Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Severance Hospital, Institute for Immunology and Immunological Disease, Yonsei University College of Medicine, Seoul, Republic of Korea.
Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
Sci Rep. 2023 Aug 22;13(1):13680. doi: 10.1038/s41598-023-40984-y.
Quantitative body composition affects the prognosis of patients with Mycobacterium avium complex pulmonary disease (MAC-PD). However, whether the qualitative body composition obtained indirectly through computed tomography (CT) affects their prognosis is debatable. We retrospectively analyzed patients with MAC-PD who underwent non-contrast CT at MAC-PD diagnosis. The cross-sectional area of the erector spinae muscle (ESM area), the Hounsfield unit of the erector spinae muscle (ESM HU), and the cross-sectional area of subcutaneous fat (SQF area) were measured at the level of the first lumbar vertebra. Myosteatosis were defined below the median value of ESM HU for each sex. Of 377 patients, 45 (11.9%) died during the follow-up. Patients who died were older and had a lower ratio of females (33.3%). In body compositions, SQF area and ESM HU were lower in the patients who died. In multivariable analysis, a low ESM HU was associated with increased mortality (ESM HU adjusted hazard ratio [aHR] 0.95, 95% confidence interval [CI] 0.93-0.97) through body composition. SQF area revealed protective effects in MAC-PD patients with body mass index ≥ 18.5 kg/m (aHR 0.98, 95% CI 0.95-1.00). In conclusion, the decrease in ESM HU, which indirectly reflects myosteatosis, is associated with mortality in patients with MAC-PD.
定量身体成分会影响分枝杆菌复合群肺病（MAC-PD）患者的预后。然而，通过计算机断层扫描（CT）间接获得的定性身体成分是否会影响其预后仍存在争议。我们回顾性分析了在 MAC-PD 诊断时接受非增强 CT 检查的 MAC-PD 患者。在第 1 腰椎水平测量竖脊肌（ESM 面积）的横截面积、竖脊肌的 Hounsfield 单位（ESM HU）和皮下脂肪的横截面积（SQF 面积）。肌少症定义为每个性别 ESM HU 的中位数以下。在 377 名患者中，有 45 名（11.9%）在随访期间死亡。死亡患者年龄较大，女性比例较低（33.3%）。在身体成分方面，死亡患者的 SQF 面积和 ESM HU 较低。多变量分析显示，低 ESM HU 与死亡率增加相关（ESM HU 调整后的危险比[aHR]0.95，95%置信区间[CI]0.93-0.97）。在身体质量指数≥18.5 kg/m 的 MAC-PD 患者中，SQF 面积显示出保护作用（aHR 0.98，95%CI 0.95-1.00）。总之，间接反映肌少症的 ESM HU 的减少与 MAC-PD 患者的死亡率相关。
