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Determination of reference values for abdominal skeletal muscle compartments in Turkish children

Tuğba Aydın1,2, Eda Cingöz3, Amine Durmuş3

  • 1Physical Therapy and Rehabilitation Department, Istanbul Physical Therapy Rehabilitation Training and Research Hospital, Istanbul, Turkiye.

Journal of Back and Musculoskeletal Rehabilitation
|December 22, 2025
PubMed

Insights

This study establishes crucial age- and sex-specific reference values for abdominal skeletal muscle area in Turkish children. These benchmarks aid in the early identification of low muscle mass, supporting pediatric health assessments.

Area of Science:

  • Pediatric imaging and body composition analysis.
  • Musculoskeletal health and sarcopenia research.
  • Clinical reference standard development.

Background:

  • Sarcopenia, characterized by muscle weakness and low muscle mass, impacts children's health, often linked to chronic diseases and malnutrition.
  • Computed tomography (CT) is the gold standard for muscle mass assessment, but pediatric reference values for abdominal skeletal muscle area (aSMA) are scarce and population-dependent.
  • Limited data exists for pediatric aSMA at lumbar levels, hindering accurate diagnosis and monitoring.

Purpose of the Study:

  • To create age- and sex-specific reference values and percentile curves for aSMA in Turkish children.
  • To establish normative data for psoas muscle area (PMA), paraspinal muscle area (PSMA), and total skeletal muscle area (TSMA) at L3, L3-L4, and L4-L5 levels.
  • To provide population-specific benchmarks for standardized abdominal skeletal muscle assessment in pediatrics.

Main Methods:

  • Retrospective analysis of abdominal CT scans from 2166 Turkish children (aged 0-18 years).
  • aSMA, PMA, PSMA, and TSMA were measured at three lumbar levels.
  • Lambda-Mu-Sigma method used for percentile curve calculation, with ±2 SD intervals established.

Main Results:

  • Age- and sex-specific percentile values (3rd-97th) and ±2 SD ranges were generated for PMA, PSMA, and TSMA.
  • Significant inter-population differences were observed when compared to other ethnic groups.
  • Normative data for PMA at L3-L4 ranged from 3.3-15.4 cm² (girls) and 3.3-27.2 cm² (boys) at the 50th percentile.

Conclusions:

  • Established level-specific normative charts (3rd-97th percentiles, ±2 SD) for PMA, PSMA, and TSMA in Turkish children (0-18 years).
  • These population-specific benchmarks standardize abdominal skeletal muscle assessment.
  • Facilitates early identification of low muscle mass in pediatric populations.

Keywords:
computed tomographymuscle masspsoas muscle areareference childrensarcopenia

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