Abstract
Background
Sarcopenia is a major health issue especially in patients on maintenance hemodialysis. Low skeletal muscle mass is included in the diagnostic criteria for sarcopenia. The skeletal muscle mass is usually evaluated by modalities such as bioimpedance analysis (BIA) or dual-energy X-ray absorptiometry, however the assessment of skeletal muscle mass using computed tomography (CT) images has not been established. The purpose of the study was to investigate the feasibility of the assessment of skeletal muscle mass using CT images in hemodialysis patients.
Methods
Skeletal muscle mass index (SMI) was measured by BIA and psoas muscle index (PMI) was measured by cross-sectional CT images in 131 patients. The relationship between SMI and PMI and the diagnostic ability of PMI for low muscle mass were evaluated. Furthermore, the patients were followed up and long-term survival in patients with low and high PMI were compared.
Results
PMI measured at the L3 vertebral level was strongly correlated with SMI (r = 0.597, p < 0.001). Age, sex, and SMI were the influencing factors for PMI. Patients with low PMI showed higher incidence rates of mortality during the follow up.
Conclusions
PMI assessed by CT image can be an alternative to BIA in patients on hemodialysis.
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Data availability
All data generated or analyzed during this study are included in this published article.
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Conceptualization: TT, KY, AI, MO, SH, MY, YM, and TI; data acquisition; TT, AM, and KT; formal analysis and investigation; TT, ST: writing—original draft preparation; TT: writing—review and editing: MT, AN: supervision; HI.
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This study was conducted retrospectively from data obtained for clinical purposes. This study was approved by the ethical committee of the Tottori University Hospital (approval number: 19A222), and was conducted according to the declaration of Helsinki.
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40620_2020_871_MOESM1_ESM.tif
Supplementary file1 Scheme of the assessment of muscle mass. Representative computed tomography images from patients with high and low PMI are shown (TIF 509 kb)
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Takata, T., Motoe, A., Tanida, K. et al. Feasibility of computed tomography-based assessment of skeletal muscle mass in hemodialysis patients. J Nephrol 34, 465–471 (2021). https://doi.org/10.1007/s40620-020-00871-5
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DOI: https://doi.org/10.1007/s40620-020-00871-5