Huang Jing, Quan Jierong, Zhou Guanghong, Yu Lu, Su Qian, Guo Fei, Long Huaicong
Department of Respiratory and Critical Care Medicine, Affiliated Hospital of North Sichuan Medical College, Nanchong, China.
Department of Medical Ultrasound, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China.
Eur J Med Res. 2025 Jul 2;30(1):560. doi: 10.1186/s40001-025-02856-1.
The purpose of this study was to explore the value of different skeletal muscles in assessing muscle mass in elderly chronic obstructive pulmonary disease (COPD) patients with sarcopenia.
A cross-sectional analysis was conducted on a sample of elderly COPD patients with and without sarcopenia. Muscle mass measurements, including body mass index (BMI), weight, skeletal muscle index (SMI), 6-m walk test (6MWT), five-repetition sit-to-stand test (5STS), grip strength, calf circumference (CC), rectus abdominis thickness (RAT), rectus femoris cross-sectional area (RF-CSA), quadriceps femoris muscle thickness (QFMT), L1 muscle cross-sectional area (L1M CSA), and pectoralis muscle cross-sectional area (PM CSA). Statistical analyses were performed to assess the correlations between these muscle measurements and muscle mass, as well as the diagnostic value of low muscle mass (LMM) in elderly COPD patients.
The results showed that there were significant differences in BMI, weight, SMI, gait speed, 5STS, grip strength, and CC between the LMM group and the normal muscle mass (NMM) group (P < 0.05). The ultrasound measurements showed that RAT, RF-CSA, and QFMT were significantly lower in the LMM group compared to the NMM group (P < 0.05). Similarly, the comparison of CT measurement parameters revealed that in the LMM group, both L1M CSA and PM CSA were significantly lower than those in the NMM group (P < 0.05). Correlation analysis revealed strong positive correlations between SMI and CC, L1M CSA, and RAT in the LMM group (p < 0.01), but no significant correlations were found with certain parameters. Receiver-operating characteristic curve analysis showed that the AUC values of PM CSA, QFMT, L1M CSA, RF-CSA and RAT in the diagnosis of LMM in elderly male COPD patients were 0.850, 0.830, 0.802, 0.722 and 0.684.
L1M CSA, RAT, RF-CSA, PM CSA, QFMT, and CC are positively correlated with muscle mass in elderly COPD patients with sarcopenia, and CC is a good screening index for predicting muscle mass. PM CSA and QFMT may be good indicators for the diagnosis of LMM in elderly male COPD patients with sarcopenia.
本研究旨在探讨不同骨骼肌在评估老年慢性阻塞性肺疾病（COPD）合并肌少症患者肌肉量方面的价值。
对一组有或无肌少症的老年COPD患者进行横断面分析。测量肌肉量，包括体重指数（BMI）、体重、骨骼肌指数（SMI）、6分钟步行试验（6MWT）、五次坐立试验（5STS）、握力、小腿围（CC）、腹直肌厚度（RAT）、股直肌横截面积（RF-CSA）、股四头肌厚度（QFMT）、L1节段肌肉横截面积（L1M CSA）和胸肌横截面积（PM CSA）。进行统计分析以评估这些肌肉测量值与肌肉量之间的相关性，以及低肌肉量（LMM）在老年COPD患者中的诊断价值。
结果显示，LMM组与正常肌肉量（NMM）组在BMI、体重、SMI、步速、5STS、握力和CC方面存在显著差异（P < 0.05）。超声测量显示，LMM组的RAT、RF-CSA和QFMT显著低于NMM组（P < 0.05）。同样，CT测量参数比较显示，在LMM组中，L1M CSA和PM CSA均显著低于NMM组（P < 0.05）。相关性分析显示，LMM组中SMI与CC、L1M CSA和RAT之间存在强正相关（p < 0.01），但与某些参数未发现显著相关性。受试者工作特征曲线分析显示，PM CSA、QFMT、L1M CSA、RF-CSA和RAT在老年男性COPD患者LMM诊断中的AUC值分别为0.850、0.830、0.802、0.722和0.684。
L1M CSA、RAT、RF-CSA、PM CSA、QFMT和CC与老年COPD合并肌少症患者的肌肉量呈正相关，CC是预测肌肉量的良好筛查指标。PM CSA和QFMT可能是老年男性COPD合并肌少症患者LMM诊断的良好指标。
