Department of Surgery, Division of HPB and Transplant Surgery, Erasmus MC University Medical Center, Rotterdam, Netherlands.
Department of Surgery, Division of Vascular and Transplant Surgery, Radboud University Medical Center Nijmegen, Nijmegen, Netherlands.
Eur J Clin Nutr. 2019 Jun;73(6):879-886. doi: 10.1038/s41430-018-0287-7. Epub 2018 Aug 24.
BACKGROUND/OBJECTIVES: Currently, there are no widely accepted cut-off points to categorize patients as sarcopenic (low skeletal muscle mass) or myosteatotic based on computed tomography (CT) measurements. Moreover, little is known about skeletal muscle mass in healthy subjects, particularly in a Western-European population.
SUBJECTS/METHODS: Skeletal muscle mass (skeletal muscle index, cm/m) and density (Hounsfield units, HU) at the level of the third lumbar vertebra were measured on contrast-enhanced CT images in live kidney donors with an age range of 18-86 years, who may be considered as healthy subjects, from 2010 to 2015. Differences between sex, body mass index (BMI), age groups, and American Society of Anesthesiologists (ASA) classification were assessed. Mann-Whitney U and Kruskal-Wallis tests were used to compare groups.
Of the 1073 included patients, 499 (46.5%) were male and the median age and BMI were 51 years and 25.4 kg/m, respectively. Male gender, increased age, and increased BMI were significantly associated with both skeletal muscle mass and density. Nomograms including these parameters were developed to calculate the estimated skeletal muscle mass and density of a healthy subject and the lower bound of the 90% prediction interval (p5) values were provided.
Skeletal muscle density and mass were significantly associated with sex, age, and BMI in a large cohort of healthy Western-European subjects. The newly developed nomograms may be used to calculate the estimated healthy skeletal muscle mass for individuals in patient populations.
背景/目的：目前，尚无被广泛接受的基于计算机断层扫描（CT）测量的临界值，可用于将患者划分为肌肉减少症（低骨骼肌量）或肌内脂过多症。此外，人们对健康受试者的骨骼肌量知之甚少，尤其是在西欧人群中。
受试者/方法：在 2010 年至 2015 年间，对年龄在 18-86 岁之间的活体肾供者进行了增强 CT 图像检查，测量了第三腰椎水平的骨骼肌量（骨骼肌指数，cm/m）和密度（亨氏单位，HU）。评估了性别、体重指数（BMI）、年龄组和美国麻醉医师协会（ASA）分类之间的差异。使用 Mann-Whitney U 和 Kruskal-Wallis 检验比较组间差异。
在纳入的 1073 例患者中，499 例（46.5%）为男性，中位年龄和 BMI 分别为 51 岁和 25.4kg/m。男性、年龄增加和 BMI 增加与骨骼肌量和密度均显著相关。开发了包含这些参数的列线图，以计算健康受试者的估计骨骼肌量和密度，并提供了 90%预测区间（p5）值的下限。
在大型西欧健康受试者队列中，骨骼肌密度和量与性别、年龄和 BMI 显著相关。新开发的列线图可用于计算患者人群中个体的估计健康骨骼肌量。
