Variation in diaphragmatic thickness according to age, body mass index, and sex in young Mexicans: a cross-sectional ultrasound study

Authors

Keywords:

GROSOR DE LOS PLIEGUES CUTÁNEOS; ÍNDICE DE MASA CORPORAL; ULTRASONOGRAFÍA; FUNCIÓN RESPIRATORIA.; SKINFOLD THICKNESS; BODY MASS INDEX; ULTRASONOGRAPHY; RESPIRATORY FUNCTION.

Abstract

Introduction: ultrasound allows for the measurement of diaphragm thickness; however, the influence of sex, age, and body mass index (BMI) on this measurement in young adults has been described with inconsistent results.

Objective: to determine whether there is a difference in diaphragm thickness between young men and women, and to identify whether age and body mass index are associated with it.

Methods: an observational, cross-sectional study was conducted on 66 young Mexicans aged 18 to 35, selected via non-probability convenience sampling. Diaphragm thickness was measured using ultrasound, and weight, height, and body mass index were recorded. Comparisons between sexes were performed using an independent-samples Student’s t-test, and the relationship with body mass index was evaluated through linear regression.

Results: the mean thickness was 2,35 mm for 35 men and 2,31 mm for 31 women, with no significant difference (p = 0.775). Thickness decreased from 2.86 mm in the 18–22 age group to 1.65 mm in the 32–35 age group (linear trend, p = 0,001). Body mass index was positively associated   with diaphragm thickness (p = 0,03).

Conclusions: in this sample, no differences were found between sexes, while diaphragm thickness was associated with both age and body mass index. These associations require confirmation through adjusted analyses in larger samples.

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Author Biographies

Javier Eliecer Pereira Rodriguez, Centro de Estudios e Investigación FISICOL. Cúcuta, Colombia.

Fisioterapeuta, Especialista en Rehabilitación Cardiopulmonar, Especialista en Epidemiología, Magister en Ciencias de la Salud, Magister en Cuidados Paliativos, Doctor en Fisiologia.

Zuleyma Terrón-Cárdenas, Centro de Estudios e Investigación FISICOL. Ciudad de México, México.

Fisioterapeuta. Máster en Rehabilitación Cardíaca, Vascular y Pulmonar.

Guadalupe Montserrat Pineda-Salmeron, Centro de Estudios e Investigación FISICOL. Puebla, México.

Fisioterapeuta. Máster en Rehabilitación Cardíaca, Vascular y Pulmonar

Luis Fernando Ceballos-Portilla , Centro de Estudios e Investigación FISICOL. Puebla, México.

Fisioterapeuta.

References

1. Dubé BP, Dres M. Diaphragm Dysfunction: Diagnostic Approaches and Management Strategies. J Clin Med[internet]. 2016[citado 26/10/2026]; 5(12):113. Disponible en: https://doi.org/10.3390/jcm5120113

2. Santana PV, Cardenas LZ, Albuquerque ALP, Carvalho CRR, Caruso P. Diaphragmatic ultrasound: a review of its methodological aspects and clinical uses. J Bras Pneumol[internet]. 2020[citado 26/10/2026]; 46(6): e20200064. Disponible en: https://doi.org/10.36416/1806-3756/e20200064

3. Haaksma ME, Smit JM, Boussuges A, Demoule A, Dres M, Ferrari G, et al. EXpert consensus On Diaphragm UltraSonography in the critically ill (EXODUS): a Delphi consensus statement on the measurement of diaphragm ultrasound-derived parameters in a critical care setting. Crit Care[internet]. 2022[citado 26/10/2026]; 26(1):99. Disponible en: https://doi.org/10.1186/s13054-022-03975-5

4. Spiesshoefer J, Herkenrath S, Henke C, Langenbruch L, Schneppe M, Randerath W, et al. Evaluation of Respiratory Muscle Strength and Diaphragm Ultrasound: Normative Values, Theoretical Considerations, and Practical Recommendations. Respiration[internet]. 2020[citado 26/10/2026]; 99(5): 369-381. Disponible en: https://doi.org/10.1159/000506016

5. Carrillo-Esper R, Pérez-Calatayud ÁA, Arch-Tirado E, Díaz-Carrillo MA, Garrido-Aguirre E, Tapia-Velazco R, et al. Standardization of Sonographic Diaphragm Thickness Evaluations in Healthy Volunteers. Respir Care[internet]. 2016[citado 26/10/2026]; 61(7):9 20-4. Disponible en: https://doi.org/10.4187/respcare.03999

