{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T18:21:38Z","timestamp":1790360498973,"version":"4.1.0"},"reference-count":46,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2019,3,21]],"date-time":"2019-03-21T00:00:00Z","timestamp":1553126400000},"content-version":"vor","delay-in-days":48,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J cachexia sarcopenia muscle"],"published-print":{"date-parts":[[2019,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Sarcopenia has been described as the age\u2010associated decrease in skeletal muscle mass. However, virtually every study of sarcopenia has measured lean body mass (LBM) or fat free mass (FFM) rather than muscle mass, specifically. In a number of published sarcopenia studies, LBM or FFM is referred to as muscle mass, leading to an incorrect assumption that measuring LBM or FFM is an accurate measure of muscle mass. As a result, the data on the effects of changes in LBM or FFM in older populations on outcomes such as functional capacity, disability, and risk of injurious falls have been inconsistent resulting in the conclusion that muscle mass is only weakly related to these outcomes. We review and describe the assumptions for the most commonly used measurements of body composition. Dual\u2010energy X\u2010ray absorptiometry (DXA) has become an increasingly common tool for the assessment of LBM or FFM and appendicular lean mass as a surrogate, but inaccurate, measurement of muscle mass. Other previously used methods (total body water, bioelectric impedance, and imaging) also have significant limitations. D<jats:sub>3<\/jats:sub>\u2010Creatine (D<jats:sub>3<\/jats:sub>\u2010Cr) dilution provides a direct and accurate measurement of creatine pool size and skeletal muscle mass. In a recent study in older men (MrOS cohort), D<jats:sub>3<\/jats:sub>\u2010Cr muscle mass was associated with functional capacity and risk of injurious falls and disability, while assessments of LBM or appendicular lean mass by DXA were only weakly or not associated with these outcomes. Inaccurate measurements of muscle mass by DXA and other methods have led to inconsistent results and potentially erroneous conclusions about the importance of skeletal muscle mass in health and disease. The assessment of skeletal muscle mass using the D<jats:sub>3<\/jats:sub>\u2010Cr dilution method in prospective cohort studies may reveal sarcopenia as a powerful risk factor for late life disability and chronic disease.<\/jats:p>","DOI":"10.1002\/jcsm.12390","type":"journal-article","created":{"date-parts":[[2019,3,22]],"date-time":"2019-03-22T04:09:01Z","timestamp":1553227741000},"page":"14-21","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":168,"title":["D<sub>3<\/sub>\u2010Creatine dilution and the importance of accuracy in the assessment of skeletal muscle mass"],"prefix":"10.1002","volume":"10","author":[{"given":"William J.","family":"Evans","sequence":"first","affiliation":[{"name":"Department of Nutritional Sciences and Toxicology University of California  Berkeley USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Hellerstein","sequence":"additional","affiliation":[{"name":"Department of Nutritional Sciences and Toxicology University of California  Berkeley USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Orwoll","sequence":"additional","affiliation":[{"name":"Department of Medicine Oregon Health and Science University  Portland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steve","family":"Cummings","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics University of California  San Francisco CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peggy M.","family":"Cawthon","sequence":"additional","affiliation":[{"name":"California Pacific Medical Center Research Institute, University of San Francisco  USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,3,21]]},"reference":[{"key":"e_1_2_5_2_1","first-page":"408","article-title":"Linking age\u2010related changes in skeletal muscle mass and composition with metabolism and disease","volume":"9","author":"Janssen I","year":"2005","journal-title":"J Nutr Health Aging"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/86.3.633"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.3389\/fnagi.2014.00269"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a009520"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1017\/BJN20061943"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40520-017-0724-9"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2005.10.013"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2012.07.005"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.ijo.0802552"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0029665115000129"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1998.84.4.1475"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005768-199805000-00020"},{"key":"e_1_2_5_14_1","first-page":"E829","article-title":"Body fat from body density: underwater weighing vs. dual\u2010photon absorptiometry","volume":"256","author":"Wang J","year":"1989","journal-title":"Am J Physiol"},{"key":"e_1_2_5_15_1","unstructured":"CostillDL ArmstrongLE KingDS FinkWJ.Muscle metabolism during exercise in the heat in unacclimatized and acclimatized man. U.S. Army Medical Research and Development Command;1985May 31 1985. Report No.: DAMD 17\u201383\u2010C\u20103009."},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1974.37.4.521"},{"key":"e_1_2_5_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/47.1.7"},{"key":"e_1_2_5_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/77.2.331"},{"key":"e_1_2_5_19_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1532-5415.2002.50216.x"},{"key":"e_1_2_5_20_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0200465"},{"key":"e_1_2_5_21_1","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.00744.2004"},{"key":"e_1_2_5_22_1","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.2001.90.6.2157"},{"key":"e_1_2_5_23_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajpendo.1999.277.3.E489"},{"key":"e_1_2_5_24_1","doi-asserted-by":"publisher","DOI":"10.1093\/epirev\/mxs006"},{"key":"e_1_2_5_25_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/glr010"},{"key":"e_1_2_5_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/jcsm.12268"},{"key":"e_1_2_5_27_1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afu115"},{"key":"e_1_2_5_28_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/glu010"},{"key":"e_1_2_5_29_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/glu023"},{"key":"e_1_2_5_30_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/61.1.72"},{"key":"e_1_2_5_31_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1532-5415.2003.51534.x"},{"key":"e_1_2_5_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2007.01140.x"},{"key":"e_1_2_5_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2011.01.003"},{"key":"e_1_2_5_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2011.04.014"},{"key":"e_1_2_5_35_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/37.3.478"},{"key":"e_1_2_5_36_1","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1978.45.4.536"},{"key":"e_1_2_5_37_1","doi-asserted-by":"publisher","DOI":"10.1002\/jcsm.12278"},{"key":"e_1_2_5_38_1","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.00045.2014"},{"key":"e_1_2_5_39_1","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.00122.2012"},{"key":"e_1_2_5_40_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13539-013-0110-1"},{"key":"e_1_2_5_41_1","doi-asserted-by":"publisher","DOI":"10.1113\/jphysiol.1962.sp007000"},{"key":"e_1_2_5_42_1","doi-asserted-by":"publisher","DOI":"10.1002\/jmri.24641"},{"key":"e_1_2_5_43_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/gly129"},{"key":"e_1_2_5_44_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/gly180"},{"key":"e_1_2_5_45_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/50A.Special_Issue.5"},{"key":"e_1_2_5_46_1","doi-asserted-by":"publisher","DOI":"10.2337\/db14-1208"},{"key":"e_1_2_5_47_1","doi-asserted-by":"publisher","DOI":"10.1002\/jcsm.12261"}],"container-title":["Journal of Cachexia, Sarcopenia and Muscle"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jcsm.12390","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jcsm.12390","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jcsm.12390","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,10]],"date-time":"2023-09-10T18:43:32Z","timestamp":1694371412000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jcsm.12390"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,2]]},"references-count":46,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2019,2]]}},"alternative-id":["10.1002\/jcsm.12390"],"URL":"https:\/\/doi.org\/10.1002\/jcsm.12390","archive":["Portico"],"relation":{},"ISSN":["2190-5991","2190-6009"],"issn-type":[{"value":"2190-5991","type":"print"},{"value":"2190-6009","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,2]]},"assertion":[{"value":"2018-12-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-12-19","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-03-21","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}