Byrne Cecily A, Fantuzzi Giamila, Stephan Jeremy T, Kim Sage, Oddo Vanessa M, Koh Timothy J, Gomez Sandra L
Cancer Health Equity and Career Development Program, University of Illinois Chicago, 1747 W. Roosevelt Rd., Chicago, IL 60608, USA.
Department of Kinesiology and Nutrition, University of Illinois Chicago, 1919 W. Taylor St., Chicago, IL 60612, USA.
Muscles. 2024 Jun;3(2):121-132. doi: 10.3390/muscles3020012. Epub 2024 Apr 16.
(1)Sarcopenia, or low skeletal mass index (SMI), contributes to higher lung cancer mortality. The SMI at third lumbar vertebrae (L3) is the reference standard for body composition analysis. However, there is a need to explore the validity of alternative landmarks in this population. We compared the agreement of sarcopenia identification at the first lumbar (L1) and second lumbar (L2) to L3 in non-Hispanic Black (NHB) and White (NHW) individuals with lung cancer.
(2)This retrospective, cross-sectional study included 214 NHB and NHW adults with lung cancer. CT scans were analyzed to calculate the SMI at L1, L2, and L3. T-tests, chi-square, Pearson's correlation, Cohen's kappa, sensitivity, and specificity analysis were used.
(3)Subjects presented with a mean age of 68.4 ± 9.9 years and BMI of 26.3 ± 6.0 kg/m. Sarcopenia prevalence varied from 19.6% at L1 to 39.7% at L3. Cohen's kappa coefficient was 0.46 for L1 and 0.64 for L2, indicating weak and moderate agreement for the identification of sarcopenia compared to L3.
(4)Sarcopenia prevalence varied greatly depending on the vertebral landmark used for assessment. Using L2 or L1 alone resulted in a 16.8% and 23.8% misclassification of sarcopenia in this cohort of individuals with lung cancer.
（1）肌肉减少症，即低骨骼肌质量指数（SMI），会导致肺癌死亡率升高。第三腰椎（L3）处的SMI是身体成分分析的参考标准。然而，有必要在这一人群中探索其他标志点的有效性。我们比较了非西班牙裔黑人（NHB）和白人（NHW）肺癌患者中，第一腰椎（L1）和第二腰椎（L2）与L3处肌肉减少症识别的一致性。
（2）这项回顾性横断面研究纳入了214名患有肺癌的NHB和NHW成年人。对CT扫描结果进行分析，以计算L1、L2和L3处的SMI。使用了t检验、卡方检验、皮尔逊相关性分析、科恩kappa系数分析、敏感性分析和特异性分析。
（3）受试者的平均年龄为68.4±9.9岁，体重指数为26.3±6.0kg/m²。肌肉减少症患病率从L1处的19.6%到L3处的39.7%不等。L1处的科恩kappa系数为0.46，L2处为0.64，这表明与L3相比，L1和L2处肌肉减少症识别的一致性较弱和中等。
（4）肌肉减少症患病率因用于评估的椎骨标志点不同而有很大差异。在这组肺癌患者中单独使用L2或L1会导致16.8%和23.8%的肌肉减少症误分类。
