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Psoas major cross-sectional area: A potential marker of cardiorespiratory fitness

Background and Aim: Cardiorespiratory fitness is an important marker for overall health that significantly correlates with obesity-associated morbidities and mortality. Maximal oxygen uptake (VO2max) recorded during an incremental exercise test is the gold standard assessment for aerobic fitness. However, its cost, chronic illness, and frailty often preclude its application. The cross-sectional area (CSA) of the abdominal psoas major muscle is a predictor of sarcopenia and surgery outcomes and represents a promising biomarker for cardiorespiratory health. Therefore, in the present study, we have planned to assess the relationship between psoas major CSA, anthropometry, and body composition in a UK-based cohort of 210 men and women. Methods: Body mass (kg), height (cm), waist circumference (cm), VO2max, and blood pressure were measured in each participant. The CSA of psoas major, rectus abdominus, and another abdominal muscle of the core muscle group were assessed. Results: Following adjustment for height, psoas major CSA was found to be a significant predictor of percentage body fat (P = 0.02) in men, and body mass index (BMI) in both men (P = 0.015) and women (P = 0.004). We found psoas major CSA correlated more strongly with VO2max (r = 0.74, P < 0.01) than any other study outcome, including age and BMI. Conclusion: Psoas major muscle CSA represents an accurate, reproducible, and time-efficient surrogate for cardiorespiratory fitness and body composition.