Chen Zi-Tong, Jin Feng-Shan, Guo Le-Hang, Li Xiao-Long, Wang Qiao, Zhao Hui, Sun Li-Ping, Xu Hui-Xiong
Center of Minimally Invasive Treatment for Tumor, Department of Medical Ultrasound, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China.
Ultrasound Research and Education Institute, Clinical Research Center for Interventional Medicine, School of Medicine, Tongji University, Shanghai, China.
Eur Radiol. 2023 Jun;33(6):4007-4015. doi: 10.1007/s00330-022-09382-2. Epub 2023 Jan 17.
We assessed muscle mass and function using ultrasound (US) and shear wave elastography (SWE) for sarcopenia in elderly patients with type 2 diabetes.
There were 84 patients with type 2 diabetes enrolled in this study; of these, 30 had sarcopenia and 54 did not. We measured appendicular skeletal muscle mass index (ASMI), handgrip strength, calf circumference, 6-m walking speed, and 5-time chair stand test. All patients were in the supine position with their knees in straight and bent poses in turn. The US-derived thickness (T, T), cross-sectional area (CSA, CSA), and SWE (SWE, SWE) of the rectus femoris muscle (RFM) were measured and the differences (ΔT, ΔCSA, ΔSWE) were calculated. We assessed the correlations of clinical indicators with US and SWE features. We then compared the clinical indicators and US and SWE features between patients with and without sarcopenia to determine independent predictors. Diagnostic models were established based on these independent predictors.
The ASMI was correlated with T (r = 0.57, p < 0.001) and CSA (r = 0.50, p < 0.001). Handgrip strength was correlated with T (r = 0.53, p < 0.001) and CSA (r = 0.51, p < 0.001). Between patients with and without sarcopenia, the indicators of age, ΔCSA, and ΔSWE were statically different (all p ≤ 0.001). Based on these results, a diagnostic model for sarcopenia was established with 83.3% sensitivity, 83.3% specificity, and 83.3% accuracy.
In elderly people with type 2 diabetes, sarcopenia patients had smaller muscle CSA and less stiffness than non-sarcopenia patients. US and SWE might be useful to screen them.
• Sarcopenia is common in elderly people with type 2 diabetes. • Ultrasound and shear wave elastography might be useful methods for quantitatively assessing muscle mass and strength. • Ultrasound and shear wave elastography might be useful methods for screening sarcopenia in elderly patients with type 2 diabetes.
我们使用超声（US）和剪切波弹性成像（SWE）评估老年2型糖尿病患者的肌肉质量和功能，以诊断肌肉减少症。
本研究纳入84例2型糖尿病患者，其中30例患有肌肉减少症，54例未患。我们测量了四肢骨骼肌质量指数（ASMI）、握力、小腿围、6分钟步行速度和5次起坐试验。所有患者均仰卧位，膝盖依次伸直和弯曲。测量股直肌（RFM）的超声衍生厚度（T，T）、横截面积（CSA，CSA）和SWE（SWE，SWE），并计算差异（ΔT，ΔCSA，ΔSWE）。我们评估了临床指标与超声和SWE特征的相关性。然后比较有和无肌肉减少症患者的临床指标以及超声和SWE特征，以确定独立预测因素。基于这些独立预测因素建立诊断模型。
ASMI与T（r = 0.57，p < 0.001）和CSA（r = 0.50，p < 0.001）相关。握力与T（r = 0.53，p < 0.001）和CSA（r = 0.51，p < 0.001）相关。有和无肌肉减少症患者之间，年龄、ΔCSA和ΔSWE指标存在统计学差异（均p≤0.001）。基于这些结果，建立了肌肉减少症诊断模型，其灵敏度为83.3%，特异度为83.3%，准确度为83.3%。
在老年2型糖尿病患者中，肌肉减少症患者的肌肉CSA较小且硬度低于非肌肉减少症患者。超声和SWE可能有助于对他们进行筛查。
• 肌肉减少症在老年2型糖尿病患者中很常见。• 超声和剪切波弹性成像可能是定量评估肌肉质量和力量的有用方法。• 超声和剪切波弹性成像可能是筛查老年2型糖尿病患者肌肉减少症 的有用方法。
