Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan; Japan Society for the Promotion of Science, Tokyo, Japan.
Department of Radiology, Keio University School of Medicine, Tokyo, Japan.
Respir Med. 2018 Dec;145:66-72. doi: 10.1016/j.rmed.2018.10.023. Epub 2018 Oct 22.
No reports exist regarding skeletal muscle involvement in patients with Mycobacterium avium complex lung disease (MAC-LD). The cross-sectional area of the erector spinae muscles (ESM) reflects physical activity and can be assessed by computed tomography (CT). We investigated the relationship between ESM and physiological parameters and prognosis in MAC-LD patients.
In this prospective observational study, the ESM was measured on single-slice axial CT images. MAC-LD patients and sex- and age-matched controls (non-MAC-LD participants) were evaluated. We evaluated the relationship between the ESM and physiological parameters and prognosis.
A total of 260 patients (209 female; median age, 69 years; 190 with nodular/bronchiectatic disease; 74 with cavitary lesions) were enrolled. The ESM was not different between MAC-LD patients and controls. In MAC-LD patients, the ESM was significantly associated with age, body mass index (BMI), pulmonary function, CT severity, and health-related quality of life (HRQL). Multivariate Cox proportional hazards analyses revealed that an ESM < -1 standard derivation (hazards ratio [HR], 2.76; P = 0.047) was significantly associated with all-cause mortality, along with BMI < 18.5 kg/m (HR, 3.67; P = 0.02) and presence of cavitary lesions (HR, 5.84; P = 0.001). However, the ESM was not significantly associated with all-cause mortality when current treatment status, % predicted functional vital capacity, and forced expiratory volume in 1 s were added to the analyses.
Although the prognostic impact was limited, ESM was significantly associated with HRQL and prognostic physiological parameters, such as BMI and pulmonary function.
尚无关于鸟分枝杆菌复合群肺病（MAC-LD）患者骨骼肌受累的报告。竖脊肌（ESM）的横截面积反映了身体活动情况，可通过计算机断层扫描（CT）进行评估。我们研究了 MAC-LD 患者的 ESM 与生理参数和预后之间的关系。
在这项前瞻性观察性研究中，我们在单层面轴向 CT 图像上测量 ESM。评估了 MAC-LD 患者和性别及年龄匹配的对照组（非 MAC-LD 参与者）的 ESM。我们评估了 ESM 与生理参数和预后之间的关系。
共纳入 260 例患者（209 例女性；中位年龄 69 岁；190 例存在结节/支气管扩张性病变；74 例存在空洞性病变）。MAC-LD 患者和对照组之间的 ESM 无差异。在 MAC-LD 患者中，ESM 与年龄、体重指数（BMI）、肺功能、CT 严重程度和健康相关生活质量（HRQL）显著相关。多变量 Cox 比例风险分析显示，ESM＜-1 个标准差（风险比[HR]，2.76；P=0.047）与全因死亡率显著相关，BMI＜18.5kg/m2（HR，3.67；P=0.02）和存在空洞性病变（HR，5.84；P=0.001）也是如此。然而，当分析中加入当前治疗状况、预测功能性肺活量百分比和 1 秒用力呼气量时，ESM 与全因死亡率无显著相关性。
尽管预后影响有限，但 ESM 与 HRQL 和预测预后的生理参数显著相关，如 BMI 和肺功能。
