2), and skeletal muscle radiodensity (SMD) were evaluated for all anatomical landmarks. ResultsA total of 128 patients were included in this analysis (53.1% females, 61.7% older adults). Patients with SARC-F scores ≥ 4 demonstrated significantly lower values of SMD across all landmarks assessed. Those reporting difficulties related to strength (P = .039), requiring assistance in walking (P = .033), and climbing stairs (P = .012) exhibited significantly lower SMD values at the L3 landmark. At gluteus and thigh levels, only patients experiencing difficulty climbing stairs (P = .012) showed significantly lower values of SMD. Only SMD at gluteus level were independently associated with SARC-F score (β adjusted -0.09, 95% CI -0.16 to -0.02). ConclusionOur findings suggest that individuals with poor muscle composition may experience a higher risk of sarcopenia/poor muscle functionality.