American Journal of Clinical Nutrition, Vol 63, 863-869, Copyright © 1996 by The American Society for Clinical Nutrition, Inc

ORIGINAL RESEARCH COMMUNICATIONS

Total-body skeletal muscle mass: evaluation of 24-h urinary creatinine excretion by computerized axial tomography

ZM Wang, D Gallagher, ME Nelson, DE Matthews and SB Heymsfield
Department of Medicine, Obesity Research Center, New York, NY 10025, USA.

A classic body-composition method is estimation of total-body skeletal muscle mass (SM, in kg) from 24-h urinary creatinine excretion (in g). Two approaches of unknown validity have been used to calculate SM from creatinine: one assumes a constant ratio of SM to creatinine, the so- called creatinine equivalence (k), and that SM = k x creatinine; the other suggests a highly variable ratio of SM to creatinine and is based on regression equations of the form SM = b + a x creatinine. We explored these two extreme possibilities by measuring SM with whole- body computerized axial tomography and collecting urinary creatinine during meat-free dietary conditions in 12 healthy adult men. Prediction equations were developed in the men that fit these two models: SM = 21.8 x creatinine (SD and CV of the ratio of SM to creatinine: 1.3 kg and 6.0%, respectively) and SM = 18.9 x creatinine + 4.1 (r = 0.92, P = 2.55 x 10(-5), SEE = 1.89 kg). The validity of each model is reviewed in the context of theoretical aspects of creatine-creatinine metabolism. This first investigation of the method of measuring urinary creatinine excretion to determine SM by using modern techniques raises important practical and basic questions related to SM prediction.

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