German researchers used deep learning models to analyze the composition of large muscles on MRI and found that the ratio of intermuscular fat to lean muscle mass was associated with high blood pressure, unhealthy lipids, and blood sugar levels. The research results were announced today. RadiologyJournal of the Radiological Society of North America (RSNA).
In this retrospective cross-sectional study, 11,348 participants (56.9% male, median age 43 years) without pre-existing conditions underwent whole-body MRI at five imaging sites. The researchers used a segmentation algorithm they developed (a method used to divide data into meaningful parts or regions based on common characteristics) to quantify the amount of intermuscular adipose tissue, or hidden fat, and the amount of functional musculature in the paraspinal muscles that run along the spine between the neck and pelvis. Until recently, measuring these features required time-consuming manual analysis.
Skeletal muscle is a major driver of metabolic health and influences cardiovascular health through multiple pathways including glucose regulation, energy metabolism, and inflammatory responses, all of which influence cardiovascular health. ”
Sebastian Ziegelmayer, MD, Principal Researcher, Technical University of Munich, Associate Professor, Radiologist
Participants’ cardiometabolic risk factors were collected as part of a prospective multicenter population study. Laboratory test results and lab tests revealed that many had previously undiagnosed conditions: high blood pressure (16.2%), abnormal blood sugar levels (8.5%), and unhealthy lipid patterns (45.9%). Lipids are fatty, oily, waxy compounds that serve a variety of functions in the body.
“While we focused on a healthy population without pre-existing conditions, we found that significant cardiometabolic risk factors were present in these participants,” Dr. Siegelmeyer said. “We found that the more intermuscular fat and less muscle mass, the greater the cardiometabolic risk factors.”
After adjusting for age, sex, physical activity, and study site, increased intermuscular adipose tissue was associated with significantly higher odds of high blood pressure (hypertension), abnormal blood sugar levels, and unhealthy lipid patterns in both men and women. Increased lean muscle mass was associated with a protective effect on cardiometabolic risk factors only in men.
“For women, lean muscle mass remained relatively stable from ages 40 to 50, but a significant decline was observed thereafter,” Dr. Siegelmeier said. “This timing coincides with the transition to menopause and decline in estrogen, which may partly explain why we found a protective association of lean muscle mass only in men.”
Researchers also found that decreased physical activity was associated with increased intermuscular adipose tissue and decreased lean muscle mass.
Dr. Siegelmeier said this study is a first step toward establishing image-based biomarkers that can identify patients who are susceptible to cardiometabolic problems.
Because MRI is already widely used for other clinical purposes, it could be used opportunistically to augment traditional risk factor screening, Dr. Siegelmeier said, potentially yielding additional health insights from scans already performed. He said this approach could help identify high-risk individuals who appear metabolically healthy by traditional criteria for early intervention.
“If we extend this to more advanced sequences using MRI, we can perform more complex analyses,” Dr. Ziegelmayer said. “Muscle composition can reflect not only cardiometabolic health but also overall health, so there is great potential in further exploring this direction.”
sauce:
Radiological Society of North America
Reference magazines:
Siegelmeyer, S. Others. (2026). Association of MRI-derived paraspinal IMAT and LMM with cardiometabolic risk factors: Results from a German cohort. Radiology. DOI: 10.1148/radiol.251347. https://pubs.rsna.org/doi/10.1148/radiol.251347
