基于腹部CT的肌少脂变或肌肉减少症与系统性红斑狼疮患者高血压之间的关联。

Association between myosteatosis or sarcopenia based on abdominal CT and hypertension in systemic lupus erythematosus patients.

作者信息

Wang Bowen, Zuo Liping, Fan Jinlei, Zhao Wei, An Yueming, Cai Wangshu, Yu Dexin

机构信息

Department of Radiology, Qilu Hospital of Shandong University, Jinan, Shandong, 250012, China.

Department of Radiology, Jinan Central Hospital, Jinan, Shandong, 250013, China.

出版信息

Lipids Health Dis. 2025 Mar 20;24(1):105. doi: 10.1186/s12944-025-02530-9.

DOI:10.1186/s12944-025-02530-9

PMID:40114114

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11924695/

Abstract

BACKGROUND

Hypertension and obesity are common in systemic lupus erythematosus (SLE) patients, with obesity-related changes potentially driving hypertension. However, the specific adiposity measures associated with hypertension in SLE patients remain unclear. This study assessed the association between myosteatosis and sarcopenia detected on abdominal CT and hypertension in SLE patients. Mediators of the association between myosteatosis and hypertension were also investigated.

METHODS

This was a retrospective study involving SLE patients enrolled from January 2017 to August 2023 and who underwent abdominal CT at the L3 level to track myosteatosis and sarcopenia based on the skeletal muscle mean radiodensity (SMD) and skeletal muscle index considered as binary and continuous variables. The association between these body composition measures and hypertension was tested using logistic regression analyses, while mediation modeling was used to assess the mediators.

RESULTS

A total of 279 adult SLE patients (median age, 41.00 [30.00, 51.00] years; 245 women) were included in this study. Hypertension was associated with myosteatosis (adjusted OR: 3.54; 95% CI: 1.18-10.61 for the binary variable and 1.31; 95% CI: 1.02-1.68 for the continuous variable). No statistically significant association was observed between hypertension and sarcopenia (adjusted OR: 0.48; 95%CI: 0.23-1.01 for the binary variable and 0.95; 95%CI: 0.78-1.16 for the continuous variable). Mediation analyses revealed eGFR could mediate the association between myosteatosis (considered as a continuous variable) and hypertension in SLE patients when taken alone (95% CI: 0.0177-0.2765) or in combination with the TyG index (95% CI: 0.0032-0.0614).

CONCLUSIONS

Myosteatosis was associated with hypertension in SLE patients. eGFR alone or in combination with the TyG index may mediate this association.

摘要

背景

高血压和肥胖在系统性红斑狼疮（SLE）患者中很常见，与肥胖相关的变化可能导致高血压。然而，SLE患者中与高血压相关的具体肥胖指标仍不清楚。本研究评估了腹部CT检测到的肌少脂性和肌肉减少症与SLE患者高血压之间的关联。还研究了肌少脂性与高血压之间关联的中介因素。

方法

这是一项回顾性研究，纳入了2017年1月至2023年8月登记的SLE患者，这些患者接受了L3水平的腹部CT检查，以根据骨骼肌平均放射密度（SMD）和骨骼肌指数追踪肌少脂性和肌肉减少症，将其视为二元变量和连续变量。使用逻辑回归分析检验这些身体成分指标与高血压之间的关联，同时使用中介模型评估中介因素。

结果

本研究共纳入279例成年SLE患者（中位年龄41.00[30.00，51.00]岁；245例女性）。高血压与肌少脂性相关（二元变量的调整OR：3.54；95%CI：1.18 - 10.61，连续变量的调整OR：1.31；95%CI：1.02 - 1.68）。未观察到高血压与肌肉减少症之间有统计学意义的关联（二元变量的调整OR：0.48；95%CI：0.23 - 1.01，连续变量的调整OR：0.95；95%CI：0.78 - 1.16）。中介分析显示，单独考虑（95%CI：0.0177 - 0.2765）或与TyG指数联合考虑（95%CI：0.0032 - 0.0614）时，估算肾小球滤过率（eGFR）可介导SLE患者中肌少脂性（视为连续变量）与高血压之间的关联。