{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T06:28:55Z","timestamp":1791440935050,"version":"4.3.3"},"reference-count":40,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T00:00:00Z","timestamp":1753833600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000069","name":"National Institute of Arthritis and Musculoskeletal and Skin Diseases","doi-asserted-by":"publisher","award":["P30 AR072581"],"award-info":[{"award-number":["P30 AR072581"]}],"id":[{"id":"10.13039\/100000069","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000069","name":"National Institute of Arthritis and Musculoskeletal and Skin Diseases","doi-asserted-by":"publisher","award":["R01 AR077273"],"award-info":[{"award-number":["R01 AR077273"]}],"id":[{"id":"10.13039\/100000069","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":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>There is increasing awareness of a role for muscle composition in sarcopenia and cachexia. Computed tomography (CT)\u2013based measures of muscle density (MusD) are commonly used to indicate composition, with a decrease in MusD reflecting an increase in muscle fat infiltration. The current study explored predictors of MusD acquired using high\u2010resolution peripheral quantitative computed tomography (HR\u2010pQCT) and whether MusD predicted physical performance. In addition, reference data for MusD were generated and applied.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>HR\u2010pQCT scans performed in 1662 adults (aged 18\u201380\u2009years) at 30% of bone length proximal from the distal end of the radius and tibia were analysed for forearm and leg MusD, respectively. Predictors of MusD were explored, and it was investigated whether MusD predicted physical performance. Centile curves were fit to the MusD data using the LMS approach to generate reference data, and a calculator was developed to enable computation of subject\u2010specific standardised outcomes. The utility of the calculator was explored in validation cohorts of female collegiate\u2010level athletes (<jats:italic>n<\/jats:italic>\u2009=\u200950) and individuals with chronic kidney disease (CKD) (<jats:italic>n<\/jats:italic>\u2009=\u200950).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Forearm and leg MusD were predicted by whole\u2010body percent fat, sex and age. Forearm and leg MusD were 0.46 (~1.9%) and 0.60\u2009mgHA\/cm<jats:sup>3<\/jats:sup> (~2.6%) lower in females than in males, respectively (all <jats:italic>p<\/jats:italic>\u2009\u2264\u20090.002). For every decade of greater age, forearm and leg MusD were 0.28 (~1.2%) and 0.75\u2009mgHA\/cm<jats:sup>3<\/jats:sup> (~3.3%) lower, respectively (all <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). These observations were independent of whole\u2010body percent fat and appendicular lean mass (ALM)\/height<jats:sup>2<\/jats:sup>. MusD predicted grip strength, fast gait speed and self\u2010reported physical function independent of ALM\/height<jats:sup>2<\/jats:sup>, body mass index and whole\u2010body percent fat. Grip strength was 0.756\u2009kg (~2.4%) greater for every 1\u2009mgHA\/cm<jats:sup>3<\/jats:sup> (~4.2%) greater forearm MusD (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Reference data were generated. Compared to the reference data, female athletes had above\u2010average leg MusD (<jats:italic>z<\/jats:italic>\u2010score\u2009=\u20090.20; 95% CI, 0.01\u20130.39), whereas those with CKD had <jats:italic>z<\/jats:italic>\u2010scores for forearm and leg MusD of \u22121.51 (95% CI, \u22121.95 to \u22121.08) and \u22121.70 (95% CI, \u22122.04 to \u22121.36), respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>HR\u2010pQCT acquired MusD provides a novel indicator of muscle composition which predicts physical function independent of muscle quantity (i.e., ALM\/height<jats:sup>2<\/jats:sup>). Whether the unique information provided by MusD has a role in quantifying health and the consequences of disease and illness (including sarcopenia and cachexia) requires further exploration. Studies in this area may be facilitated by the reference data generated which enable MusD in an individual or population of interest to be expressed relative to sex\u2010 and age\u2010matched norms.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jcsm.70029","type":"journal-article","created":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T09:14:29Z","timestamp":1753866869000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Reference Data and Predictors of HR\u2010pQCT\u2010Derived Muscle Density and Its Prediction of Physical Performance"],"prefix":"10.1002","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6415-4936","authenticated-orcid":false,"given":"Stuart\u00a0J.","family":"Warden","sequence":"first","affiliation":[{"name":"Department of Physical Therapy School of Health and Human Sciences, Indiana University Indianapolis  Indianapolis Indiana USA"},{"name":"Indiana Center for Musculoskeletal 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