Skeletal muscle mass and quality: evolution of modern measurement concepts in the context of sarcopenia

Proc Nutr Soc. 2015 Nov;74(4):355-66. doi: 10.1017/S0029665115000129. Epub 2015 Apr 8.


The first reports of accurate skeletal muscle mass measurement in human subjects appeared at about the same time as introduction of the sarcopenia concept in the late 1980s. Since then these methods, computed tomography and MRI, have been used to gain insights into older (i.e. anthropometry and urinary markers) and more recently developed and refined methods (ultrasound, bioimpedance analysis and dual-energy X-ray absorptiometry) of quantifying regional and total body skeletal muscle mass. The objective of this review is to describe the evolution of these methods and their continued development in the context of sarcopenia evaluation and treatment. Advances in these technologies are described with a focus on additional quantifiable measures that relate to muscle composition and 'quality'. The integration of these collective evaluations with strength and physical performance indices is highlighted with linkages to evaluation of sarcopenia and the spectrum of related disorders such as sarcopenic obesity, cachexia and frailty. Our findings show that currently available methods and those in development are capable of non-invasively extending measures from solely 'mass' to quality evaluations that promise to close the gaps now recognised between skeletal muscle mass and muscle function, morbidity and mortality. As the largest tissue compartment in most adults, skeletal muscle mass and aspects of muscle composition can now be evaluated by a wide array of technologies that provide important new research and clinical opportunities aligned with the growing interest in the spectrum of conditions associated with sarcopenia.

Keywords: ALST appendicular lean soft tissue; BIA bioimpedance analysis; Body composition; CT computed tomography; Cachexia; DCR deuterated creatine; DXA dual-energy X-ray absorptiometry; HU Hounsfield units; IMAT intermuscular adipose tissue; Nutritional assessment; Sarcopenia; Sarcopenic obesity; see standard error of the estimate.

Publication types

  • Review

MeSH terms

  • Body Composition*
  • Diagnostic Imaging / methods*
  • Humans
  • Muscle Strength*
  • Muscle, Skeletal* / pathology
  • Muscle, Skeletal* / physiopathology
  • Physical Fitness*
  • Sarcopenia / complications
  • Sarcopenia / diagnosis*