Bolton C E, Ionescu A A, Evans W D, Pettit R J, Shale D J
Section of Respiratory and Communicable Diseases, Department of Medicine, University of Wales College of Medicine, Llandough Hospital, Cardiff and Vale NHS Trust, Penarth, South Glamorgan CF64 2XX, UK.
Thorax. 2003 Oct;58(10):885-9. doi: 10.1136/thorax.58.10.885.
Regional body composition was determined in adults with cystic fibrosis (CF). Our hypothesis was that dual energy x ray absorptiometry (DXA) scanning could assess the fat free mass, bone mineral content, and fat mass and determine the distribution of the changes.
Height squared indices were derived for fat mass (FMI), fat free mass (FFMI), and bone mineral content (BMCI) of the arm, leg, and trunk by DXA in 51 patients and 18 age/sex matched healthy subjects.
The arm and leg FFMI in patients were less than in healthy controls (p<0.05); the deficit was leg>arm>trunk (-18.19%, -14.86%, +0.09%, p<0.02) and was related to severity of lung disease. Patients with a normal BMI and low total FFM (hidden loss) had a lower arm, leg and trunk FFMI than those with a normal BMI and total FFM (p<0.05). The BMCI for all body segments was lower in patients than in controls (p<0.001). The BMCI was lower in the leg and trunk (p<0.01) in patients with severe disease than in those with mild lung disease. In those with hidden FFM loss the BMCI was lower (p<0.05 in leg and trunk). There was no difference in the BMCI deficit between body segments. Fat mass in patients was not reduced.
Preferential loss of FFM is related to severity of lung disease and occurs in patients with a normal BMI. A similar loss of BMC occurs while FM is preserved. A hierarchical pattern of FFM loss of legs>arms>trunk was shown; BMC loss was evenly distributed.
对成年囊性纤维化（CF）患者的局部身体成分进行测定。我们的假设是双能X线吸收法（DXA）扫描可评估去脂体重、骨矿物质含量和脂肪量，并确定变化的分布情况。
通过DXA对51例患者和18名年龄/性别匹配的健康受试者的手臂、腿部和躯干的脂肪量（FMI）、去脂体重（FFMI）和骨矿物质含量（BMCI）得出身高平方指数。
患者的手臂和腿部FFMI低于健康对照组（p<0.05）；差异为腿部>手臂>躯干（-18.19%，-14.86%，+0.09%，p<0.02），且与肺部疾病严重程度相关。体重指数（BMI）正常但总去脂体重（FFM）较低（隐性丢失）的患者，其手臂、腿部和躯干的FFMI低于BMI和总FFM正常的患者（p<0.05）。患者所有身体部位的BMCI均低于对照组（p<0.001）。重症患者腿部和躯干的BMCI低于轻症肺部疾病患者（p<0.01）。在隐性FFM丢失的患者中，腿部和躯干的BMCI较低（p<0.05）。身体各部位之间的BMCI差异无统计学意义。患者的脂肪量未减少。
去脂体重的优先丢失与肺部疾病严重程度相关，且发生在BMI正常的患者中。骨矿物质含量（BMC）出现类似丢失，而脂肪量得以保留。显示出去脂体重丢失的层次模式为腿部>手臂>躯干；BMC丢失分布均匀。
