Ohashi Kazuki, Ishikawa Toru, Hoshii Asami, Hokari Tamaki, Noguchi Hirohito, Suzuki Mitsuyuki, Hirosawa Hiroshi, Imai Michitaka, Mitobe Yuta, Yoshida Toshiaki
Department of Nursing, Sapporo University of Health Sciences, Hokkaido 007-0894, Japan.
Department of Gastroenterology and Hepatology, Saiseikai Niigata Hospital, Niigata 950-1104, Japan.
J Clin Med. 2021 Apr 1;10(7):1419. doi: 10.3390/jcm10071419.
Although dual-energy X-ray absorptiometry (DXA) and body impedance analysis are commonly used to measure skeletal muscle mass (SMM), a computed tomography (CT) scan is preferred in clinical practice. We aimed to propose the cut-off values of skeletal muscle mass index (SMI) calculated using CT scans, using DXA as the reference method. We retrospectively assessed 589 patients with chronic liver disease. The SMI was assessed using appendicular SMM by DXA and total muscle area at the level of the third lumbar vertebra (L3) calculated by CT. The cut-off value was determined with reference to the Asian Working Group for Sarcopenia criteria. DXA identified 251 (42.6%) patients as having presarcopenia. In men, the cut-off value of SMI for presarcopenia was determined to be 45.471 cm/m, with an area under the curve (AUC) of 0.863 (95% confidence interval (CI): 0.823 to 0.903), and in women, this value was determined to be 35.170 cm/m, with an AUC of 0.846 (95% CI: 0.800 to 0.892). Cohen's kappa coefficient was 0.575 (95% CI: 0.485-0.665) in men and 0.539 (95% CI: 0.438-0.639) in women.
虽然双能X线吸收法（DXA）和人体阻抗分析常用于测量骨骼肌质量（SMM），但在临床实践中，计算机断层扫描（CT）更为可取。我们旨在以DXA作为参考方法，提出通过CT扫描计算的骨骼肌质量指数（SMI）的临界值。我们回顾性评估了589例慢性肝病患者。通过DXA使用四肢骨骼肌质量评估SMI，并通过CT计算第三腰椎（L3）水平的总肌肉面积。根据亚洲肌少症工作组的标准确定临界值。DXA将251例（42.6%）患者确定为存在肌少症前期。在男性中，肌少症前期SMI的临界值确定为45.471 cm/m，曲线下面积（AUC）为0.863（95%置信区间（CI）：0.823至0.903），在女性中，该值确定为35.170 cm/m，AUC为0.846（95%CI：0.800至0.892）。男性的Cohen's kappa系数为0.575（95%CI：0.485 - 0.665），女性为0.539（95%CI：0.438 - 0.639）。
