Association between diaphragm excursion and whole-body muscle mass in older adults: an observational study

Abstract Symptoms of diaphragm dysfunction, such as exertional dyspnea and decreased exercise tolerance, share similarities with the symptoms of skeletal muscle mass reduction caused by conditions like sarcopenia. Given that the diaphragm is also a skeletal muscle, sarcopenia may be associated with...

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Main Authors: Shuji Ouchi, Toru Yamada, Takahiro Shinohara, Suguru Mabuchi, Kazuharu Nakagawa, Kanako Yoshimi, Ayane Horike, Tatsuya Mayama, Kenji Toyoshima, Yoshiaki Tamura, Atsushi Araki, Ryoichi Hanazawa, Akihiro Hirakawa, Hiroyuki Ichige, Takeshi Ishida, Takuma Kimura, Haruka Tohara, Masayoshi Hashimoto
Format: Article
Language:English
Published: Nature Portfolio 2025-07-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-08997-x
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author Shuji Ouchi
Toru Yamada
Takahiro Shinohara
Suguru Mabuchi
Kazuharu Nakagawa
Kanako Yoshimi
Ayane Horike
Tatsuya Mayama
Kenji Toyoshima
Yoshiaki Tamura
Atsushi Araki
Ryoichi Hanazawa
Akihiro Hirakawa
Hiroyuki Ichige
Takeshi Ishida
Takuma Kimura
Haruka Tohara
Masayoshi Hashimoto
author_facet Shuji Ouchi
Toru Yamada
Takahiro Shinohara
Suguru Mabuchi
Kazuharu Nakagawa
Kanako Yoshimi
Ayane Horike
Tatsuya Mayama
Kenji Toyoshima
Yoshiaki Tamura
Atsushi Araki
Ryoichi Hanazawa
Akihiro Hirakawa
Hiroyuki Ichige
Takeshi Ishida
Takuma Kimura
Haruka Tohara
Masayoshi Hashimoto
author_sort Shuji Ouchi
collection DOAJ
description Abstract Symptoms of diaphragm dysfunction, such as exertional dyspnea and decreased exercise tolerance, share similarities with the symptoms of skeletal muscle mass reduction caused by conditions like sarcopenia. Given that the diaphragm is also a skeletal muscle, sarcopenia may be associated with diaphragm dysfunction, but the specifics of this relationship remain unclear. This study aimed to assess the relationship between diaphragm function—measured by ultrasonography (thickness, thickening fraction, and excursion)—and muscle mass of the extremities, trunk, and whole body using bioimpedance analysis. We recruited older adults from an outpatient clinic for swallowing rehabilitation or frailty. Muscle mass was measured through bioimpedance analysis, and diaphragm function was evaluated with ultrasonography. The relationships between diaphragm ultrasound results and muscle mass measurements were analyzed with regression models adjusted for age, sex, and height. The study included 114 participants (mean age 78.0 years; 45.6% male). The skeletal muscle index was 7.2 kg/m² for men and 5.9 kg/m² for women, with 20% meeting the Asian Working Group for Sarcopenia 2019 criteria. Diaphragm excursion during deep breathing was significantly associated with muscle mass of the extremities, trunk, and whole body (p < 0.001 in simple analysis; p < 0.01 in multiple analysis). Diaphragm thickness and thickening fraction showed no significant associations with muscle mass. Diaphragm excursion could be an adequate indicator of sarcopenia in cases where limb-based measurement is not possible, and therefore unreliable.
