TY - JOUR
T1 - Standardized measurement of abdominal muscle by computed tomography
T2 - association with cardiometabolic risk in the Framingham Heart Study
AU - Kammerlander, Andreas
AU - Lyass, Asya
AU - Mahoney, Taylor F.
AU - Taron, Jana
AU - Eslami, Parastou
AU - Lu, Michael T.
AU - Long, Michelle T.
AU - Vasan, Ramachandran S.
AU - Massaro, Joseph M.
AU - Hoffmann, Udo
N1 - Funding Information:
Dr Kammerlander reports receiving a grant from the Austrian Society of Cardiology during the time of this work. Dr. Taron reports funding by Deutsche Forschungsgesellschaft (DFG, German Research Foundation) – TA 1438/1-2. T; speakers bureau Siemens Healthcare GmbH and speakers bureau Bayer AG, unrelated to this work. Dr Vasan is supported in part by the Evans Medical Foundation and the Jay and Louis Coffman Endowment from the Department of Medicine, Boston University School of Medicine. Dr Long is supported in part by the National Institute of Diabetes and Digestive and Kidney Diseases K23 DK113252, the Doris Duke Charitable Foundation, Gilead Sciences Research Scholars Award, the Boston University School of Medicine Department of Medicine Career Investment Award, and the Boston University Clinical Translational Science Institute UL1 TR001430. Dr Long and is on the advisory board for Novo Nordisk and reports consulting fees for Iterative Scopes and Ionis Pharmaceuticals and research funding from Gilead Sciences and Echosens Corporation, all not related to the present research. Dr Hoffmann reports research support not related to the present research: research grants on behalf of the institution: KOWA, MedImmune, HeartFlow, Duke University, Oregon Health & Science University (American Heart Association, 13FTF16450001), Columbia University (National Institutes of Health [NIH], 5R01-HL109711), NIH/National Heart, Lung, and Blood Institute (NHLBI) 5K24HL113128, NIH/ NHLBI 5T32HL076136, NIH/NHLBI 5U01HL123339; and consulting fees: Duke University and Recor Medical.
Publisher Copyright:
© 2022, The Author(s).
PY - 2022/10
Y1 - 2022/10
N2 - Objectives: To provide a standard for total abdominal muscle mass (TAM) quantification on computed tomography (CT) and investigate its association with cardiovascular risk in a primary prevention setting. Methods: We included 3016 Framingham Heart Study participants free of cardiovascular disease (CVD) who underwent abdominal CT between 2002 and 2005. On a single CT slice at the level of L3/L4, we segmented (1) TAM-Area, (2) TAM-Index (= TAM-Area/height) and, (3) TAM-Fraction (= TAM-Area/total cross-sectional CT-area). We tested the association of these muscle mass measures with prevalent and incident cardiometabolic risk factors and incident CVD events during a follow-up of 11.0 ± 2.7 years. Results: In this community-based sample (49% women, mean age: 50.0 ± 10.0 years), all muscle quantity measures were significantly associated with prevalent and incident cardiometabolic risk factors and CVD events. However, only TAM-Fraction remained significantly associated with key outcomes (e.g., adj. OR 0.68 [0.55, 0.84] and HR 0.73 [0.57, 0.92] for incident hypertension and CVD events, respectively) after adjustment for age, sex, body mass index, and waist circumference. Moreover, only higher TAM-Fraction was associated with a lower risk (e.g., adj. OR: 0.56 [0.36–0.89] for incident diabetes versus TAM-Area: adj. OR 1.26 [0.79–2.01] and TAM-Index: 1.09 [0.75–1.58]). Conclusion: TAM-Fraction on a single CT slice at L3/L4 is a novel body composition marker of cardiometabolic risk in a primary prevention setting that has the potential to improve risk stratification beyond traditional measures of obesity. Key Points: • In this analysis of the Framingham Heart Study (n = 3016), TAM-F on a single slice CT was more closely associated with prevalent and incident cardiometabolic risk factors as compared to TAM alone or TAM indexed to body surface area. • TAM-F on a single abdominal CT slice at the level of L3/L4 could serve as a standard measure of muscle mass and improve risk prediction.
AB - Objectives: To provide a standard for total abdominal muscle mass (TAM) quantification on computed tomography (CT) and investigate its association with cardiovascular risk in a primary prevention setting. Methods: We included 3016 Framingham Heart Study participants free of cardiovascular disease (CVD) who underwent abdominal CT between 2002 and 2005. On a single CT slice at the level of L3/L4, we segmented (1) TAM-Area, (2) TAM-Index (= TAM-Area/height) and, (3) TAM-Fraction (= TAM-Area/total cross-sectional CT-area). We tested the association of these muscle mass measures with prevalent and incident cardiometabolic risk factors and incident CVD events during a follow-up of 11.0 ± 2.7 years. Results: In this community-based sample (49% women, mean age: 50.0 ± 10.0 years), all muscle quantity measures were significantly associated with prevalent and incident cardiometabolic risk factors and CVD events. However, only TAM-Fraction remained significantly associated with key outcomes (e.g., adj. OR 0.68 [0.55, 0.84] and HR 0.73 [0.57, 0.92] for incident hypertension and CVD events, respectively) after adjustment for age, sex, body mass index, and waist circumference. Moreover, only higher TAM-Fraction was associated with a lower risk (e.g., adj. OR: 0.56 [0.36–0.89] for incident diabetes versus TAM-Area: adj. OR 1.26 [0.79–2.01] and TAM-Index: 1.09 [0.75–1.58]). Conclusion: TAM-Fraction on a single CT slice at L3/L4 is a novel body composition marker of cardiometabolic risk in a primary prevention setting that has the potential to improve risk stratification beyond traditional measures of obesity. Key Points: • In this analysis of the Framingham Heart Study (n = 3016), TAM-F on a single slice CT was more closely associated with prevalent and incident cardiometabolic risk factors as compared to TAM alone or TAM indexed to body surface area. • TAM-F on a single abdominal CT slice at the level of L3/L4 could serve as a standard measure of muscle mass and improve risk prediction.
KW - Cardiometabolic risk
KW - Cardiovascular risk
KW - Computed tomography
KW - Muscle fraction
KW - Muscle mass
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U2 - 10.1007/s00330-022-08934-w
DO - 10.1007/s00330-022-08934-w
M3 - Article
C2 - 35779090
AN - SCOPUS:85133236810
SN - 0938-7994
VL - 32
SP - 7068
EP - 7078
JO - European Radiology
JF - European Radiology
IS - 10
ER -