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      Defining reference values for body composition indices by magnetic resonance imaging in UK Biobank

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          Abstract

          Background

          Magnetic resonance imaging (MRI) is the gold standard for evaluating body composition. However, the reference ranges have not been established.

          Methods

          Three lean tissue and seven adipose tissue parameters based on MRI data from the UK Biobank were used in this study. Participants with European ancestry and data on at least one parameter were screened. Age‐ and sex‐specific percentile curves were generated using the lambda–mu–sigma method. Three levels of reference ranges were provided, which were equivalent to the mean ± 1 standard deviation ( SD), 2 SDs and 2.5 SDs.

          Results

          The final analysis set for each parameter ranged from 4842 to 14 148 participants (53.4%–56.6% women) with a median age of 61. For lean tissue parameters, compared with those at age 45, the median total lean tissue volume and total thigh fat‐free muscle volume at age 70 were 2.83 and 1.73 L, and 3.02 and 1.51 L lower in men and women, respectively. The median weight‐to‐muscle ratios at age 45 were 0.51 and 0.83 kg/L lower compared with those at age 70 in men and women, respectively. Adipose tissue parameters showed inconsistent differences. In men, the median muscle fat infiltration, visceral adipose tissue (VAT) volume, total abdominal adipose tissue index and abdominal fat ratio were 1.48%, 0.32 L, 0.08 L/m 2 and 0.4 higher, and the median abdominal subcutaneous adipose tissue (ASAT) volume and total adipose tissue volume were 0.47 and 0.41 L lower, respectively, at age 70 than at age 45. The median total trunk fat volume was approximately 9.53 L at all ages. In women, the median muscle fat infiltration and VAT volume were 1.68% and 0.76 L higher, respectively, at age 70 than at age 45. The median ASAT volume, total adipose tissue volume, total trunk fat volume, total abdominal adipose tissue index and abdominal fat ratio were 0.35 L, 0.78 L, 1.12 L, 0.49 L/m 2 and 0.06 higher, respectively, at age 60 than at age 45. The medians of the former three parameters were 0.33 L, 0.14 L and 0.20 L lower, at age 70 than at age 60. The medians of the latter two parameters were approximately 3.64 L/m 2 and 0.55 at ages between 60 and 70.

          Conclusions

          We have established reference ranges for MRI‐measured body composition parameters in a large community‐dwelling population. These findings provide a more accurate assessment of abnormal adipose and muscle conditions.

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          Most cited references40

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          UK Biobank: An Open Access Resource for Identifying the Causes of a Wide Range of Complex Diseases of Middle and Old Age

          Cathie Sudlow and colleagues describe the UK Biobank, a large population-based prospective study, established to allow investigation of the genetic and non-genetic determinants of the diseases of middle and old age.
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            Sarcopenia: revised European consensus on definition and diagnosis

            Abstract Background in 2010, the European Working Group on Sarcopenia in Older People (EWGSOP) published a sarcopenia definition that aimed to foster advances in identifying and caring for people with sarcopenia. In early 2018, the Working Group met again (EWGSOP2) to update the original definition in order to reflect scientific and clinical evidence that has built over the last decade. This paper presents our updated findings. Objectives to increase consistency of research design, clinical diagnoses and ultimately, care for people with sarcopenia. Recommendations sarcopenia is a muscle disease (muscle failure) rooted in adverse muscle changes that accrue across a lifetime; sarcopenia is common among adults of older age but can also occur earlier in life. In this updated consensus paper on sarcopenia, EWGSOP2: (1) focuses on low muscle strength as a key characteristic of sarcopenia, uses detection of low muscle quantity and quality to confirm the sarcopenia diagnosis, and identifies poor physical performance as indicative of severe sarcopenia; (2) updates the clinical algorithm that can be used for sarcopenia case-finding, diagnosis and confirmation, and severity determination and (3) provides clear cut-off points for measurements of variables that identify and characterise sarcopenia. Conclusions EWGSOP2's updated recommendations aim to increase awareness of sarcopenia and its risk. With these new recommendations, EWGSOP2 calls for healthcare professionals who treat patients at risk for sarcopenia to take actions that will promote early detection and treatment. We also encourage more research in the field of sarcopenia in order to prevent or delay adverse health outcomes that incur a heavy burden for patients and healthcare systems.
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              Asian Working Group for Sarcopenia: 2019 Consensus Update on Sarcopenia Diagnosis and Treatment

