Abstract:
Background: Appendicular skeletal muscle mass (ASMM) is a measure of body muscle content, and it correlates
with nutrition and physical status. Estimation of ASMM using anthropometric models is a well-established strategy
to overcome issues related to the restricted availability of sophisticated techniques in measuring ASMM. This study
aimed to assess the validity of four selected anthropometric models in estimating ASMM in middle-aged women in
Sri Lanka.
Methods: A group of women (n = 165) aged 30–60 years underwent a series of anthropometric measurements
such as body weight, height, circumferences, and skin fold thickness at specific sites. The limb circumferences were
corrected for subcutaneous adipose tissue thickness. Two models developed by Lee et al. (ASM 1, ASM2) and two
models developed by Wen et al. (ASM3, ASM4) were validated using ASMM measured by dual energy x-ray absorptiometry
(ASMMDXA) as the reference standard.
Results: Mean (SD) age of the study group was 49.0 (8.2) years. Mean (SD) ASMMDXA and ASMM estimated by the four
models were ASMMDXA = 15.39 (2.75) kg, ASM1 = 18.36 (3.27) kg, ASM2 = 16.46 (3.01) kg, ASM3 = 15.44 (2.40) kg, and
ASM4 = 14.44 (2.45) kg. Correlations of ASMMDXA with ASMM estimated by the models were as follows: ASM1, r = 0.68,
R2 = 0.46, SEE = 2.02 kg; ASM2, r = 0.90, R2 = 0.81, SEE = 1.18 kg; ASM3, r = 0.90, R2 = 0.81, SEE = 1.17 kg; and ASM4, r = 0.
91, R2 = 0.82, SEE = 1.14 kg. ASMM estimated by ASM3 was not significantly different (P > 0.05) from ASMMDXA with
mean difference of − 0.05 (range, 0.12 to − 0.23). Bland and Altman plot revealed satisfactory measurement agreements
between ASM3 and ASMMDXA. The ASMM estimated by the other three models was significantly different from the
ASMMDXA (P < 0.05).
Conclusion: The ASM3 model introduced by Wen et al. met all validation criteria and can be recommended for the
estimation of ASMM in middle-aged women in Sri Lanka.
