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The use of portable A-mode ultrasound in appendicular lean mass measurements among older adults: a comparison study with dual-energy X-ray absorptiometry and handgrip strength

European Journal of Clinical Nutrition volume 79, pages 136–141 (2025)Cite this article

Subjects

Abstract

Background/objectives

Strength and muscle mass are key factors for the diagnosis of sarcopenia. The EWGSOP2 recommended using ultrasound (US) as a reliable device to measure muscle mass (MM), but A-mode US still needs to be validated for older adults. This study aimed to evaluate the association between measurements of muscle thickness (MT) by portable A-mode US and, muscle quantity by Dual-Energy X-ray absorptiometry (DXA) in older adults.

Methods

Cross-sectional study, with 115 participants included. Muscle mass was assessed by DXA and MT of the biceps, triceps, anterior thigh, and calf by A-mode US and handgrip strength by a dynamometer.

Results

The majority were women (n = 96; 83%), 69 ± 6 years. The MT sum (biceps, triceps, thigh, and calf) assessed by the US was not associated with the appendicular lean mass (ALM) assessed by DXA after controlling for sex and age (R2 = 0.524; p = 0.139; effect size = 0.53). The MT sum biceps and triceps was still significantly associated with MM arms/2 even when controlling for sex and age (which were also significant) (R2 = 0.551; p < 0.001; effect size = 0.56). The MT sum thigh and calf was not associated with MM legs/2 in adjusted models (R2 = 0.499; p = 0.688; effect size = 0.51).

Conclusions

This finding shows that the portable A-mode US may not be an appropriate method for estimating MM in extremities (the sum of arms and legs), but can be appropriate for estimating only MM arms in healthy older adults.

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Data availability

Data from the study can be found within the article and additional data are available from the corresponding author on reasonable request.

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Acknowledgements

The authors would like to thank all participants and those responsible for the places where the data were collected (Laboratory of Investigation in Metabolism and Diabetes—LIMED) and the places where participants were recruited.

Funding

This study was supported by the São Paulo Research Foundation (FAPESP) [Finance Code 2021/01304-0 and 2020/00944-2], by Coordination for the Improvement of Higher Education Personnel—Brazil (Coordenação de Aperfeiçoamento de Pessoal de Nível Superior—CAPES), Finance Code 001 and, the Lemann Center for Brazilian Studies. LPC thanks Cnpq—Conselho Nacional de Desenvolvimento Científico e Tecnológico for her productivity grant 304838/2022-5.

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Authors and Affiliations

  1. School of Applied Sciences, University of Campinas, Limeira, Brazil

    Lara Vilar Fernandes, Ana Carolina Junqueira Vasques & Ligiana Pires Corona

  2. School of Medical Sciences, University of Campinas, Campinas, Brazil

    Gabriela Benatti de Oliveira

  3. Federal University of Technology-Paraná, Curitiba, Paraná, Brazil

    Wagner Luis Ripka

  4. School of Social Work, University of Illinois at Urbana-Champaign, Champaign, IL, USA

    Xiayu Summer Chen & Flavia Cristina Drumond Andrade

Authors
  1. Lara Vilar Fernandes
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  2. Gabriela Benatti de Oliveira
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  4. Xiayu Summer Chen
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  5. Flavia Cristina Drumond Andrade
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  6. Ana Carolina Junqueira Vasques
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Contributions

LVF: Investigation, Data Curation, Data Analysis, and Writing; GBO: Investigation, Data Curation, and Writing; WLR: Data Analysis and Writing; XSC: Writing; FCDA: Data Analysis, Writing; ACJV: Supervision and Writing; LPC: Conceptualization, Investigation, Methodology, Supervision, Funding Acquisition, Formal Analysis, and Writing. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Lara Vilar Fernandes.

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Competing interests

The authors declare no competing interests.

Ethical approval

The present study was approved by the Research Ethics Committee of UNICAMP (Number: 5.027.838). All participants provided written informed consent before any assessment. This study followed the ethical standards of the responsible Research Ethics Committee and the Declaration of Helsinki.

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Fernandes, L.V., de Oliveira, G.B., Ripka, W.L. et al. The use of portable A-mode ultrasound in appendicular lean mass measurements among older adults: a comparison study with dual-energy X-ray absorptiometry and handgrip strength. Eur J Clin Nutr 79, 136–141 (2025). https://doi.org/10.1038/s41430-024-01521-w

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