Department of Radiology, University of Genoa, Largo Rosanna Benzi 8, 16100 Genoa, Italy.
AJR Am J Roentgenol. 2010 Mar;194(3):728-34. doi: 10.2214/AJR.09.3130.
The purpose of this study was to study the relationship between fatty degeneration of thigh muscles and vitamin D status in elderly adults.
For six months, 121 patients 65 years old or older were evaluated. Myopathy, muscular impairment, and conditions influencing vitamin D status other than diet and sunlight were exclusion criteria. Twenty patients (10 men and 10 women; mean age, 77.6 years) underwent MRI. Thigh muscles were scanned from the hip to the knee with T1- and T2-weighted spin-echo sequences. Skeletal muscles were evaluated for fatty degeneration and atrophy from grade 0 to 3 (grade 0 = normal appearance, grade 3 = severe changes). The relationship between muscular fatty degeneration, 25-hydroxyvitamin D (25-OHD) levels, and scores on Tinetti scales for balance and gait were examined.
In the evaluation of the extensor muscles for fatty degeneration and atrophy, grade 0 was present in three patients (15%), grade 1 in 11 (55%), and grade 2 in six (30%). In the flexor muscles, grade 0 was found in one patient (5%), grade 1 in five (25%), and grade 2 in 14 (70%); grade 3 changes were not seen. Muscular fatty degeneration negatively correlated with 25-OHD levels (r = -0.50, p < 0.01) and the Tinetti scores (balance: r = -0.40, p < 0.05; gait: r = -0.50, p < 0.05). In 11 vitamin D-deficient patients (55%), there was selective complete atrophy of at least one thigh muscle. The gracilis and sartorius muscles were spared.
In elderly adults, fatty degeneration of thigh muscles was associated with vitamin D deficiency and impaired balance and gait. Selective complete fatty degeneration of single muscles was observed.
本研究旨在探讨老年人大腿肌肉脂肪变性与维生素 D 状态的关系。
本研究共纳入 121 例年龄在 65 岁及以上的患者，随访 6 个月。排除标准为肌病、肌肉功能障碍以及影响维生素 D 状态的其他因素（如饮食和日照）。20 例患者（男 10 例，女 10 例；平均年龄 77.6 岁）接受了 MRI 检查。采用 T1 加权和 T2 加权自旋回波序列对髋关节至膝关节的大腿肌肉进行扫描。从 0 级到 3 级评估骨骼肌的脂肪变性和萎缩（0 级=正常外观，3 级=严重改变）。检查了肌肉脂肪变性、25-羟维生素 D（25-OHD）水平与 Tinetti 平衡和步态量表评分之间的关系。
在评估股四头肌的脂肪变性和萎缩时，0 级见于 3 例（15%），1 级见于 11 例（55%），2 级见于 6 例（30%）。在股二头肌中，0 级见于 1 例（5%），1 级见于 5 例（25%），2 级见于 14 例（70%）；未见 3 级改变。肌肉脂肪变性与 25-OHD 水平（r=-0.50，p<0.01）和 Tinetti 评分（平衡：r=-0.40，p<0.05；步态：r=-0.50，p<0.05）呈负相关。在 11 例维生素 D 缺乏的患者（55%）中，至少有一条大腿肌肉出现选择性完全萎缩。股薄肌和缝匠肌未受累。
在老年人中，大腿肌肉脂肪变性与维生素 D 缺乏以及平衡和步态受损有关。观察到单块肌肉的选择性完全脂肪变性。
