Pitfalls in the measurement of muscle mass: a need for a reference standard

Fanny Buckinx, Francesco Landi, Matteo Cesari, Roger A Fielding, Marjolein Visser, Klaus Engelke, Stefania Maggi, Elaine Dennison, Nasser M Al-Daghri, Sophie Allepaerts, Jurgen Bauer, Ivan Bautmans, Maria Luisa Brandi, Olivier Bruyère, Tommy Cederholm, Francesca Cerreta, Antonio Cherubini, Cyrus Cooper, Alphonso Cruz-Jentoft, Eugene McCloskey, Bess Dawson-Hughes, Jean-Marc Kaufman, Andrea Laslop, Jean Petermans, Jean-Yves Reginster, René Rizzoli, Sian Robinson, Yves Rolland, Ricardo Rueda, Bruno Vellas, John A Kanis, Fanny Buckinx, Francesco Landi, Matteo Cesari, Roger A Fielding, Marjolein Visser, Klaus Engelke, Stefania Maggi, Elaine Dennison, Nasser M Al-Daghri, Sophie Allepaerts, Jurgen Bauer, Ivan Bautmans, Maria Luisa Brandi, Olivier Bruyère, Tommy Cederholm, Francesca Cerreta, Antonio Cherubini, Cyrus Cooper, Alphonso Cruz-Jentoft, Eugene McCloskey, Bess Dawson-Hughes, Jean-Marc Kaufman, Andrea Laslop, Jean Petermans, Jean-Yves Reginster, René Rizzoli, Sian Robinson, Yves Rolland, Ricardo Rueda, Bruno Vellas, John A Kanis

Abstract

Background: All proposed definitions of sarcopenia include the measurement of muscle mass, but the techniques and threshold values used vary. Indeed, the literature does not establish consensus on the best technique for measuring lean body mass. Thus, the objective measurement of sarcopenia is hampered by limitations intrinsic to assessment tools. The aim of this study was to review the methods to assess muscle mass and to reach consensus on the development of a reference standard.

Methods: Literature reviews were performed by members of the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis working group on frailty and sarcopenia. Face-to-face meetings were organized for the whole group to make amendments and discuss further recommendations.

Results: A wide range of techniques can be used to assess muscle mass. Cost, availability, and ease of use can determine whether the techniques are better suited to clinical practice or are more useful for research. No one technique subserves all requirements but dual energy X-ray absorptiometry could be considered as a reference standard (but not a gold standard) for measuring muscle lean body mass.

Conclusions: Based on the feasibility, accuracy, safety, and low cost, dual energy X-ray absorptiometry can be considered as the reference standard for measuring muscle mass.

Keywords: Lean body mass; Lean mass; Muscle mass; Reference standard.

© 2018 The Authors. Journal of Cachexia, Sarcopenia and Muscle published by John Wiley & Sons Ltd on behalf of the Society on Sarcopenia, Cachexia and Wasting Disorders.

Figures

Figure 1
Figure 1
Body compartments based on reference man.
Figure 2
Figure 2
Relations between appendicular lean soft tissue (ALST) and total‐body skeletal muscle (SM) mass.25

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