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An Analysis of Muscle Quality and Its Relationship to Bone Density and Obesity in a Pediatric Autopsy Sample From New
Ethan C Hill1, Kathryn E Coakley2, Bria Riggs1
1Department of Orthopaedics and Rehabilitation, University of New Mexico School of Medicine, Albuquerque, New Mexico, USA.
Insights
Muscle quality in children and adolescents is linked to bone health and metabolic dysfunction. Higher muscle mass and density correlate with better bone mineral density, while lower muscle quality is associated with metabolic dysfunction-associated steatotic liver disease in males.
Area of Science:
- Pediatric Health
- Musculoskeletal Health
- Metabolic Health
Background:
- Muscle quality metrics are vital indicators of physical activity and health.
- These metrics are understudied in pediatric populations.
- This study examines muscle quality in relation to bone density and obesity in children and adolescents.
Purpose of the Study:
- To investigate the associations between skeletal muscle area and density with bone mineral density (BMD) and obesity-related factors in a pediatric autopsy sample.
- To explore relationships with metabolic dysfunction-associated steatotic liver disease (MASLD), sex, race/ethnicity, and age at death.
Main Methods:
- Analysis of postmortem computed tomography (PMCT) data from individuals aged 5-20.99 years.
- Measurement of skeletal muscle indices (muscle area relative to stature) and muscle density (Hounsfield units) for psoas major and thigh muscles.
- Multiple linear regression to assess relationships with BMD, obesity, MASLD, sex, race/ethnicity, age, and mode of death.
Main Results:
- Skeletal muscle indices and density positively correlated with femoral BMD (pooled sex) and lumbar BMD (females).
- Higher muscle indices were linked to obesity; higher muscle density was linked to lower subcutaneous adiposity.
- Reduced psoas muscle index associated with MASLD in males; males had higher muscle indices than females.
- Native American individuals showed lower muscle indices compared to Hispanic and non-Hispanic White peers.
Conclusions:
- Muscle quality is positively associated with skeletal health in females.
- Muscle quality is negatively associated with MASLD in males.
- Early-life physical activity and structural factors significantly influence musculoskeletal health development.
Introduction:
Muscle quality metrics are useful indicators of physical activity and overall health but have been underexamined in pediatric samples. This study investigates associations between skeletal muscle area and density, bone mineral density (BMD), and obesity-related factors in a pediatric autopsy sample from New Mexico.
Methods:
We analyzed postmortem computed tomography (PMCT) data of individuals aged 5-20.99 years at time of death. Skeletal muscle indices-muscle area relative to stature-were measured for the psoas major and thigh muscles at femoral midshaft. Muscle density was also calculated using Hounsfield units at these sites. Multiple linear regression was used to test the relationship between these proxies of muscle quality to BMD, obesity, metabolic dysfunction-associated steatotic liver disease (MASLD), sex, race/ethnicity, age at death, and mode of death.
Results:
Skeletal muscle indices and density were positively associated with femoral BMD in a pooled-sex sample and lumbar BMD in females. Skeletal muscle indices were positively associated with obesity and muscle density was negatively associated with levels of subcutaneous adiposity. A reduced psoas muscle index was significantly associated with MASLD in males. Males have greater skeletal muscle indices than females, but the sexes have similar muscle density. Native American individuals exhibited lower muscle indices compared to Hispanic and non-Hispanic White peers.
Conclusions:
Muscle quality is positively related to skeletal health in girls and negatively associated with MASLD in boys. These findings underscore the importance of early-life physical activity and structural context in shaping musculoskeletal health.
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