              Clinical and research interest in sarcopenia has burgeoned internationally, Asia included. The Asian Working Group for Sarcopenia (AWGS) 2014 consensus defined sarcopenia as "age-related loss of muscle mass, plus low muscle strength, and/or low physical performance" and specified cutoffs for each diagnostic component; research in Asia consequently flourished, prompting this update. AWGS 2019 retains the previous definition of sarcopenia but revises the diagnostic algorithm, protocols, and some criteria: low muscle strength is defined as handgrip strength <28 kg for men and <18 kg for women; criteria for low physical performance are 6-m walk <1.0 m/s, Short Physical Performance Battery score ≤9, or 5-time chair stand test ≥12 seconds. AWGS 2019 retains the original cutoffs for height-adjusted muscle mass: dual-energy X-ray absorptiometry, <7.0 kg/m2 in men and <5.4 kg/m2 in women; and bioimpedance, <7.0 kg/m2 in men and <5.7 kg/m2 in women. In addition, the AWGS 2019 update proposes separate algorithms for community vs hospital settings, which both begin by screening either calf circumference (<34 cm in men, <33 cm in women), SARC-F (≥4), or SARC-CalF (≥11), to facilitate earlier identification of people at risk for sarcopenia. Although skeletal muscle strength and mass are both still considered fundamental to a definitive clinical diagnosis, AWGS 2019 also introduces "possible sarcopenia," defined by either low muscle strength or low physical performance only, specifically for use in primary health care or community-based health promotion, to enable earlier lifestyle interventions. Although defining sarcopenia by body mass index-adjusted muscle mass instead of height-adjusted muscle mass may predict adverse outcomes better, more evidence is needed before changing current recommendations. Lifestyle interventions, especially exercise and nutritional supplementation, prevail as mainstays of treatment. Further research is needed to investigate potential long-term benefits of lifestyle interventions, nutritional supplements, or pharmacotherapy for sarcopenia in Asians.
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                Author and article information

                Contributors
                shanying@pkuszh.com
                shiyu@pkuszh.com
                Journal
                J Cachexia Sarcopenia Muscle
                J Cachexia Sarcopenia Muscle
                10.1007/13539.2190-6009
                JCSM
                Journal of Cachexia, Sarcopenia and Muscle
                John Wiley and Sons Inc. (Hoboken )
                2190-5991
                2190-6009
                30 January 2023
                April 2023
                : 14
                : 2 ( doiID: 10.1002/jcsm.v14.2 )
                : 992-1002
                Affiliations
                [ 1 ] Clinical Research Academy Peking University Shenzhen Hospital, Peking University Shenzhen Guangdong China
                [ 2 ] Renal Division Peking University Shenzhen Hospital, Peking University Shenzhen China
                [ 3 ] BGI‐Shenzhen Shenzhen China
                [ 4 ] College of Life Sciences University of Chinese Academy of Sciences Beijing China
                [ 5 ] Department of Ultrasound Peking University Shenzhen Hospital, Peking University Shenzhen Guangdong China
                Author notes
                [*] [* ] Correspondence to: Ying Shan, Clinical Research Academy, Peking University Shenzhen Hospital, Peking University, 1120 Lianhua Road, Futian District, Shenzhen 518036, Guangdong, China. Email: shanying@ 123456pkuszh.com ;

                Yu Shi, Department of Ultrasound, Peking University Shenzhen Hospital, Peking University, 1120 Lianhua Road, Futian District, Shenzhen 518036, Guangdong, China. Email: shiyu@ 123456pkuszh.com

                Author information
                https://orcid.org/0000-0003-1053-7189
                Article
                JCSM13181 JCSM-D-22-00098
                10.1002/jcsm.13181
                10067500
                36717370
                d2670e73-b2cd-4c27-b661-2e356e5aebcd
                © 2023 The Authors. Journal of Cachexia, Sarcopenia and Muscle published by John Wiley & Sons Ltd on behalf of Society on Sarcopenia, Cachexia and Wasting Disorders.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

                History
                : 06 December 2022
                : 17 February 2022
                : 02 January 2023
                Page count
                Figures: 3, Tables: 5, Pages: 11, Words: 3921
                Funding
                Funded by: National Natural Science Foundation of China , doi 10.13039/501100001809;
                Award ID: 8220120355
                Funded by: San‐Ming Project of Medicine, Shenzhen , doi 10.13039/501100012151;
                Award ID: SZSM201812097
                Funded by: Shenzhen Science and Technology Innovation Commission , doi 10.13039/501100010877;
                Award ID: JCYJ20200109140412476
                Funded by: General Program for Clinical Research at Peking University Shenzhen Hospital
                Award ID: LCYJ2020001
                Funded by: Scientific Research Foundation of Peking University Shenzhen Hospital
                Award ID: KYQD2022203
                Categories
                Original Article
                Original Articles
                Custom metadata
                2.0
                April 2023
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.2.7 mode:remove_FC converted:02.04.2023

                Orthopedics
                abdominal body composition,lambda–mu–sigma method,magnetic resonance imaging,reference ranges

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