{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T01:05:09Z","timestamp":1792026309125,"version":"4.4.0"},"reference-count":43,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:00:00Z","timestamp":1787097600000},"content-version":"vor","delay-in-days":18,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100017530","name":"Fresenius Kabi","doi-asserted-by":"publisher","award":["C24051"],"award-info":[{"award-number":["C24051"]}],"id":[{"id":"10.13039\/100017530","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":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Nutritional ultrasound (NU) enables direct assessment of skeletal muscle and adipose tissue, yet population\u2010based reference values and cut\u2010offs remain scarce. We aimed to establish age\u2010 and sex\u2010specific normative values for rectus femoris (RF) and abdominal adipose tissue NU measurements in apparently healthy adults.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Multicentre cross\u2010sectional study of 1789 healthy blood donors (842 women, 947 men), aged 18\u201380\u2009years (mean 41.5\u2009\u00b1\u200914.9). Standardised NU assessed RF cross\u2010sectional area (CSA), circumference, transverse (X) and anteroposterior (Y) axes, and abdominal and thigh adipose tissue. Anthropometry, bioelectrical impedance analysis (BIA) and handgrip strength (HGS) were obtained. Age\u2010 and sex\u2010specific percentiles were generated across predefined age groups (18\u201330, 31\u201345, 46\u201360 and &gt;\u200960\u2009years). T\u2010scores for RF parameters were derived from a young reference subgroup aged 18\u201345\u2009years (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091001). Associations with sex, age, body mass index and physical activity were analysed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      All NU parameters differed significantly by sex (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Median RF\u2010CSA was 4.60\u2009cm\n                      <jats:sup>2<\/jats:sup>\n                      (IQR 3.83\u20135.58) in women and 6.77\u2009cm\n                      <jats:sup>2<\/jats:sup>\n                      (5.55\u20137.91) in men; median RF\u2010Y axis at rest was 1.56\u2009cm (1.33\u20131.80) and 1.91\u2009cm (1.65\u20132.17), and during contraction 1.97\u2009cm (1.71\u20132.24) and 2.47\u2009cm (2.15\u20132.78), respectively. Median total abdominal subcutaneous adipose tissue (T\u2010SAT) was 1.77\u2009cm (1.16\u20132.39) in women and 1.65\u2009cm (1.13\u20132.22) in men. RF measurements correlated moderately\u2013strongly with BIA\u2010derived muscle mass (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.45\u20130.65) and HGS (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.49\u20130.58). T\u2010SAT correlated with BIA fat mass and waist circumference (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.45\u20130.65), whereas visceral adipose tissue showed weaker associations (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009\u2248\u20090.33). RF\u2010CSA and RF\u2010Y axis increased across physical\u2010activity categories (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). Absolute RF values did not differ by BMI; however, when indexed to body weight, participants with BMI\u2009&gt;\u200925\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      had lower RF\u2010CSA and RF\u2010Y values (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). RF parameters followed a normal distribution, whereas adipose tissue measures did not. In the young reference group (18\u201345\u2009years), mean \u00b1 SD RF\u2010Y axis was 1.68\u2009\u00b1\u20090.33\u2009cm in women and 2.05\u2009\u00b1\u20090.37\u2009cm in men. When applying T\u2010score criteria, the \u22122 standard deviation cut\u2010off identified 1.4%\u201311.7% of adults aged \u226545\u2009years as having low muscle mass.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study provides the first age\u2010 and sex\u2010specific population\u2010based reference values for nutritional ultrasound measurements in an apparently healthy adult Spanish population. These findings support the validity, clinical applicability, and standardisation of nutritional ultrasound for the assessment of muscle mass, with potential utility in the diagnosis of sarcopenia and malnutrition.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jcsm.70344","type":"journal-article","created":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T09:44:49Z","timestamp":1787132689000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Normative Reference Values and Cut\u2010Off Points for Nutritional Ultrasound: The VALORES Study"],"prefix":"10.1002","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-2768-8151","authenticated-orcid":false,"given":"Carolina","family":"Moreno\u2010Torres\u2010Taboada","sequence":"first","affiliation":[{"name":"Department of Endocrinology and Nutrition Regional University Hospital of M\u00e1laga  M\u00e1laga Spain"},{"name":"Department of Medicine and Dermatology, Faculty of Medicine University of Malaga  M\u00e1laga Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 M.","family":"Romero\u2010M\u00e1rquez","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Nutrition Virgen de las Nieves University Hospital  Granada Spain"},{"name":"Foundation for Biosanitary Research of Eastern Andalusia \u2010 Alejandro Otero (FIBAO)  Granada Spain"},{"name":"Faculty of Health Sciences. Department of Nutrition and Sports Sciences International University of La Rioja  Logro\u00f1o Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda","family":"Garc\u00eda\u2010Olivares","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Nutrition Regional University Hospital of M\u00e1laga  M\u00e1laga Spain"},{"name":"Department of Medicine and Dermatology, Faculty of Medicine University of Malaga  M\u00e1laga Spain"},{"name":"IBIMA BIONAND Platform Biomedical Research Institute of M\u00e1laga  M\u00e1laga Spain"},{"name":"Department of Endocrinology and Nutrition Quir\u00f3nSalud M\u00e1laga Hospital  M\u00e1laga Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda","family":"Novo\u2010Rodr\u00edguez","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Nutrition Virgen de las Nieves University Hospital  Granada Spain"},{"name":"Foundation for Biosanitary Research of Eastern Andalusia \u2010 Alejandro Otero (FIBAO)  Granada Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roc\u00edo","family":"Fern\u00e1ndez\u2010Jim\u00e9nez","sequence":"additional","affiliation":[{"name":"Department of Medicine and Dermatology, Faculty of Medicine University of Malaga  M\u00e1laga Spain"},{"name":"IBIMA BIONAND Platform Biomedical Research Institute of M\u00e1laga  M\u00e1laga Spain"},{"name":"Department of Endocrinology and Nutrition Quir\u00f3nSalud M\u00e1laga Hospital  M\u00e1laga Spain"},{"name":"Department of Endocrinology and Nutrition Virgen de la Victoria University Hospital  M\u00e1laga Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabel","family":"Vegas\u2010Aguilar","sequence":"additional","affiliation":[{"name":"IBIMA BIONAND Platform Biomedical Research Institute of M\u00e1laga  M\u00e1laga Spain"},{"name":"Department of Endocrinology and Nutrition Virgen de la Victoria University Hospital  M\u00e1laga Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro Pablo","family":"Garc\u00eda\u2010Luna","sequence":"additional","affiliation":[{"name":"Nutrition Unit, Endocrinology and Nutrition Department Virgen del Roc\u00edo University Hospital  Sevilla Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Garc\u00eda\u2010Rey","sequence":"additional","affiliation":[{"name":"Nutrition Unit, Endocrinology and Nutrition Department Virgen del Roc\u00edo University Hospital  Sevilla Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Manuel","family":"Garc\u00eda\u2010Almeida","sequence":"additional","affiliation":[{"name":"Department of Medicine and Dermatology, Faculty of Medicine University of Malaga  M\u00e1laga Spain"},{"name":"IBIMA BIONAND Platform Biomedical Research Institute of M\u00e1laga  M\u00e1laga Spain"},{"name":"Department of Endocrinology and Nutrition Quir\u00f3nSalud M\u00e1laga Hospital  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