Effect of body weight and muscularity on human diaphragm muscle mass, thickness, and area

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Abstract
To assess the consequences to the human diaphragm of alterations in body weight and muscularity, the mass, thickness, area and length of diaphragm muscle were measured at necropsy. Of 33 subjects who were clinically well until sudden death, 27 had sedentary occupations and normal weight (group N), while 6 were nonobese laborers whose average weight was 40% greater than normal (group M). Among 37 patients dying of more prolonged illness, 23 were of normal weight (group W), while 14 weighed 71% of normal (group U). Subjects with obesity, chronic pulmonary disease or edema were excluded. Disease per se did not significantly affect diaphragm dimensions. However, in group M diaphragm muscle mass, thickness, area and length were 165, 129, 125 and 117% of normal (P < 0.005); in group U the corresponding values were 57, 73, 77 and 83% (P < 0.001). Thus alterations in body weight and muscularity profoundly affect diaphragm muscle mass, causing a nearly 3-fold variation between muscular normal subjects and underweight patients.