Department of Radiology, Korea University Ansan Hospital, Ansan, Korea.
Department of Radiology, Uijeongbu Eulji Medical Center, Uijeongbu, Korea.
AJR Am J Roentgenol. 2021 Jun;216(6):1596-1606. doi: 10.2214/AJR.20.22934. Epub 2021 Apr 14.
The objectives of this study were to propose the use of the cross-sectional area of paravertebral muscle (PMA) and the ratio of the PMA to the cross-sectional area of visceral fat (PVR) as new indexes of sarcopenia or sarcopenic obesity through comparison with existing indexes and to show the clinical associations of PMA and PVR with hypertension and diabetes. A total of 1270 participants (608 men and 662 women; mean [± SD] age, 63.57 ± 6.94 years) were recruited from a community-based population of elderly individuals. PMA and PVR were measured on single-slice abdominal CT images. Pearson correlation was used to evaluate the correlation of PMA and PVR with widely used imaging and muscle function indexes of sarcopenia and sarcopenic obesity. Tertile categories of PMA and PVR were evaluated to investigate associations with risks for hypertension and diabetes in men and women, by use of separate multivariable logistic regression models. PMA was correlated with the cross-sectional area of thigh muscle on CT, appendicular skeletal muscle mass (ASM) on dual-energy x-ray absorptiometry, height-adjusted ASM (calculated as ASM divided by the height in meters squared), and body mass index (BMI)-adjusted ASM (calculated as ASM divided by BMI) ( < .01). PMA was also correlated with hand grip strength and gait speeds ( < .01). PVR was correlated with height-adjusted ASM and BMI-adjusted ASM ( < .01). A high PVR significantly decreased the odds ratios for hypertension and diabetes in the unadjusted model and the model adjusted for age, smoking, and drinking status. The ratio of the cross-sectional area of thigh muscle to the cross-sectional area of visceral fat and the BMI-adjusted ASM produced results similar to those of PVR in terms of the odds ratios for hypertension and diabetes. Single-slice abdominal CT can supply PMA and visceral fat information together. PMA and PVR were found to be reliable indexes of sarcopenia and sarcopenic obesity. A high PVR was associated with low risks for hypertension and diabetes.
本研究旨在通过与现有指标的比较，提出使用椎旁肌横截面积（PMA）和 PMA 与内脏脂肪横截面积的比值（PVR）作为肌少症或肌少症性肥胖的新指标，并展示 PMA 和 PVR 与高血压和糖尿病的临床关联。共有 1270 名参与者（608 名男性和 662 名女性；平均[±SD]年龄为 63.57±6.94 岁）从一个基于社区的老年人群中招募。在单次腹部 CT 图像上测量 PMA 和 PVR。采用皮尔逊相关分析评估 PMA 和 PVR 与肌少症和肌少症性肥胖的广泛应用的影像学和肌肉功能指标的相关性。使用单独的多变量逻辑回归模型评估 PMA 和 PVR 的三分位数类别与男性和女性高血压和糖尿病风险的关系。
PMA 与 CT 上大腿肌肉的横截面积、双能 X 射线吸收法测定的四肢骨骼肌质量（ASM）、身高校正的 ASM（计算为 ASM 除以米的平方）和 BMI 校正的 ASM（计算为 ASM 除以 BMI）呈正相关（<.01）。PMA 也与握力和步速呈正相关（<.01）。PVR 与身高校正的 ASM 和 BMI 校正的 ASM 呈正相关（<.01）。未调整模型和调整年龄、吸烟和饮酒状况的模型中，高 PVR 显著降低了高血压和糖尿病的比值比。大腿肌肉横截面积与内脏脂肪横截面积的比值和 BMI 校正的 ASM 在高血压和糖尿病的比值比方面与 PVR 的结果相似。
单次腹部 CT 可同时提供 PMA 和内脏脂肪信息。PMA 和 PVR 是肌少症和肌少症性肥胖的可靠指标。高 PVR 与高血压和糖尿病的低风险相关。
