Adverse muscle composition predicts all‐cause mortality in the UK Biobank imaging study
Abstract Background Adverse muscle composition (MC) as measured by magnetic resonance imaging has previously been linked to poor function, comorbidity, and increased hospitalization. The aim of this study was to investigate if adverse MC predicts all‐cause mortality using data from UK Biobank. Metho...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2021-12-01
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| Series: | Journal of Cachexia, Sarcopenia and Muscle |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/jcsm.12834 |
| _version_ | 1798032657093754880 |
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| author | Jennifer Linge Mikael Petersson Mikael F. Forsgren Arun J. Sanyal Olof Dahlqvist Leinhard |
| author_facet | Jennifer Linge Mikael Petersson Mikael F. Forsgren Arun J. Sanyal Olof Dahlqvist Leinhard |
| author_sort | Jennifer Linge |
| collection | DOAJ |
| description | Abstract Background Adverse muscle composition (MC) as measured by magnetic resonance imaging has previously been linked to poor function, comorbidity, and increased hospitalization. The aim of this study was to investigate if adverse MC predicts all‐cause mortality using data from UK Biobank. Methods There were 40 178 participants scanned using a 6 min magnetic resonance imaging protocol. Images were analysed for thigh fat‐tissue free muscle volume and muscle fat infiltration (MFI) using AMRA® Researcher (AMRA Medical, Linköping, Sweden). For each participant, a sex, weight, and height invariant muscle volume z‐score was calculated. Participants were partitioned into four MC groups: (i) normal MC, (ii) only low muscle volume [<25th percentile for muscle volume z‐score (population wide)], (iii) only high MFI [>75th percentile (population wide, sex‐specific)], and (iv) adverse MC (low muscle volume z‐score and high MFI). Association of MC groups with mortality was investigated using Cox proportional‐hazard modelling with normal MC as referent (unadjusted and adjusted for low hand grip strength, sex, age, body mass index, previous diagnosis of disease (cancer, type 2 diabetes and coronary heart disease), lifestyle, and socioeconomic factors (smoking, alcohol consumption, physical activity, and Townsend deprivation index). Results Muscle composition measurements were complete for 39 804 participants [52% female, mean (SD) age 64.2 (7.6) years and body mass index 26.4 (4.4) kg/m2]. Three hundred twenty‐eight deaths were recorded during a follow‐up period of 2.9 (1.4) years after imaging. At imaging, adverse MC was detected in 10.5% of participants. The risk of death from any cause in adverse MC compared with normal MC was 3.71 (95% confidence interval 2.81–4.91, P < 0.001). Only low muscle volume and only high MFI were independently associated with all‐cause mortality [1.58 (1.13–2.21), P = 0.007, and 2.02 (1.51–2.71), P < 0.001, respectively]. Adjustment of low hand grip strength [1.77 (1.28–2.44), P < 0.001] did not attenuate the associations with any of the MC groups. In the fully adjusted model, adverse MC and only high MFI remained significant (P < 0.001 and P = 0.020) while the association with only low muscle volume was attenuated to non‐significance (P = 0.560). The predictive performance of adverse MC [1.96 (1.42–2.71), P < 0.001] was comparable with that of previous cancer diagnosis [1.93 (1.47–2.53), P < 0.001] and smoking [1.71 (1.02–2.84), P = 0.040]. Low hand grip strength was borderline non‐significant [1.34 (0.96–1.88), P = 0.090]. Conclusions Adverse MC was a strong and independent predictor of all‐cause mortality. Sarcopenia guidelines can be strengthened by including cut‐offs for myosteatosis enabling detection of adverse MC. |
| first_indexed | 2024-04-11T20:16:23Z |
| format | Article |
| id | doaj.art-cd2cb792c6a64bb88b6bf3b7151c9b80 |
| institution | Directory Open Access Journal |
| issn | 2190-5991 2190-6009 |
| language | English |
| last_indexed | 2024-04-11T20:16:23Z |
| publishDate | 2021-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Cachexia, Sarcopenia and Muscle |
