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BRIEF RESEARCH REPORT article
Front. Physiol.
Sec. Clinical and Translational Physiology
Volume 16 - 2025 | doi: 10.3389/fphys.2025.1566463
Age-and sex-specific reference values for CT-based low skeletal muscle quantity and quality in healthy living kidney donors
Provisionally accepted
David Martin*
Paola Dolce
Martin Hübner
Tobias ZinggDavid FuksJean-Pierre VenetzDamien Maier
Maurice Matter
Fabio Becce- Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
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Background: Computed tomography(CT) imaging is a useful tool for assessing skeletal muscle mass and quality. The present study aimed to determine age-and sex-specific reference values for CT-based skeletal muscle markers in a healthy population, and to correlate them with serum creatinine and 24-hour urinary creatinine excretion(24h-UCE). Methods: Skeletal muscle index(SMI) -a marker of muscle mass/quantity -and skeletal muscle radiation attenuation(SMRA) and intermuscular adipose tissue index(IMATI) -markers of muscle quality/myosteatosis -were determined using a deep-learning-based method from axial CT images at the level of the 3rd lumbar vertebra in living kidney donors assessed between 01/2005 and 05/2023. Age-and sex-specific reference values were determined by the 5 th percentile, and correlation was tested with the Pearson correlation coefficient. Results: CT scans of 394 healthy individuals were included. The mean age was 53 years(SD 12), mean BMI was 25.2 kg/m2(SD 3.9), and 130 patients(33%) were male. The reference values for low skeletal muscle mass(SMI) in males were 43.7 cm2/m2(20-39 years), 44.9 cm2/m2(40-59 years), and 39.7 cm2/m2(≥60 years). In females, the corresponding values were 33.8 cm2/m2(20-39 years), 34.8 cm 2/m2(40-59 years), and 31.2 cm2/m2 (≥60 years). SMI showed a moderate correlation with serum creatinine(r=0.452, p<0.001) but a weak correlation with 24h-UCE(r=0.188, p=0.003). Correlations were all weak for SMRA(creatinine: r=0.220, p<0.001; 24h-UCE: r=0.177, p=0.006) and IMATI(creatinine: r=-0.101, p=0.054; 24h-UCE, r=-0.108, p=0.093).The age-and sex-specific reference values reported here could be used in clinical practice and future studies to identify patients at risk of muscle decline.
Keywords: Living kidney donor, computed tomography, muscle mass, muscle quality, myosteatosis
Received: 07 Feb 2025; Accepted: 08 Apr 2025.
Copyright: © 2025 Martin, Dolce, Hübner, Zingg, Fuks, Venetz, Maier, Matter and Becce. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: David Martin, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
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