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J. Cachexia Sarcopenia Muscle, Apr 2025, 16 (2) | https://doi.org/10.1002/jcsm.13760
Impact of Muscle Quality on Muscle Strength and Physical Performance Beyond Muscle Mass or Diabetes Status
Jung A. Kim1, Chol Shin2,3, Inha Jung4, So Young Park4, Da Young Lee4, Ji Hee Yu4, Hyunjoo Cho4, Seung Ku Lee2, Kyoung Jin Kim1, Eyun Song5, Kyeong Jin Kim1, Nam Hoon Kim1, Hye Jin Yoo5, Sin Gon Kim1, Kyung Mook Choi5, Nan Hee Kim4, Ji A. Seo4
1Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University Anam Hospital, Seoul, Republic of Korea
2Institute of Human Genomic Study, College of Medicine, Korea University, Seoul, Republic of Korea
3Biomedical Research Center, Korea University Ansan Hospital, Ansan, Republic of Korea
4Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Republic of Korea
5Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University Guro Hospital, Seoul, Republic of Korea
Jung A. Kim and Chol Shin contributed equally to this study.
Correspondence: Nan Hee Kim, Ji A. Seo
1Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University Anam Hospital, Seoul, Republic of Korea
2Institute of Human Genomic Study, College of Medicine, Korea University, Seoul, Republic of Korea
3Biomedical Research Center, Korea University Ansan Hospital, Ansan, Republic of Korea
4Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Republic of Korea
5Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University Guro Hospital, Seoul, Republic of Korea
Jung A. Kim and Chol Shin contributed equally to this study.
Correspondence: Nan Hee Kim, Ji A. Seo
Abstract
Background: Muscle quality, represented by myosteatosis, is recognized as an important factor in sarcopenia. In this study, we aimed to determine the associations between myosteatosis, muscle strength and physical performance among the elderly South Korean population.
Methods: We included 1440 participants (mean age 62.7 ± 6.2 years) from the Korean Genome and Epidemiology Study (KoGES). Based on the computed tomography attenuation of mid-thigh imaging, the total muscle area (TMA), normal-attenuation muscle area (NAMA), low-attenuation muscle area (LAMA) and inter-intramuscular adipose tissue (IMAT) and its indices were used to evaluate myosteatosis. Muscle strength was evaluated using hand grip strength, whereas physical performance was evaluated through 4-m gait speed, a 30-s sit-to-stand test and 2-min walking test.
Results: Of the 1440 patients, 51.5% were women, and 37.2% had diabetes. With aging, the LAMA index gradually increased, and the NAMA index gradually decreased in both men and women (p for trend < 0.001). The NAMA index was positively associated, whereas the LAMA and IMAT indices were negatively associated with muscle strength and physical performance after adjusting for age and sex. Higher tertiles of the NAMA index were consistently associated with improved physical performance across all appendicular skeletal muscle tertiles. The relationship between the NAMA index or LAMA index and muscle strength and physical performance did not differ according to diabetic status. Regular exercise was associated with a higher NAMA index and a lower LAMA index in the non-diabetic group; however, no significant difference in muscle quality was observed in the diabetic group in relation to exercise.
Conclusions: Reduced myosteatosis was positively associated with greater muscle strength and better physical performance in both men and women, regardless of muscle mass or diabetes status; improving myosteatosis may be a therapeutic target for the prevention of sarcopenia.
Methods: We included 1440 participants (mean age 62.7 ± 6.2 years) from the Korean Genome and Epidemiology Study (KoGES). Based on the computed tomography attenuation of mid-thigh imaging, the total muscle area (TMA), normal-attenuation muscle area (NAMA), low-attenuation muscle area (LAMA) and inter-intramuscular adipose tissue (IMAT) and its indices were used to evaluate myosteatosis. Muscle strength was evaluated using hand grip strength, whereas physical performance was evaluated through 4-m gait speed, a 30-s sit-to-stand test and 2-min walking test.
Results: Of the 1440 patients, 51.5% were women, and 37.2% had diabetes. With aging, the LAMA index gradually increased, and the NAMA index gradually decreased in both men and women (p for trend < 0.001). The NAMA index was positively associated, whereas the LAMA and IMAT indices were negatively associated with muscle strength and physical performance after adjusting for age and sex. Higher tertiles of the NAMA index were consistently associated with improved physical performance across all appendicular skeletal muscle tertiles. The relationship between the NAMA index or LAMA index and muscle strength and physical performance did not differ according to diabetic status. Regular exercise was associated with a higher NAMA index and a lower LAMA index in the non-diabetic group; however, no significant difference in muscle quality was observed in the diabetic group in relation to exercise.
Conclusions: Reduced myosteatosis was positively associated with greater muscle strength and better physical performance in both men and women, regardless of muscle mass or diabetes status; improving myosteatosis may be a therapeutic target for the prevention of sarcopenia.
논문정보
- Research article
- 2025년 04월 (BRIC 등록일 2025-03-05)
- 국내 연구진
- 의약학 > 응용의학
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