Abstract

Summary

Loss of bone mineral density and skeletal muscle area are linked in lung transplant patients. This loss is greater in patients with restrictive compared with obstructive lung diseases.

Introduction

Sarcopenia and osteoporosis are associated with aging and chronic illnesses and may be linked in patients with advanced lung disease. Pectoralis muscle index (PMI) quantitated on computed tomography (CT) of the chest can be used to measure skeletal muscle mass. This study aimed to determine the relationship of PMI to clinical parameters including bone mineral density (BMD) in candidates for lung transplantation.

Methods

A retrospective review of transplant candidates at a single center was performed. Demographic, anthropomorphic, and clinical data were recorded. Pectoralis muscle area (PMA) was determined on an axial slice from a chest CT. PMI was calculated as the PMA divided by height squared. BMD was obtained from routine dual-energy X-ray absorptiometry (DXA) scan.

Results

In 226 included patients, mean PMI was 8.2 ± 3.0 cm²/m² in males and 6.1 ± 2.1 cm²/m² in females. Osteopenia was present in 44.4%, and 23.2% of patients had osteoporosis. Patients with obstructive lung disease had lower body mass index (22.0 ± 4.9 versus 27.9 ± 4.9 kg/m², p < 0.001), PMI (6.0 ± 2.3 versus 8.2 ± 2.8 cm²/m², p < 0.001), and BMD (− 2.3 ± 1.1 versus − 1.3 ± 1.1, p < 0.001) compared with patients with restrictive lung disease. PMI was a significant predictor of BMD (β = 0.16, p < 0.001).

Conclusion

The association between muscle area and BMD in lung transplant candidates suggests that similar mechanisms may underlie the development of both. Differences in PMI and BMD in patients with obstructive versus restrictive lung disease may result from differences in respiratory physiology or disease processes.

中文翻译：

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胸大肌区域与肺移植候选者的骨矿物质密度和肺功能有关。

摘要

概括

肺移植患者的骨矿物质密度和骨骼肌面积的损失是相关的。与阻塞性肺病相比，限制性肺病患者的这种损失更大。

介绍

肌肉减少症和骨质疏松症与衰老和慢性疾病有关，并且可能与晚期肺病患者有关。在胸部计算机断层扫描 (CT) 上定量的胸大肌指数 (PMI) 可用于测量骨骼肌质量。本研究旨在确定 PMI 与临床参数的关系，包括肺移植候选者的骨矿物质密度 (BMD)。

方法

对单个中心的移植候选者进行了回顾性审查。记录人口统计学、拟人化和临床数据。胸大肌面积 (PMA) 是在胸部 CT 的轴向切片上确定的。PMI 计算为 PMA 除以高度的平方。BMD 是从常规双能 X 射线骨密度仪 (DXA) 扫描中获得的。

结果

在纳入的 226 名患者中，男性的平均 PMI 为 8.2 ± 3.0 cm ² /m ²，女性为 6.1 ± 2.1 cm ² /m ²。44.4% 的患者出现骨质减少，23.2% 的患者患有骨质疏松症。阻塞性肺病患者的体重指数较低（22.0 ± 4.9 vs 27.9 ± 4.9 kg/m ²，p  < 0.001）、PMI（6.0 ± 2.3 vs 8.2 ± 2.8 cm ² /m ²，p  < 0.001）和 BMD (− 2.3 ± 1.1 vs − 1.3 ± 1.1, p  < 0.001) 与限制性肺病患者相比。PMI 是 BMD 的重要预测指标 (β = 0.16, p  < 0.001)。

结论

肺移植候选者的肌肉面积和 BMD 之间的关联表明，相似的机制可能是两者发展的基础。阻塞性和限制性肺病患者 PMI 和 BMD 的差异可能是由于呼吸生理学或疾病过程的差异。