# Computed tomography muscle size and composition associations with hip and spine bone strength over 4 years: SOMMA-CT

> **NIH NIH R01** · WAKE FOREST UNIVERSITY HEALTH SCIENCES · 2024 · $758,494

## Abstract

PROJECT SUMMARY
Osteoporotic fractures are associated with significant morbidity and mortality, and their U.S. economic burden
is projected to reach $20 billion by 2025. Aging accelerates the decline of both muscle and bone, increasing
fracture risk. Understanding how muscle and bone interact anatomically, mechanically, and biochemically to
reduce bone strength could profoundly advance fracture prevention by identifying new fracture risk screening
and intervention targets to diagnose and treat age-related musculoskeletal decline. Computed tomography
(CT) scans hold great promise for assessing regional muscle and bone phenotypes to identify older adults at
high risk of fracture. Specifically, bone strength – a CT and finite element modeling assessment of 3D bone
morphology, bone mineral density (BMD), and cortical thickness – is a stronger predictor of fracture risk than
BMD alone. Building on the Study of Muscle, Mobility & Aging (SOMMA), the proposed SOMMA-CT ancillary
study is uniquely positioned to explore how thigh and trunk muscle properties from CT (via automated and
radiomic analysis), D3Cr muscle mass (D3-creatine dilution), muscle performance, as well as circulating muscle-
bone crosstalk biomarkers, relate to changes in bone strength at the hip and spine (2 clinically-relevant fracture
sites). SOMMA is a prospective study examining aging-related muscle biology contributions to mobility disability
(R01 AG059416). This ancillary study in 360 SOMMA older men and women (ages 70-94) will employ an
efficient and cost-effective longitudinal design that adds: 1) a 4th-year follow-up CT scan and blood draw, and
2) advanced processing of baseline and 4-year CT scans and blood samples to extract new longitudinal
muscle and bone phenotypes. Specific Aims are to: 1) Determine if muscle quantity and composition (CT-
derived thigh and trunk muscle area, muscle density, intermuscular fat, and radiomic texture features of muscle
heterogeneity; D3Cr muscle mass) are associated with changes in hip and spine bone strength over 4 years of
aging. 2) Determine if muscle performance (leg extensor specific power; 4-m gait speed; time to complete 5 chair
stands) is associated with change in hip and spine bone strength over 4 years of aging. We will also explore
how biomarkers of muscle-bone crosstalk (myokines: aminobutyric acids; osteokines: CTX-1, P1NP) relate to
bone strength both cross-sectionally and longitudinally, and test if these biomarkers mediate the muscle-bone
associations in Aims 1-2. The scientific premise is that thigh and trunk muscle degeneration will be associated
with declining hip and spine bone strength, and that circulating biomarkers will offer mechanistic insights on
muscle-bone crosstalk contributors to bone strength. This investigation in an aging cohort will increase our
knowledge of the dynamic interrelationships and crosstalk between muscle and bone. New discoveries in this
area could impact over 158 million older adults worldwide w...

## Key facts

- **NIH application ID:** 10919820
- **Project number:** 5R01AG079975-02
- **Recipient organization:** WAKE FOREST UNIVERSITY HEALTH SCIENCES
- **Principal Investigator:** Ashley Weaver
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $758,494
- **Award type:** 5
- **Project period:** 2023-09-05 → 2028-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10919820

## Citation

> US National Institutes of Health, RePORTER application 10919820, Computed tomography muscle size and composition associations with hip and spine bone strength over 4 years: SOMMA-CT (5R01AG079975-02). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/10919820. Licensed CC0.

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