Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, 22 S. Greene Street, Baltimore, MD, 21201, USA.
University of Maryland School of Medicine, Baltimore, MD, USA.
Skeletal Radiol. 2023 Jan;52(1):47-55. doi: 10.1007/s00256-022-04132-3. Epub 2022 Jul 27.
Gluteal muscle quality influences risk of falling and mobility limitation. We sought (1) to compare gluteal muscle fatty infiltration (FI) between groups of older women with urinary incontinence (UI) at risk for falling (at-risk group) and not at risk for falling (not-at-risk group), and (2) to determine correlation of gluteal FI with Timed Up and Go (TUG) and Short Physical Performance Battery (SPPB) performance.
Prospective pilot study of gluteal FI on pelvis MRI for 19 women with UI, aged ≥ 70 years. A musculoskeletal radiologist selected axial T1-weighted MR images; then, two blinded medical student research assistants analyzed gluteal FI by quantitative fuzzy C-means segmentation. TUG and SPPB tests were performed. TUG ≥ 12 s defined participants as at risk for falling. Descriptive, correlation, and reliability analyses were performed.
Mean age, 76.3 ± 4.8 years; no difference for age or body mass index (BMI) between the at-risk (n = 5) versus not-at-risk (n = 14) groups. SPPB score (p = 0.013) was lower for the at-risk group (6.4 ± 3.1) than for the not-at-risk group (10.2 ± 1.9). Fuzzy C-means FI-%-estimate differed between the at-risk group and the not-at-risk group for bilateral gluteus medius/minimus (33.2% ± 15.6% versus 19.5% ± 4.1%, p = 0.037) and bilateral gluteus maximus (33.6% ± 15.6% versus 19.7% ± 6.9%, p = 0.047). Fuzzy C-means FI-%-estimate for bilateral gluteus maximus had significant (p < 0.050) moderate correlation with age (rho = - 0.64), BMI (rho = 0.65), and TUG performance (rho = 0.52). Fuzzy C-means FI-%-estimates showed excellent inter-observer and intra-observer reliability (intraclass correlation coefficient, ≥ 0.892).
Older women with UI at risk for falling have greater levels of gluteal FI and mobility limitation as compared to those not at risk for falling.
臀肌质量影响跌倒风险和活动受限。我们旨在：(1)比较有尿失禁（UI）且有跌倒风险（风险组）和无跌倒风险（无风险组）的老年女性的臀肌脂肪浸润（FI）；(2)确定臀肌 FI 与计时起立行走（TUG）和简易体能状况量表（SPPB）的相关性。
前瞻性研究了 19 名年龄≥70 岁的 UI 老年女性的骨盆 MRI 上的臀肌 FI。一名肌肉骨骼放射科医生选择了轴位 T1 加权 MRI 图像；然后，两名盲法医学研究生研究助理通过定量模糊 C 均值分割法分析了臀肌 FI。进行了 TUG 和 SPPB 测试。TUG≥12 秒定义为有跌倒风险。进行了描述性、相关性和可靠性分析。
平均年龄为 76.3±4.8 岁；风险组（n=5）和无风险组（n=14）的年龄和体重指数（BMI）无差异。风险组的 SPPB 评分（p=0.013）低于无风险组（分别为 6.4±3.1 和 10.2±1.9）。风险组和无风险组双侧臀中肌/小肌（33.2%±15.6%比 19.5%±4.1%，p=0.037）和双侧臀大肌（33.6%±15.6%比 19.7%±6.9%，p=0.047）的模糊 C 均值 FI-%-估计值不同。双侧臀大肌的模糊 C 均值 FI-%-估计值与年龄（rho=-0.64，p<0.050）、BMI（rho=0.65）和 TUG 表现（rho=0.52）呈显著（p<0.050）中度相关性。模糊 C 均值 FI-%-估计值具有良好的观察者间和观察者内可靠性（组内相关系数，≥0.892）。
与无跌倒风险的患者相比，有 UI 且有跌倒风险的老年女性臀肌 FI 水平更高，活动能力受限。
