Jo Min Ho, Lim Tae Seop, Jeon Mi Young, Lee Hye Won, Kim Beom Kyung, Park Jun Yong, Kim Do Young, Ahn Sang Hoon, Han Kwang-Hyub, Kim Seung Up
Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul 03722, Korea.
Yonsei Liver Center, Severance Hospital, Seoul 03722, Korea.
J Clin Med. 2019 Mar 7;8(3):322. doi: 10.3390/jcm8030322.
Computed tomography (CT) and bioimpedance analysis (BIA) can assess skeletal muscle mass (SMM). Our objective was to identify the predictors of discordance between CT and BIA in assessing SMM. Participants who received a comprehensive medical health check-up between 2010 and 2018 were recruited. The CT and BIA-based diagnostic criteria for low SMM are as follows: Defined CT cutoff values (lumbar skeletal muscle index (LSMI) <1 standard deviation (SD) and means of 46.12 cm²/m² for men and 34.18 cm²/m² for women) and defined BIA cutoff values (appendicular skeletal muscle/height² <7.0 kg/m² for men and <5.7 kg/m² for women). A total of 1163 subjects were selected. The crude and body mass index (BMI)-adjusted SMM assessed by CT were significantly associated with those assessed by BIA (correlation coefficient = 0.78 and 0.68, respectively; < 0.001). The prevalence of low SMM was 15.1% by CT and 16.4% by BIA. Low SMM diagnosed by CT was significantly associated with advanced age, female gender, and lower serum albumin level, whereas low SMM diagnosed by BIA was significantly associated with advanced age, female gender, and lower BMI (all < 0.05). Upon multivariate analysis, age >65 years, female and BMI <25 kg/m² had significantly higher risks of discordance than their counterparts (all < 0.05). We found a significant association between SMM assessed by CT and BIA. SMM assessment using CT and BIA should be interpreted cautiously in older adults (>65 years of age), female and BMI <25 kg/m².
计算机断层扫描(CT)和生物电阻抗分析(BIA)可用于评估骨骼肌质量(SMM)。我们的目的是确定CT和BIA在评估SMM时不一致的预测因素。招募了2010年至2018年间接受全面医学健康检查的参与者。基于CT和BIA的低SMM诊断标准如下:定义的CT临界值(腰椎骨骼肌指数(LSMI)<1个标准差(SD),男性为46.12cm²/m²,女性为34.18cm²/m²)和定义的BIA临界值(四肢骨骼肌/身高²,男性<7.0kg/m²,女性<5.7kg/m²)。共选择了1163名受试者。CT评估的粗体和体重指数(BMI)调整后的SMM与BIA评估的SMM显著相关(相关系数分别为0.78和0.68;<0.001)。CT诊断的低SMM患病率为15.1%,BIA诊断的患病率为16.4%。CT诊断的低SMM与高龄、女性性别和较低的血清白蛋白水平显著相关,而BIA诊断的低SMM与高龄、女性性别和较低的BMI显著相关(均<0.05)。多变量分析显示,年龄>65岁、女性和BMI<25kg/m²的患者出现不一致的风险显著高于对照组(均<0.05)。我们发现CT和BIA评估的SMM之间存在显著关联。对于老年人(>65岁)、女性和BMI<25kg/m²的人群,使用CT和BIA进行SMM评估时应谨慎解释。