Reference values and cut-points for trunk myopenia and myosteatosis in Chinese adults: a secondary analysis of the China Action on Spine and Hip study.

Authors

Ling Wang, Fangfang Duan, Yandong Liu, Dong Yan, Kai Li, Wenkai Wu, Yi Yuan, Quanzhong Ren, Kangkang Ma, Fengyun Zhou, Zitong Cheng, Jian Geng, Renxian Wang, Xiaoguang Cheng, Wenshuang Zhang

Published in

Quantitative imaging in medicine and surgery. Volume 16. Issue 7. Pages 587. Jul 01, 2026. Epub Jun 10, 2026.

Abstract

Sarcopenia is a prevalent condition associated with adverse health outcomes, necessitating accurate assessment of skeletal muscle quantity and quality. Computed tomography (CT) is the gold-standard imaging modality for evaluating trunk skeletal muscle area (TrSMA) and density (TrSMD), with opportunistic CT offering a means to assess these metrics without additional radiation exposure. However, the clinical application of CT-based sarcopenia assessment in Chinese populations is hindered by the absence of large-scale, population-specific reference values and cut-off points, particularly for both myopenia (low muscle mass) and myosteatosis (fatty infiltration). This study aims to establish sex- and age-specific percentile reference values and diagnostic cut-off points for CT-derived TrSMA and TrSMD at the L1 and L3 vertebral levels with a large cohort of community-dwelling Chinese adults.
We retrospectively analyzed abdominal CT scans from 4,016 community‑dwelling Chinese adults (21-80 years) across 12 regions. TrSMA and TrSMD at L1 and L3 were segmented using OsiriX. Sex- and age-specific percentile curves were modeled using the lambda-mu-sigma (LMS) method within the generalized additive models for location, scale, and shape (GAMLSS) framework. Estimated age-related differences in TrSMA and TrSMD from ages 25 to 75 years were calculated using LMS-derived medians. Sex‑specific cut‑off points for myopenia and myosteatosis were defined in the 21- to 40-year subgroup using the mean minus two standard deviations (M‑2SD) approach.
From ages 25 to 75 years, LMS-derived L1/L3-TrSMA values were lower by 0.45%/0.55% per year in men and 0.33%/0.41% per year in women; corresponding differences in L1/L3-TrSMD were 0.38%/0.35% and 0.55%/0.52% per year. More pronounced age-related decreases were observed in peri- and postmenopausal women and older men. M‑2SD cut‑offs at L1 were 96.0 cm² and 29.8 Hounsfield Unit (HU) (men), 63.1 cm² and 26.4 HU (women); at L3 were 122.3 cm² and 31.7 HU (men), 75.4 cm² and 27.5 HU (women).
We provide the first CT‑based, sex‑ and age‑specific reference values and cut‑points for trunk myopenia and myosteatosis in Chinese adults, facilitating standardized sarcopenia diagnosis and research.

PMID:
42433560
Bibliographic data and abstract were imported from PubMed on 11 Jul 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.