Proposal for new diagnostic criteria for low skeletal muscle mass based on computed tomography imaging in Asian adults

Objectives Low skeletal muscle, referred to as sarcopenia, has been shown to be an independent predictor of lower overall survival in various kinds of diseases. Several studies have evaluated the low skeletal muscle mass using computed tomography (CT) imaging. However, the cutoff values based on CT imaging remain undetermined in Asian populations. Methods Preoperative plain CT imaging at the third lumbar vertebrae level was used to measure the psoas muscle mass index (PMI, cm2/m2) in 541 adult donors for living donor liver transplantation (LDLT). We analyzed PMI distribution according to sex or donor age, and determined the sex-specific cutoff values of PMI to define low skeletal muscle mass. Results PMI in men was significantly higher than observed in women (8.85 ± 1.61 cm2/m2 versus 5.77 ± 1.21 cm2/m2; P < 0.001). PMI was significantly lower in individuals ≥50 y than in younger donors in both men and women (P < 0.001 and P < 0.001, respectively). On the basis of the younger donor data, we determined the sex-specific cutoff values for the low skeletal muscle mass were 6.36 cm2/m2 for men and 3.92 cm2/m2 for women (mean − 2 SD). Conclusion Data from healthy young Asian adults were used to establish new criteria for low skeletal muscle mass that would be applicable for defining sarcopenia in Asian populations.