Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, 29010 Malaga, Spain.
Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, 29010 Malaga, Spain.
Nutrients. 2024 Aug 28;16(17):2885. doi: 10.3390/nu16172885.
Body composition (BC) techniques, including bioelectrical impedance analysis (BIVA), nutritional ultrasound (NU), and computed tomography (CT), can detect nutritional diagnoses such as sarcopenia (Sc). Sc in idiopathic pulmonary fibrosis (IPF) is associated with greater severity and lower survival. Our aim was to explore the correlation of BIVA, NU and functional parameters with BC at T12 level CT scans in patients with IPF but also its relationship with degree of Sc, malnutrition and mortality.
This bicentric cross-sectional study included 60 IPF patients (85.2% male, 70.9 ± 7.8 years). Morphofunctional assessment (MFA) techniques included BIVA, NU, CT at T12 level (T12-CT), handgrip strength, and timed up and go. CT data were obtained using FocusedON. Statistical analysis was conducted using JAMOVI version 2.3.22 to determine the cutoff points for Sc in T12-CT and to analyze correlations with other MFA techniques.
the cutoff for muscle area in T12-CT was ≤77.44 cm (area under the curve (AUC) = 0.734, sensitivity = 41.7%, specificity = 100%). The skeletal muscle index (SMI_T12CT) cutoff was ≤24.5 cm/m (AUC = 0.689, sensitivity = 66.7%, specificity = 66.7%). Low SMI_T12CT exhibited significantly reduced median survival and higher risk of mortality compared to those with normal muscle mass (SMI cut off ≥ 28.8 cm/m). SMI_T12CT was highly correlated with body cell mass from BIVA (r = 0.681) and rectus femoris cross-sectional area (RF-CSA) from NU (r = 0.599). Cronbach's α for muscle parameters across different MFA techniques and CT was 0.735, confirming their validity for evaluating muscle composition.
T12-CT scan is a reliable technique for measuring low muscle mass in patients with IPF, specifically when the L3 vertebrae are not captured. An SMI value of <28.8 is a good predictor of low lean mass and 12-month mortality in IPF patients.
人体成分（BC）技术，包括生物电阻抗分析（BIVA）、营养超声（NU）和计算机断层扫描（CT），可检测到肌少症（Sc）等营养诊断。特发性肺纤维化（IPF）中的 Sc 与更严重的病情和更低的生存率相关。我们的目的是探索 BIVA、NU 和功能参数与 IPF 患者 T12 水平 CT 扫描的 BC 之间的相关性，以及与 Sc 程度、营养不良和死亡率的关系。
这项双中心横断面研究纳入了 60 名 IPF 患者（85.2%为男性，70.9±7.8 岁）。形态功能评估（MFA）技术包括 BIVA、NU、T12 水平 CT（T12-CT）、握力和计时起立行走。CT 数据使用 FocusedON 获得。使用 JAMOVI 版本 2.3.22 进行统计分析，以确定 T12-CT 中 Sc 的截断值，并分析与其他 MFA 技术的相关性。
T12-CT 中肌肉面积的截断值为≤77.44cm（曲线下面积（AUC）=0.734，灵敏度=41.7%，特异性=100%）。骨骼肌肉指数（SMI_T12CT）的截断值为≤24.5cm/m（AUC=0.689，灵敏度=66.7%，特异性=66.7%）。与肌肉质量正常（SMI 截断值≥28.8cm/m）的患者相比，低 SMI_T12CT 表现出明显缩短的中位生存期和更高的死亡风险。SMI_T12CT 与 BIVA 中的细胞内液质量（r=0.681）和 NU 中的股直肌横截面积（RF-CSA）（r=0.599）高度相关。不同 MFA 技术和 CT 之间的肌肉参数的 Cronbach's α 为 0.735，证实了它们评估肌肉成分的有效性。
T12-CT 扫描是一种可靠的技术，可用于测量 IPF 患者的低肌肉量，特别是当无法捕捉 L3 椎骨时。SMI 值<28.8 是预测 IPF 患者低瘦体重和 12 个月死亡率的良好指标。