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spelling doaj-art-f14a50d4f59b47a99aaeeb6d20f34a3d2025-08-20T03:45:27ZengNature PortfolioScientific Reports2045-23222025-07-011511810.1038/s41598-025-08997-xAssociation between diaphragm excursion and whole-body muscle mass in older adults: an observational studyShuji Ouchi0Toru Yamada1Takahiro Shinohara2Suguru Mabuchi3Kazuharu Nakagawa4Kanako Yoshimi5Ayane Horike6Tatsuya Mayama7Kenji Toyoshima8Yoshiaki Tamura9Atsushi Araki10Ryoichi Hanazawa11Akihiro Hirakawa12Hiroyuki Ichige13Takeshi Ishida14Takuma Kimura15Haruka Tohara16Masayoshi Hashimoto17Department of General Medicine, Graduate School of Medical and Dental Sciences, Institute of Science TokyoDepartment of General Medicine, Graduate School of Medical and Dental Sciences, Institute of Science TokyoDepartment of General Medicine, Graduate School of Medical and Dental Sciences, Institute of Science TokyoDepartment of General Medicine, Graduate School of Medical and Dental Sciences, Institute of Science TokyoDepartment of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Institute of Science TokyoDepartment of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Institute of Science TokyoDepartment of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Institute of Science TokyoDepartment of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Institute of Science TokyoDepartment of Diabetes, Metabolism, and Endocrinology, Tokyo Metropolitan Institute for Geriatrics and GerontologyDepartment of Diabetes, Metabolism, and Endocrinology, Tokyo Metropolitan Institute for Geriatrics and GerontologyDepartment of Diabetes, Metabolism, and Endocrinology, Tokyo Metropolitan Institute for Geriatrics and GerontologyDepartment of Clinical Biostatistics, Graduate School of Medical and Dental Sciences, Institute of Science TokyoDepartment of Clinical Biostatistics, Graduate School of Medical and Dental Sciences, Institute of Science TokyoDepartment of Community Medicine (Ibaraki), Graduate School of Medical and Dental Sciences, Institute of Science TokyoDepartment of Community Medicine (Ibaraki), Graduate School of Medical and Dental Sciences, Institute of Science TokyoDepartment of R&D Innovation for Home Care Medicine, Graduate School of Medical and Dental Sciences, Institute of Science TokyoDepartment of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Institute of Science TokyoDepartment of General Medicine, Graduate School of Medical and Dental Sciences, Institute of Science TokyoAbstract Symptoms of diaphragm dysfunction, such as exertional dyspnea and decreased exercise tolerance, share similarities with the symptoms of skeletal muscle mass reduction caused by conditions like sarcopenia. Given that the diaphragm is also a skeletal muscle, sarcopenia may be associated with diaphragm dysfunction, but the specifics of this relationship remain unclear. This study aimed to assess the relationship between diaphragm function—measured by ultrasonography (thickness, thickening fraction, and excursion)—and muscle mass of the extremities, trunk, and whole body using bioimpedance analysis. We recruited older adults from an outpatient clinic for swallowing rehabilitation or frailty. Muscle mass was measured through bioimpedance analysis, and diaphragm function was evaluated with ultrasonography. The relationships between diaphragm ultrasound results and muscle mass measurements were analyzed with regression models adjusted for age, sex, and height. The study included 114 participants (mean age 78.0 years; 45.6% male). The skeletal muscle index was 7.2 kg/m² for men and 5.9 kg/m² for women, with 20% meeting the Asian Working Group for Sarcopenia 2019 criteria. Diaphragm excursion during deep breathing was significantly associated with muscle mass of the extremities, trunk, and whole body (p < 0.001 in simple analysis; p < 0.01 in multiple analysis). Diaphragm thickness and thickening fraction showed no significant associations with muscle mass. Diaphragm excursion could be an adequate indicator of sarcopenia in cases where limb-based measurement is not possible, and therefore unreliable.https://doi.org/10.1038/s41598-025-08997-xOlder adultsDiaphragmSkeletal muscleUltrasonographyElectric impedanceSarcopenia
spellingShingle Shuji Ouchi
Toru Yamada
Takahiro Shinohara
Suguru Mabuchi
Kazuharu Nakagawa
Kanako Yoshimi
Ayane Horike
Tatsuya Mayama
Kenji Toyoshima
Yoshiaki Tamura
Atsushi Araki
Ryoichi Hanazawa
Akihiro Hirakawa
Hiroyuki Ichige
Takeshi Ishida
Takuma Kimura
Haruka Tohara
Masayoshi Hashimoto
Association between diaphragm excursion and whole-body muscle mass in older adults: an observational study
Scientific Reports
Older adults
Diaphragm
Skeletal muscle
Ultrasonography
Electric impedance
Sarcopenia
title Association between diaphragm excursion and whole-body muscle mass in older adults: an observational study
title_full Association between diaphragm excursion and whole-body muscle mass in older adults: an observational study
title_fullStr Association between diaphragm excursion and whole-body muscle mass in older adults: an observational study
title_full_unstemmed Association between diaphragm excursion and whole-body muscle mass in older adults: an observational study
title_short Association between diaphragm excursion and whole-body muscle mass in older adults: an observational study
title_sort association between diaphragm excursion and whole body muscle mass in older adults an observational study
topic Older adults
Diaphragm
Skeletal muscle
Ultrasonography
Electric impedance
Sarcopenia
url https://doi.org/10.1038/s41598-025-08997-x
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