Does Muscle Atrophy and Fatty Infiltration Plateau or Persist in Chronic Spinal Cord Injury?
Does Muscle Atrophy and Fatty Infiltration Plateau or Persist in Chronic Spinal Cord Injury?
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DOI：
10.1016/j.jocd.2017.06.001
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发表时间：
2018-07-01
影响因子：
2.5
通讯作者：
Giangregorio, Lora M.
中科院分区：
文献类型：
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作者：
Moore, Cameron D.;Craven, B. Catharine;Giangregorio, Lora M.
脊髓损伤（SCI）后下肢肌肉萎缩和脂肪浸润使个体易患代谢综合征以及相关的糖尿病和心血管疾病。本研究的目的是前瞻性地测量下肢远端肌肉的肌肉萎缩和脂肪含量的变化，并探讨慢性SCI和各种损伤的成年人队列中的相关因素。肌肉横截面积和密度通过70名慢性SCI受试者（50名男性，平均年龄49岁，C2-T12，美国脊髓损伤协会损伤量表A-D）小腿66%部位的外周定量计算机断层扫描计算，在研究入组时和2年内每年一次。混合模型重复测量方差分析（rANOVA）检查了肌肉面积和密度的纵向变化，回归分析使用16个先验选择的潜在相关性探索与肌肉变化相关的因素。在2年内观察到肌肉面积和密度变化的高度个体差异（范围：8.5至-22.6 cm（2）; 6.4至-8.6 mg/cm（3））。重复测量方差分析显示肌肉面积显著减少（估计平均差异[95%置信区间] -1.76 [-3.29至-0.23]）cm（2），p = 0.025）和密度（-1.04 [-1.94至-0.14] mg/cm（3），p < 0.024）;然而，去除离群值后，面积变化不显著。回归分析解释了肌肉密度变化的一小部分变异性;然而，在事后敏感性分析后，没有一个预先选择的变量与肌肉密度变化显著相关。下肢肌肉大小和脂肪含量在慢性SCI后可能不会达到“稳定状态”。下肢肌肉的进行性萎缩和脂肪浸润可能对慢性SCI后的代谢综合征、心血管疾病风险和相关死亡率有不良影响。
Atrophy and fatty infiltration of lower extremity muscle after spinal cord injury (SCI) predisposes individuals to metabolic syndrome and related diabetes and cardiovascular disease. The objective of this study was to prospectively measure changes in muscle atrophy and fat content of distal lower extremity muscles and explore related factors in a cohort of adults with chronic SCI and diverse impairments. Muscle cross-sectional area and density were calculated from peripheral quantitative computed tomography scans of the 66% site of the calf from 70 participants with chronic SCI (50 male, mean age 49 years, C2-T12, American Spinal Injury Association Impairment Scale A-D) at study enrollment and annually for 2 years. Mixed-model repeated measures analysis of variance (rANOVA) examined longitudinal changes in muscle area and density, and regression analyses explored factors related to muscle changes using 16 potential correlates selected a priori. A high degree of individual variation in muscle area and density change was observed over 2 years (range: 8.5 to -22.6 cm(2); 6.4 to -8.6 mg/cm(3)). Repeated measures analysis of variance revealed significant reductions in muscle area (estimated mean difference [95% confidence intervals] -1.76 [-3.29 to -0.23]) cm(2), p = 0.025) and density (-1.04 [-1.94 to -0.14] mg/cm(3), p < 0.024); however, changes in area were not significant with outliers removed. Regression analyses explained a small proportion of the variability in muscle density change; however, none of the preselected variables were significantly related to changes in muscle density after post hoc sensitivity analyses. Lower extremity muscle size and fat content may not reach a "steady-state" after chronic SCI. Progressive atrophy and fatty infiltration of lower extremity muscle may have adverse implications for metabolic syndrome and cardiovascular disease risk and related mortality after chronic SCI.