OBJECTIVE: The relationship between myosteatosis and muscle quality in hemodialyzed patients remains unknown. This study aimed to investigate the relationship between computed tomography (CT)-based abdominal myosteatosis indicators and handgrip strength (HGS) in these patients. METHODS: This study enrolled 128 hemodialyzed patients who underwent CT, bioimpedance analysis (BIA), and HGS measurement. CT-based abdominal myosteatosis indicators were measured, including psoas muscle density (PMD), paraspinous muscle density (PSMD), and abdominal skeletal muscle density (ASMD), defined as the mean CT value of each muscle at the third lumbar vertebral level. The association between these indicators and HGS was analyzed, and the diagnostic abilities of these indicators to detect low muscle strength, as defined by HGS cutoff values (male, <
28 kg
female, <
18 kg), were investigated. RESULTS: The PMD, PSMD, and ASMD were independently correlated with HGS (β = 0.310, P = .0041
β = 0.210, P = .033
and β = 0.252, P = .011, respectively), but not with BIA-estimated skeletal muscle index. Sixty-two (48.4%) patients had low HGS. After adjusting for confounding factors, the adjusted C-statistics of PMD, PSMD, and ASMD for detecting low HGS were 0.845 (reference), 0.836 (P = .56), and 0.837 (P = .50), respectively. Moreover, an increase in the PMD alone was independently associated with a decrease in the risk of low HGS (adjusted odds ratio: 0.912 (95% confidence interval 0.841-0.982), P = .015). CONCLUSIONS: CT-based abdominal myosteatosis indicators were independently associated with HGS, but not with BIA-estimated skeletal muscle index, and may aid in detecting clinically acceptable low HGS in hemodialyzed patients. The PMD may be the most recommended myosteatosis indicator for assessing muscle quality in this population.