Estimation of Total Body Skeletal Muscle Mass in Chinese Adults: Prediction Model by Dual-Energy X-Ray Absorptiometry

Xinyu Zhao,Junyi Zhang,Jianming Hua,Zimian Wang,Wei He,Shankuan Zhu,Junming Yue

doi:10.1371/journal.pone.0053561

Abstract

BackgroundThere are few reports on total body skeletal muscle mass (SM) in Chinese. The objective of this study is to establish a prediction model of SM for Chinese adults.MethodologyAppendicular lean soft tissue (ALST) was measured by dual energy X-ray absorptiometry (DXA) and SM by magnetic resonance image (MRI) in 66 Chinese adults (52 men and 14 women). Images of MRI were segmented into compartments including intermuscular adipose tissue (IMAT) and IMAT-free SM. Regression was used to fit the prediction model . Age and gender were adjusted in the fitted model. The piece-wise linear function was performed to further explore the effect of age on SM. ‘Leave-One-Out Cross Validation’ was utilized to evaluate the prediction performance. The significance of observed differences between predicted and actual SM was tested by t test and the level of agreement was assessed by the method of Bland and Altman.ResultsMen had greater ALST and IMAT-free SM than women. ALST was the primary predictor and highly correlated with IMAT-free SM (R2 = 0.94, SEE = 1.11 kg, P<0.001). Age was an additional predictor (SM prediction model with age adjusted R 2 = 0.95, SEE = 1.05 kg, P<0.001). There was a piece-wise linear relationship between age and IMAT-free SM: IMAT-free SM = 1.21×ALST−0.98, (Age <45 years) and IMAT-free SM = 1.21×ALST−0.98−0.04× (Age−45), (Age ≥45years). The prediction performance of this age-adjusted model was good due to ‘Leave-One-Out Cross Validation’. No significant difference between measured and predicted IMAT-free SM was detected.ConclusionPrevious SM prediction model developed in multi-ethnic groups underestimated SM by 2.3% and 3.4% for Chinese men and women. A new prediction model by DXA has been established to predict SM in Chinese adults.

Highlights

Skeletal muscle is the largest non-adipose tissue component of the tissue-system level of human body composition [1] and is central to the study of nutritional, physiologic and metabolic processes [2,3,4]
No significant difference between measured and predicted intermuscular adipose tissue (IMAT)-free skeletal muscle mass (SM) was detected
Previous SM prediction model developed in multi-ethnic groups underestimated SM by 2.3% and 3.4% for Chinese men and women

Summary

Introduction

Skeletal muscle is the largest non-adipose tissue component of the tissue-system level of human body composition [1] and is central to the study of nutritional, physiologic and metabolic processes [2,3,4]. Magnetic resonance imaging (MRI) is currently applied as the golden standard for evaluating skeletal muscle due to its high accuracy and lack of radiation to the subjects [4,5]. Dual energy X-ray absorptiometry (DXA) is considered an alternative approach to estimate skeletal muscle in vivo, with substantially lower costs and less radiation exposure [4,6]. Several studies have used DXA to predict skeletal muscle mass [6,7,8,9,10,11]. There is no reported DXA-based skeletal muscle prediction model applicable to Chinese adults. There are few reports on total body skeletal muscle mass (SM) in Chinese. The objective of this study is to establish a prediction model of SM for Chinese adults

Objectives

Methods

Results

Conclusion