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Trunk Muscle Composition 2 Months After Hip Fracture: Findings From the Baltimore Hip Studies

Published:December 19, 2018DOI:https://doi.org/10.1016/j.apmr.2018.10.023

      Abstract

      Objective

      To determine if hip fracture patients would have smaller cross-sectional area (CSA) and lower radiological attenuation (suggesting greater fat infiltration) in all trunk muscles as compared to older adults without hip fractures.

      Design

      Cross-sectional analysis of computed tomography (CT) scans.

      Setting

      Clinical imaging facility.

      Participants

      Forty-one white participants (19 men, 22 women) from the Baltimore Hip Studies seventh cohort at 2 months postfracture were compared to 693 white participants (424 men, 269 women) from the Health, Aging and Body Composition (Health ABC) study at the year 6 visit (N=734).

      Intervention

      Not applicable.

      Main Outcome Measures

      Trunk muscle CSA and attenuation values were obtained from a single 10-mm, axial CT scan completed at the L4-L5 disc space in each participant.

      Results

      The hip fracture cohort had significantly smaller CSA for all trunk muscles (range: 12.1%-38% smaller) compared to the Health ABC cohort (P<.01), with the exception of the rectus abdominus muscle in men (P=.12). But, hip fracture patients, particularly female patients, had higher attenuation levels (lower intramuscular fat) in all trunk muscles (P<.0001).

      Conclusions

      Findings are consistent with atrophy of the trunk muscles in the hip fracture population without a high level of intramuscular fat. Future work should evaluate the role of trunk muscle composition in the functional recovery of older adults after hip fracture.

      Keywords

      List of abbreviations:

      BHS-7 (Baltimore Hip Studies seventh cohort), BMD (bone mineral density), BMI (body mass index), CSA (cross-sectional area), CT (computed tomography), Health ABC (Health, Aging and Body Composition), IRB (institutional review board)
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