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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肺移植候选者的胸大肌面积与骨矿物质密度和肺功能相关

摘要

概要

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。与阻塞性肺疾病相比，限制性疾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，可能与晚期肺部疾病有关。通过胸部计算机断层扫描（CT）定量的胸大肌指数（PMI）可用于测量骨骼肌质量。这项研究旨在确定PMI与临床参数之间的关系，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，拟人化和临床数据。在胸部CT的轴向切片上确定胸大肌面积（PMA）。将PMI计算为PMA除以高度的平方。BMD是从常规双能X射线吸收法（DXA）扫描获得的。

结果

在226名患者中，男性平均PMI为8.2±3.0 cm ² / m ²，女性平均PMI为6.1±2.1 cm ² / m ²。骨质减少症占44.4％，患有骨质疏松症的患者占23.2％。阻塞性肺疾病患者的体重指数较低（22.0±4.9对27.9±4.9 kg / m ²，p  <0.001），PMI（6.0±2.3对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）与限制性肺疾病患者相比。PMI是BMD的重要预测因子（β= 0.16，p  <0.001）。

结论

肺移植候选者的肌肉面积与BMD之间的关联表明相似的机制可能是两者共同发展的基础。阻塞性和限制性肺疾病患者的PMI和BMD差异可能是由于呼吸生理或疾病过程的差异所致。