Key result
Higher total abdominal muscle fraction (TAM-Fraction) on CT was significantly associated with a lower risk of incident cardiovascular disease events (HR 0.73 per 1-SD increase) after adjustment for traditional obesity measures.
Why the study?
To establish a standard for total abdominal muscle mass quantification on CT and investigate its association with cardiovascular risk in a primary prevention setting.
Does total abdominal muscle mass fraction on CT predict incident cardiometabolic risk factors and CVD events in a primary prevention cohort?
Cohort (n=3,016)
No
Does total abdominal muscle mass fraction on CT predict incident cardiometabolic risk factors and CVD events in a primary prevention cohort?
Answers are grounded in this paper and cite their sources.
TAM-Fraction on a single abdominal CT slice is a novel body composition marker that improves cardiometabolic risk prediction beyond traditional obesity measures.
OBJECTIVES: To provide a standard for total abdominal muscle mass (TAM) quantification on computed tomography (CT) and investigate its association with cardiovascular risk in a primary prevention setting. METHODS: We included 3016 Framingham Heart Study participants free of cardiovascular disease (CVD) who underwent abdominal CT between 2002 and 2005. On a single CT slice at the level of L3/L4, we segmented (1) TAM-Area, (2) TAM-Index (= TAM-Area/height) and, (3) TAM-Fraction (= TAM-Area/total cross-sectional CT-area). We tested the association of these muscle mass measures with prevalent and incident cardiometabolic risk factors and incident CVD events during a follow-up of 11.0 ± 2.7 years. RESULTS: In this community-based sample (49% women, mean age: 50.0 ± 10.0 years), all muscle quantity measures were significantly associated with prevalent and incident cardiometabolic risk factors and CVD events. However, only TAM-Fraction remained significantly associated with key outcomes (e.g., adj. OR 0.68 [0.55, 0.84] and HR 0.73 [0.57, 0.92] for incident hypertension and CVD events, respectively) after adjustment for age, sex, body mass index, and waist circumference. Moreover, only higher TAM-Fraction was associated with a lower risk (e.g., adj. OR: 0.56 [0.36-0.89] for incident diabetes versus TAM-Area: adj. OR 1.26 [0.79-2.01] and TAM-Index: 1.09 [0.75-1.58]). CONCLUSION: TAM-Fraction on a single CT slice at L3/L4 is a novel body composition marker of cardiometabolic risk in a primary prevention setting that has the potential to improve risk stratification beyond traditional measures of obesity. KEY POINTS: • In this analysis of the Framingham Heart Study (n = 3016), TAM-F on a single slice CT was more closely associated with prevalent and incident cardiometabolic risk factors as compared to TAM alone or TAM indexed to body surface area. • TAM-F on a single abdominal CT slice at the level of L3/L4 could serve as a standard measure of muscle mass and improve risk prediction.
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Kammerlander et al. (2022) conducted a cohort in Primary prevention of cardiovascular disease (n=3,016). Total abdominal muscle fraction (TAM-Fraction) vs. Lower TAM-Fraction was evaluated on Incident CVD events (HR 0.73, 95% CI 0.57-0.92, p=0.0094). Higher total abdominal muscle fraction (TAM-Fraction) on CT was significantly associated with a lower risk of incident cardiovascular disease events (HR 0.73 per 1-SD increase) after adjustment for traditional obesity measures.
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