6. Boon AJ, Harper CJ, Ghahfarokhi LS, Strommen JA, Watson JC, Sorenson EJ. Two-dimensional ultrasound imaging of the diaphragm: quantitative values in normal subjects. Muscle Nerve[internet]. 2013[citado 26/10/2026]; 47(6): 884-9. Disponible en: https://doi.org/10.1002/mus.23702

7. Boussuges A, Rives S, Finance J, Chaumet G, Vallée N, Risso JJ, et al. Ultrasound Assessment of Diaphragm Thickness and Thickening: Reference Values and Limits of Normality When in a Seated Position. Front Med (Lausanne) [internet]. 2021[citado 26/10/2026]; 8: 742703. Disponible en: https://doi.org/10.3389/fmed.2021.74270

8. van Doorn JLM, Wijntjes J, Saris CGJ, Ottenheijm CAC, van Alfen N, Doorduin J. Association of diaphragm thickness and echogenicity with age, sex, and body mass index in healthy subjects. Muscle Nerve[internet]. 2022[citado 26/10/2026]; 66(2): 197-202. Disponible en: https://doi.org/10.1002/mus.27639

9. Yamada T, Minami T, Yoshino S, Emoto K, Mabuchi S, Hanazawa R, et al. Diaphragm Ultrasonography: Reference Values and Influencing Factors for Thickness, Thickening Fraction, and Excursion in the Seated Position. Lung[internet]. 2024[citado 26/10/2026]; 202(1): 83-90. Disponible en: https://doi.org/10.1007/s00408-023-00662-2

10. Zhang T, Liu Y, Xu D, Dong R, Song Y. Diaphragm Assessment by Multimodal Ultrasound Imaging in Healthy Subjects. Int J Gen Med[internet]. 2024[citado 26/10/2026]; 17: 4015-4024. Disponible en: https://doi.org/10.2147/ijgm.s478136

11. Goligher EC, Laghi F, Detsky ME, Farias P, Murray A, Brace D, et al. Measuring diaphragm thickness with ultrasound in mechanically ventilated patients: feasibility, reproducibility and validity. Intensive Care Med[internet]. 2015[citado 26/10/2026]; 41(4): 642-9. Disponible en: https://doi.org/10.1007/s00134-015-3687-3

12. Oguri M, Okanishi T, Ikeguchi T, Ogo K, Kanai S, Maegaki Y, et al. Influence of gender on diaphragm thickness using a method for determining intima media thickness in healthy young adults. BMC Med Imaging[internet]. 2022[citado 26/10/2026]; 22(1): 26. Disponible en: https://doi.org/10.1186/s12880-022-00748-y

13. Cardenas LZ, Santana PV, Caruso P, Ribeiro de Carvalho CR, Pereira de Albuquerque AL. Diaphragmatic Ultrasound Correlates with Inspiratory Muscle Strength and Pulmonary Function in Healthy Subjects. Ultrasound Med Biol[internet]. 2018[citado 26/10/2026]; 44(4): 786-793. Disponible en: https://doi.org/10.1016/j.ultrasmedbio.2017.11.020

14. Cesanelli L, Cesanelli F, Degens H, Satkunskiene D. Obesity-related reduced spirometry and altered breathing pattern are associated with mechanical disadvantage of the diaphragm. Respir Physiol Neurobiol[internet]. 2024[citado 26/10/2026]; 325: 104267. Disponible en: https://doi.org/10.1016/j.resp.2024.104267

15. Ross R, Neeland IJ, Yamashita S, Shai I, Seidell J, Magni P, et al. Waist circumference as a vital sign in clinical practice: a Consensus Statement from the IAS and ICCR Working Group on Visceral Obesity. Nat Rev Endocrinol[internet]. 2020[citado 26/10/2026]; 16(3): 177-189. Disponible en: https://doi.org/10.1038/s41574-019-0310-7

Published

2026-11-09

How to Cite

1.
Pereira Rodriguez JE, Terrón-Cárdenas Z, Pineda-Salmeron GM, Murillo-Morales YA, Ceballos-Portilla LF. Variation in diaphragmatic thickness according to age, body mass index, and sex in young Mexicans: a cross-sectional ultrasound study. Univ. Méd. Pinareña [Internet]. 2026 Nov. 9 [cited 2026 Nov. 11];22(1):e1407. Available from: https://revgaleno.sld.cu/index.php/ump/article/view/1407

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