Shinohara Takahiro, Yamada Toru, Ouchi Shuji, Mabuchi Suguru, Hanazawa Ryoichi, Nakagawa Kazuharu, Yoshimi Kanako, Mayama Tatsuya, Horike Ayane, Toyoshima Kenji, Tamura Yoshiaki, Araki Atsushi, Tohara Haruka, Hirakawa Akihiro, Kimura Takuma, Ishida Takeshi, Hashimoto Masayoshi
Department of General Medicine, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo, Tokyo 113-8510, Japan.
Department of Clinical Biostatistics, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo, Tokyo 113-8510, Japan.
Diagnostics (Basel). 2025 Jan 3;15(1):90. doi: 10.3390/diagnostics15010090.
: The diaphragm is important for respiration, but the effects of age-related muscle loss and sarcopenia on diaphragm function are unclear. We evaluated the associations of sarcopenia and skeletal muscle mass (SMM) with diaphragm function. : This study was conducted at three Japanese hospitals from May 2023 to September 2024. The participants underwent bioelectrical impedance for SMM assessment, as well as pulmonary function tests. Diaphragm ultrasound was used to measure the thickness at functional residual capacity (FRC), thickening fraction (TF), and diaphragm excursion (DE) during deep breathing (DB), and their associations with sarcopenia and low skeletal muscle index (SMI) were analyzed. : Overall, 148 patients (mean age 78.1 years; sarcopenia, = 35; non-sarcopenia, = 103) were included. No statistically significant differences in thickness(FRC), TF and DE were observed between the sarcopenia group and the non-sarcopenia group. The low SMI group had significantly lower thickness (difference -0.22, 95% CI; -0.41, -0.29) and DE (difference -9.2, 95%CI; -14.0, -4.49) than the normal SMI group. Multivariable linear regression analyses adjusted for age, sex, and stature revealed no association between thickness (FRC) and sarcopenia ( = 0.98), but thickness (FRC) was negatively associated with low SMI ( = 0.034). DE during DB was negatively associated with sarcopenia ( = 0.024) and low SMI ( = 0.001). TF showed no associations. : DE during DB was reduced in patients with sarcopenia and low SMI, and thickness (FRC) was reduced in those with low SMI without sarcopenia.
膈肌对呼吸很重要，但年龄相关的肌肉流失和肌肉减少症对膈肌功能的影响尚不清楚。我们评估了肌肉减少症和骨骼肌质量（SMM）与膈肌功能的关联。
本研究于2023年5月至2024年9月在三家日本医院进行。参与者接受了生物电阻抗测量以评估SMM，并进行了肺功能测试。使用膈肌超声测量功能残气量（FRC）时的厚度、增厚分数（TF）以及深呼吸（DB）时的膈肌偏移（DE），并分析它们与肌肉减少症和低骨骼肌指数（SMI）的关联。
总体而言，纳入了148名患者（平均年龄78.1岁；肌肉减少症患者35例，非肌肉减少症患者103例）。肌肉减少症组和非肌肉减少症组在厚度（FRC）、TF和DE方面未观察到统计学上的显著差异。低SMI组的厚度（差异-0.22，95%CI：-0.41，-0.29）和DE（差异-9.2，95%CI：-14.0，-4.49）显著低于正常SMI组。在对年龄、性别和身高进行调整的多变量线性回归分析中，厚度（FRC）与肌肉减少症之间无关联（P=0.98），但厚度（FRC）与低SMI呈负相关（P=0.034）。DB期间的DE与肌肉减少症（P=0.024）和低SMI（P=0.001）呈负相关。TF未显示出关联。
肌肉减少症和低SMI患者DB期间的DE降低，而无肌肉减少症的低SMI患者厚度（FRC）降低。
