Imaging Biomarkers of Human Skeletal Muscle (Mass, Morphology and Texture Features of Muscle Groups in the Body Trunk and Thigh) in Sarcopenia and Cardiometabolic Disease

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The aim of the project is to characterise the skeletal musculature from MRI image data sets of the entire German National Cohort (GNC, NAKO Gesundheitsstudie) (about 30,000 participants with MRI image data) with regard to clinically relevant changes, whereby both the volume or the maximum cross-sectional area and the composition and spatial distribution (texture) of fatty tissue and connective tissue of defined muscle groups in the trunk and thigh are investigated. The skeletal musculature is of outstanding importance for mobility and metabolism of the human organism. It is known that changes in muscle structure with breakdown of contractile elements and increase in fat and connective tissue (sarcopenia) often lead to loss of mobility and need for care in elderly patients. Metabolic diseases such as diabetes as well as cardiovascular and pulmonary diseases are also associated with a reduction in muscle strength and endurance in many patients. The associated structural changes in the musculature have been little researched so far. In the first phase of the project (January 2020 - December 2022) in the "Priority Programme SPP 2177", AI-based automated evaluation programmes for the segmentation of four muscle groups (m. psoas, m. gluteus, m. quadriceps femoris and flexor muscles of the thigh) and texture analysis of the segmented muscle areas were developed and quality-tested. Corresponding data have already been collected and evaluated on approximately 11,000 data sets initially available from the GNC/NAKO. In the second funding phase, which is now being applied for, the image analyses are to be extended to all 30,000 data sets now available. One goal is to determine muscle characteristics (such as volume, fat content, texture characteristics) and their dependence on age, gender and constitution (BMI, body height) in the entire cohort. As the GNC/NAKO data derived from questionnaire and physical or laboratory examinations are only now becoming available, the second phase of the project will also evaluate the correlations of muscle characteristics with physical activity and muscle strength measurements as well as with disease-related data (oral glucose tolerance test, blood pressure, presence of pulmonary or cardiovascular diseases). Specific, image-morphological muscle characteristics are sought that can serve as diagnostic or prognostic biomarkers for the physiological ageing process as well as for pathological changes in the musculature. The regulation of muscular structure and especially of fat content is not independent of the distribution of visceral and subcutaneous fat tissue as well as of ectopic fat deposits in the liver. In order to clarify these relationships, close interaction is planned with the project groups in SP 2177, which are working on the analysis of body fat distribution and ageing (close collaboration is already established).