Association between abdominal muscle mass measured by dual-source computed tomography and coronary artery calcification in patients with Type 2 diabetes mellitus

Objective To describe the correlation between abdominal muscle mass and CAC in T2DM patients using DSCT, and to determine the preferred muscle imaging indicators in diagnosing and predicting positive CAC patients. Materials and methods 108 T2DM patients were included (57.0 ± 10.9 years old). We acquired both CAC score and abdominal-chest DSCT data. DSCT measurements (intermuscular adipose tissue [IMAT], total abdominal muscle area [TAMA], normal attenuation muscle area [NAMA], low attenuation muscle area [LAMA], fat fraction [FF], LAMA/body mass index [BMI], NAMA/BMI, and NAMA/TAMA index) of 7 muscles (psoas major [PM], quadratus lumborum [QL], erector spinae [ES], rectus abdominis [RA], transversus abdominis [TA], oblique abdominals [OA], abdominal core muscles [ACM]) on the level of the third lumbar vertebra were conducted. T2DM patients were divided into four subgroups based on CAC score: negative controls (NCs) (0 score), mild (<100 score), moderate (100–300 score), and severe (>300 score). The following statistical analyses were conducted: intergroup differences were compared using the Mann-Whitney test, diagnostic performance was evaluated via receiver operating characteristic (ROC) curve analysis, associations were assessed with Spearman correlation, and predictors were identified through logistic regression. A P -value <0.05 was considered statistically significant. Result Compared with NCs, TAMA, NAMA, NAMA/BMI, and NAMA/TAMA index were significantly higher in the group of all CAC ( P <0.05), while TAMA was significantly lower ( P <0.05). The NAMA, NAMA/BMI and the NAMA/TAMA index in four representative muscles (PM, QL, ES, and RA) demonstrated certain diagnostic performance (AUC range, 0.70-0.97, 0.85-0.99 and 0.81-0.97). Overall, NAMA/TAMA index in OA exhibited the strongest negative correlation with CAC score (r=-0.56, P < 0.01), and NAMA/BMI in the ACM emerged as an independent risk factor for positive CAC (odds ratio=0.63, P = 0.02). Conclusion Abdominal muscle mass measured by DSCT was significantly associated with CAC score in T2DM patients. Overall, the NAMA/BMI showed optimal diagnostic value for CAC across severity levels. Moreover, NAMA/BMI in the ACM may serve as a predictive biomarker for positive CAC.