{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T01:05:12Z","timestamp":1792026312433,"version":"4.4.0"},"reference-count":41,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,3,4]],"date-time":"2025-03-04T00:00:00Z","timestamp":1741046400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,3,4]],"date-time":"2025-03-04T00:00:00Z","timestamp":1741046400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","award":["NRF\u2010022R1A2C1013479"],"award-info":[{"award-number":["NRF\u2010022R1A2C1013479"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J cachexia sarcopenia muscle"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Muscle quality, represented by myosteatosis, is recognized as an important factor in sarcopenia. In this study, we aimed to determine the associations between myosteatosis, muscle strength and physical performance among the elderly South Korean population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We included 1440 participants (mean age 62.7\u2009\u00b1\u20096.2\u2009years) from the Korean Genome and Epidemiology Study (KoGES). Based on the computed tomography attenuation of mid\u2010thigh imaging, the total muscle area (TMA), normal\u2010attenuation muscle area (NAMA), low\u2010attenuation muscle area (LAMA) and inter\u2010intramuscular adipose tissue (IMAT) and its indices were used to evaluate myosteatosis. Muscle strength was evaluated using hand grip strength, whereas physical performance was evaluated through 4\u2010m gait speed, a 30\u2010s sit\u2010to\u2010stand test and 2\u2010min walking test.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of the 1440 patients, 51.5% were women, and 37.2% had diabetes. With aging, the LAMA index gradually increased, and the NAMA index gradually decreased in both men and women (\n                      <jats:italic>p<\/jats:italic>\n                      for trend &lt;\u20090.001). The NAMA index was positively associated, whereas the LAMA and IMAT indices were negatively associated with muscle strength and physical performance after adjusting for age and sex. Higher tertiles of the NAMA index were consistently associated with improved physical performance across all appendicular skeletal muscle tertiles. The relationship between the NAMA index or LAMA index and muscle strength and physical performance did not differ according to diabetic status. Regular exercise was associated with a higher NAMA index and a lower LAMA index in the non\u2010diabetic group; however, no significant difference in muscle quality was observed in the diabetic group in relation to exercise.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Reduced myosteatosis was positively associated with greater muscle strength and better physical performance in both men and women, regardless of muscle mass or diabetes status; improving myosteatosis may be a therapeutic target for the prevention of sarcopenia.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jcsm.13760","type":"journal-article","created":{"date-parts":[[2025,3,11]],"date-time":"2025-03-11T17:54:55Z","timestamp":1741715695000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Impact of Muscle Quality on Muscle Strength and Physical Performance Beyond Muscle Mass or Diabetes Status"],"prefix":"10.1002","volume":"16","author":[{"given":"Jung\u00a0A","family":"Kim","sequence":"first","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of Internal Medicine Korea University Anam Hospital  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chol","family":"Shin","sequence":"additional","affiliation":[{"name":"Institute of Human Genomic Study, College of Medicine Korea University  Seoul Republic of Korea"},{"name":"Biomedical Research Center Korea University Ansan Hospital  Ansan Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inha","family":"Jung","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of Internal Medicine Korea University Ansan Hospital  Ansan Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"So\u00a0Young","family":"Park","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of Internal Medicine Korea University Ansan Hospital  Ansan Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Da\u00a0Young","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of Internal Medicine Korea University Ansan Hospital  Ansan Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji\u00a0Hee","family":"Yu","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of Internal Medicine Korea University Ansan Hospital  Ansan Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyunjoo","family":"Cho","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of Internal Medicine Korea University Ansan Hospital  Ansan Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seung\u00a0Ku","family":"Lee","sequence":"additional","affiliation":[{"name":"Institute of Human Genomic Study, College of Medicine Korea University  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyoung\u00a0Jin","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of Internal Medicine Korea University Anam Hospital  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eyun","family":"Song","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of Internal Medicine Korea University Guro Hospital  Seoul Republic of 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