Hayashi Yusuke, Tanabe Naoya, Shimizu Kaoruko, Maetani Tomoki, Shiraishi Yusuke, Oguma Tsuyoshi, Sunadome Hironobu, Sakamoto Ryo, Sato Atsuyasu, Sato Susumu, Date Hiroshi, Matsumoto Hisako, Hirai Toyohiro
Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Ann Allergy Asthma Immunol. 2024 Dec;133(6):667-674.e4. doi: 10.1016/j.anai.2024.08.016. Epub 2024 Aug 22.
Lower skeletal muscle density may reflect muscle adiposity and metabolic dysregulation that potentially impair disease control and lung function independent of high body mass index (BMI) in patients with asthma.
To investigate whether the lower density of pectoralis muscles (PMs) and erector spinae muscles (ESMs) on chest computed tomography was associated with airway structural changes in patients with asthma.
Consecutive patients with asthma and healthy controls undergoing chest computed tomography were retrospectively analyzed. The ESM and PM density, areas of subcutaneous adipose tissue near the PM and epicardial adipose tissue, wall area percent of the airways, and airway fractal dimension (AFD) were quantified on computed tomography.
The study included 179 patients with asthma (52% women) and 88 controls (47% women). All the controls were 60 years old or younger. The PM and ESM density in female patients with asthma who were 60 years old or younger were significantly lower than those in controls after adjustment for BMI. In female patients with asthma at all ages, lower PM and ESM density (but not subcutaneous or epicardial adipose tissue area) was associated with greater wall area percent of the airways and lower AFD after adjusting for age, height, BMI, smoking status, blood eosinophil count, and oral corticosteroid use. The only association between ESM density and AFD was found in male patients with asthma.
Lower skeletal muscle density may be associated with airway wall thickening and less complexity of the airway luminal tree in female patients with asthma.
较低的骨骼肌密度可能反映肌肉脂肪堆积和代谢失调，这可能在哮喘患者中独立于高体重指数（BMI）损害疾病控制和肺功能。
研究胸部计算机断层扫描中胸肌（PMs）和竖脊肌（ESMs）密度降低是否与哮喘患者的气道结构变化相关。
对连续接受胸部计算机断层扫描的哮喘患者和健康对照进行回顾性分析。在计算机断层扫描上量化ESMs和PMs密度、PMs附近皮下脂肪组织和心外膜脂肪组织的面积、气道壁面积百分比和气道分形维数（AFD）。
该研究纳入了179例哮喘患者（52%为女性）和88例对照（47%为女性）。所有对照年龄均在60岁及以下。在调整BMI后，60岁及以下女性哮喘患者的PMs和ESMs密度显著低于对照。在各年龄段的女性哮喘患者中，调整年龄、身高、BMI、吸烟状况、血嗜酸性粒细胞计数和口服糖皮质激素使用情况后，较低的PMs和ESMs密度（而非皮下或心外膜脂肪组织面积）与气道壁面积百分比增加和AFD降低相关。仅在男性哮喘患者中发现ESMs密度与AFD之间存在关联。
较低的骨骼肌密度可能与女性哮喘患者的气道壁增厚和气道管腔树复杂性降低有关。
