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1 Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania 15261; 2 National Institute on Aging, Bethesda, Maryland 20892; 3 Department of Radiology, University of Colorado Health Sciences Center, Denver, Colorado 80261; and 4 Institute for Research in Extramural Medicine, Vrije University, Amsterdam, The Netherlands
Although loss of muscle mass is considered a
cause of diminished muscle strength with aging, little is known
regarding whether composition of aging muscle affects strength. The
skeletal muscle attenuation coefficient, as determined by computed
tomography, is a noninvasive measure of muscle density, and lower
values reflect increased muscle lipid content. This investigation
examined the hypothesis that lower values for muscle attenuation are
associated with lower voluntary isokinetic knee extensor strength at
60°/s in 2,627 men and women aged 70-79 yr participating in
baseline studies of the Health ABC Study, a longitudinal study of
health, aging, and body composition. Strength was higher in men than in women (132.3 ± 34.5 vs. 81.4 ± 22.0 N · m,
P < 0.01). Men had greater muscle attenuation values
(37.3 ± 6.5 vs. 34.7 ± 7.0 Hounsfield units) and muscle
cross-sectional area (CSA) at the midthigh than women (132.7 ± 22.4 vs. 93.3 ± 17.5 cm2, P < 0.01 for both). The strength per muscle CSA (specific force) was also higher
in men (1.00 ± 0.21 vs. 0.88 ± 0.21 N · m · cm
2). The attenuation coefficient
was significantly lower for hamstrings than for quadriceps (28.7 ± 8.7 vs. 41.1 ± 6.9 Hounsfield units, P < 0.01). Midthigh muscle attenuation values were lowest
(P < 0.01) in the eldest men and women and were
negatively associated with total body fat (r = 
0.53,
P < 0.01). Higher muscle attenuation values were also
associated with greater specific force production (r = 0.26, P < 0.01). Multivariate regression analysis
revealed that the attenuation coefficient of muscle was independently
associated with muscle strength after adjustment for muscle CSA and
midthigh adipose tissue in men and women. These results demonstrate
that the attenuation values of muscle on computed tomography in older persons can account for differences in muscle strength not attributed to muscle quantity.
aging; computed tomography; adipose tissue; muscle strength
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