Department of Radiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 301 Middle Yanchang Road, Shanghai, 200072, China.
BMC Musculoskelet Disord. 2023 Feb 21;24(1):136. doi: 10.1186/s12891-023-06229-9.
With the wide application of QCT in the clinical assessment of osteoporosis and sarcopenia, the characteristics of musculoskeletal degeneration in middle-aged and elderly people need to be further revealed. We aimed to investigate the degenerate characteristics of lumbar and abdominal muscles in middle-aged and elderly people with varying bone mass.
A total of 430 patients aged 40-88 years were divided into normal, osteopenia, and osteoporosis groups according to quantitative computed tomography (QCT) criteria. The skeletal muscular mass indexes (SMIs) of five muscles [abdominal wall muscles (AWM), rectus abdominis (RA), psoas major muscle (PMM), posterior vertebral muscles (PVM), and paravertebral muscles (PM)] included in lumbar and abdominal muscles were measured by QCT. Differences in SMIs among three groups, as well as the correlation between SMIs and volumetric bone mineral density (vBMD) were analyzed. The areas under the curves (AUCs) for SMIs for prediction of low bone mass and osteoporosis were calculated.
In male group, SMIs of RA and PM in osteopenia group were significantly lower than those in the normal group (P = 0.001 and 0.023, respectively). In female group, only SMI of RA in osteopenia group was significantly lower than that in the normal group (P = 0.007). SMI of RA was positively correlated with vBMD with the highest coefficients in male and female groups (r = 0.309 and 0.444, respectively). SMIs of AWM and RA had higher AUCs varying from 0.613 to 0.737 for prediction of low bone mass and osteoporosis in both genders.
The changes of SMIs of the lumbar and abdominal muscles in patients with varying bone mass are asynchronous. SMI of RA is expected to be a promising imaging marker for predicting abnormal bone mass.
ChiCTR1900024511 (Registered 13-07-2019).
随着定量 CT(QCT)在骨质疏松症和肌肉减少症临床评估中的广泛应用,需要进一步揭示中老年人肌肉骨骼退变的特征。我们旨在研究不同骨量的中老年人腰椎和腹部肌肉的退变特征。
根据定量 CT(QCT)标准,将 430 名年龄在 40-88 岁的患者分为正常、骨量减少和骨质疏松组。使用 QCT 测量包括腰椎和腹部肌肉在内的 5 块肌肉(腹壁肌肉、腹直肌、腰大肌、椎旁后肌和椎旁肌)的骨骼肌质量指数(SMI)。分析三组之间 SMI 的差异,以及 SMI 与体积骨密度(vBMD)的相关性。计算 SMI 预测低骨量和骨质疏松症的曲线下面积(AUC)。
在男性组中,骨量减少组的 RA 和 PM 肌肉 SMI 明显低于正常组(P=0.001 和 0.023)。在女性组中,仅骨量减少组的 RA 肌肉 SMI 明显低于正常组(P=0.007)。RA 肌肉 SMI 与 vBMD 呈正相关,在男女组中相关性最高(r=0.309 和 0.444)。在男女组中,AWM 和 RA 肌肉 SMI 的 AUC 较高,用于预测低骨量和骨质疏松症的 AUC 从 0.613 到 0.737。
不同骨量患者的腰椎和腹部肌肉 SMI 变化不同。RA 肌肉 SMI 有望成为预测异常骨量的有前途的影像学标志物。
ChiCTR1900024511(注册于 2019-07-13)。