生物电阻抗分析与胸部 CT 测量竖脊肌面积的相关性：一项横断面研究。
Correlation Between Bioelectrical Impedance Analysis and Chest CT-Measured Erector Spinae Muscle Area: A Cross-Sectional Study.
机构信息
Department of Geriatrics, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.
Department of Radiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
出版信息
Front Endocrinol (Lausanne). 2022 Jul 19;13:923200. doi: 10.3389/fendo.2022.923200. eCollection 2022.
BACKGROUND
Skeletal muscle mass (SMM) plays an important part in diverse health and disease states. Bioelectrical impedance analysis (BIA) and computed tomography (CT) are available for its assessment. However, muscle mass assessed by BIA may be influenced by multiple factors. The erector spinae muscle area (ESA) on chest CT is recently presumed to be representative of SMM. This study aimed to derive BIA from the ESA and evaluate the magnitude of association (between ESA measured from chest CT) and BIA.
METHODS
Subjects hospitalized for health checkups between December 2020 and December 2021, having undergone both BIA (50 kHz, 0.8 mA) and chest CT, were included. ESA was quantified at the level of the 12th thoracic vertebra (T12-ESA) by a standardized semi-automated segmentation algorithm. Low SMM was defined using the Asian Working Group for Sarcopenia criteria. The association between T12-ESA and BIA was then evaluated. Stratified analyses by sex and BMI were also performed.
RESULTS
Among 606 included subjects (59.7 ± 16.6 years, 63.5% male), 110 (18.2%) had low SMM. BMI in low and normal SMM groups was 20.1 and 24.7 kg/m, respectively. Current smoking, drinking, chronic obstructive pulmonary disease, and chronic renal dysfunction were more frequently seen in the low SMM group than in the normal SMM group. The final regression model included T12-ESA, weight, BMI, and age, and had an adjusted of 0.806 with BIA. In the validation group, the correlation between T12-ESA-derived BIA and BIA remained high (Pearson correlation = 0.899). Stratified analysis disclosed a stronger correlation between T12-ESA and BIA in male subjects than in female subjects (adjusted = 0.790 vs. adjusted = 0.711, < 0.05), and a better correlation was observed in obese (BMI ≥ 30 kg/m) compared with underweight (BMI < 18.5 kg/m) subjects (adjusted 0.852 vs. adjusted = 0.723, < 0.05). Additional analysis revealed a significant correlation between T12-ESA and skeletal muscle cross-sectional area at the 3rd lumbar vertebra (L3-CSA) (adjusted = 0.935, < 0.001).
CONCLUSIONS
CT-based assessment of ESA at the T12 level is feasible and correlated well with BIA, especially in male subjects and obese subjects.
背景
骨骼肌量（SMM）在多种健康和疾病状态中起着重要作用。生物电阻抗分析（BIA）和计算机断层扫描（CT）可用于评估 SMM。然而，BIA 评估的肌肉量可能受到多种因素的影响。胸部 CT 上的竖脊肌面积（ESA）最近被认为是 SMM 的代表。本研究旨在从 ESA 导出 BIA，并评估 ESA 与 BIA 之间的关联程度。
方法
纳入 2020 年 12 月至 2021 年 12 月期间因健康检查住院，同时接受 BIA（50 kHz，0.8 mA）和胸部 CT 检查的受试者。使用标准化半自动分割算法在第 12 胸椎（T12-ESA）水平量化 ESA。使用亚洲肌少症工作组标准定义低 SMM。然后评估 T12-ESA 与 BIA 之间的相关性。还进行了按性别和 BMI 分层的分析。
结果
在纳入的 606 名受试者中（59.7±16.6 岁，63.5%为男性），110 名（18.2%）存在低 SMM。低 SMM 和正常 SMM 组的 BMI 分别为 20.1 和 24.7 kg/m。低 SMM 组较正常 SMM 组更常出现当前吸烟、饮酒、慢性阻塞性肺疾病和慢性肾功能不全。最终回归模型包括 T12-ESA、体重、BMI 和年龄，与 BIA 的调整 为 0.806。在验证组中，T12-ESA 衍生 BIA 与 BIA 之间的相关性仍然很高（Pearson 相关系数=0.899）。分层分析显示，T12-ESA 与 BIA 之间的相关性在男性受试者中强于女性受试者（调整后 = 0.790 比调整后 = 0.711，<0.05），在肥胖（BMI≥30 kg/m）受试者中优于消瘦（BMI<18.5 kg/m）受试者（调整后 0.852 比调整后 = 0.723，<0.05）。进一步分析显示，T12-ESA 与第 3 腰椎（L3-CSA）的骨骼肌横截面积之间存在显著相关性（调整后 = 0.935，<0.001）。
结论
T12 水平的基于 CT 的 ESA 评估是可行的，与 BIA 相关性良好，尤其是在男性和肥胖受试者中。
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