| spelling | doaj.art-cd2cb792c6a64bb88b6bf3b7151c9b802022-12-22T04:04:57ZengWileyJournal of Cachexia, Sarcopenia and Muscle2190-59912190-60092021-12-011261513152610.1002/jcsm.12834Adverse muscle composition predicts all‐cause mortality in the UK Biobank imaging studyJennifer Linge0Mikael Petersson1Mikael F. Forsgren2Arun J. Sanyal3Olof Dahlqvist Leinhard4AMRA Medical Linköping SwedenAMRA Medical Linköping SwedenAMRA Medical Linköping SwedenDepartment of Internal Medicine and Division of Gastroenterology, Hepatology and Nutrition Virginia Commonwealth University Richmond VA USAAMRA Medical Linköping SwedenAbstract Background Adverse muscle composition (MC) as measured by magnetic resonance imaging has previously been linked to poor function, comorbidity, and increased hospitalization. The aim of this study was to investigate if adverse MC predicts all‐cause mortality using data from UK Biobank. Methods There were 40 178 participants scanned using a 6 min magnetic resonance imaging protocol. Images were analysed for thigh fat‐tissue free muscle volume and muscle fat infiltration (MFI) using AMRA® Researcher (AMRA Medical, Linköping, Sweden). For each participant, a sex, weight, and height invariant muscle volume z‐score was calculated. Participants were partitioned into four MC groups: (i) normal MC, (ii) only low muscle volume [<25th percentile for muscle volume z‐score (population wide)], (iii) only high MFI [>75th percentile (population wide, sex‐specific)], and (iv) adverse MC (low muscle volume z‐score and high MFI). Association of MC groups with mortality was investigated using Cox proportional‐hazard modelling with normal MC as referent (unadjusted and adjusted for low hand grip strength, sex, age, body mass index, previous diagnosis of disease (cancer, type 2 diabetes and coronary heart disease), lifestyle, and socioeconomic factors (smoking, alcohol consumption, physical activity, and Townsend deprivation index). Results Muscle composition measurements were complete for 39 804 participants [52% female, mean (SD) age 64.2 (7.6) years and body mass index 26.4 (4.4) kg/m2]. Three hundred twenty‐eight deaths were recorded during a follow‐up period of 2.9 (1.4) years after imaging. At imaging, adverse MC was detected in 10.5% of participants. The risk of death from any cause in adverse MC compared with normal MC was 3.71 (95% confidence interval 2.81–4.91, P < 0.001). Only low muscle volume and only high MFI were independently associated with all‐cause mortality [1.58 (1.13–2.21), P = 0.007, and 2.02 (1.51–2.71), P < 0.001, respectively]. Adjustment of low hand grip strength [1.77 (1.28–2.44), P < 0.001] did not attenuate the associations with any of the MC groups. In the fully adjusted model, adverse MC and only high MFI remained significant (P < 0.001 and P = 0.020) while the association with only low muscle volume was attenuated to non‐significance (P = 0.560). The predictive performance of adverse MC [1.96 (1.42–2.71), P < 0.001] was comparable with that of previous cancer diagnosis [1.93 (1.47–2.53), P < 0.001] and smoking [1.71 (1.02–2.84), P = 0.040]. Low hand grip strength was borderline non‐significant [1.34 (0.96–1.88), P = 0.090]. Conclusions Adverse MC was a strong and independent predictor of all‐cause mortality. Sarcopenia guidelines can be strengthened by including cut‐offs for myosteatosis enabling detection of adverse MC.https://doi.org/10.1002/jcsm.12834SarcopeniaMagnetic resonance imagingFrailtyMyosteatosisMuscle fat infiltration |
| spellingShingle | Jennifer Linge Mikael Petersson Mikael F. Forsgren Arun J. Sanyal Olof Dahlqvist Leinhard Adverse muscle composition predicts all‐cause mortality in the UK Biobank imaging study Journal of Cachexia, Sarcopenia and Muscle Sarcopenia Magnetic resonance imaging Frailty Myosteatosis Muscle fat infiltration |
| title | Adverse muscle composition predicts all‐cause mortality in the UK Biobank imaging study |
| title_full | Adverse muscle composition predicts all‐cause mortality in the UK Biobank imaging study |
| title_fullStr | Adverse muscle composition predicts all‐cause mortality in the UK Biobank imaging study |
| title_full_unstemmed | Adverse muscle composition predicts all‐cause mortality in the UK Biobank imaging study |
| title_short | Adverse muscle composition predicts all‐cause mortality in the UK Biobank imaging study |
| title_sort | adverse muscle composition predicts all cause mortality in the uk biobank imaging study |
| topic | Sarcopenia Magnetic resonance imaging Frailty Myosteatosis Muscle fat infiltration |
| url | https://doi.org/10.1002/jcsm.12834 |
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