Denervation impacts muscle quality and knee bone mineral density after spinal cord injury
Denervation impacts muscle quality and knee bone mineral density after spinal cord injury
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DOI：
10.1038/s41393-023-00885-3
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发表时间：
2023-03-10
期刊：
影响因子：
2.2
通讯作者：
Gorgey, Ashraf S.
中科院分区：
文献类型：
--
作者：
Alazzam, Ahmad M.;Goldsmith, Jacob A.;Gorgey, Ashraf S.
研究设计横断面研究目的比较失神经支配与神经支配脊髓损伤患者的肌肉大小、身体成分、骨矿物质密度（BMD）和代谢特征。地点Hunter Holmes McGuire退伍军人事务部（VA）医学中心。方法收集16名慢性脊髓损伤患者的身体成分、骨矿物质密度（BMD）、肌肉大小和代谢参数（n = 8去神经支配，n = 8神经支配）使用双能X射线吸收法（DXA），磁共振成像（MRI），和空腹血液样本。结果失神经支配组的全股肌横截面积（CSA）、膝伸肌CSA、股直肌CSA和股伸肌CSA的百分比差异均小于失神经支配组（P < 0.05），分别为38%、49%、49%和61%。去神经组的腿部瘦体重也较低（28%）（p < 0.05）。去神经组的全肌肌内脂肪（IMF%; 15.5%）、膝伸肌IMF%（22%）和%脂肪质量（10.9%）显著更高（p < 0.05）。失神经组的膝关节股骨远端和胫骨近端BMD较低，分别为18-22%和17-23%; p < 0.05。某些指标的代谢谱更有利的失神经组，但不显着。结论SCI的结果在骨骼肌萎缩和身体成分的显着变化。下运动神经元（LMN）损伤导致下肢肌肉的去神经支配，这加剧了萎缩。与神经支配的参与者相比，去神经支配的参与者表现出小腿瘦体重和肌肉CSA，更大的肌肉IMF和减少的膝关节BMD。未来的研究需要探索脊髓损伤后失神经肌肉的治疗方法。
Study designCross-sectional study.ObjectivesTo compare muscle size, body composition, bone mineral density (BMD), and metabolic profiles in denervated versus innervated individuals with spinal cord injury (SCI).SettingHunter Holmes McGuire Veterans Affairs (VA) Medical Center.MethodsBody composition, bone mineral density (BMD), muscle size, and metabolic parameters were collected in 16 persons with chronic SCI (n = 8 denervated, n = 8 innervated) using dual-energy x-ray absorptiometry (DXA), magnetic resonance imaging (MRI), and fasting blood samples. BMR was measured by indirect calorimetry.ResultsPercent differences of the whole thigh muscle cross-sectional area (CSA; 38%), knee extensor CSA (49%), vasti CSA (49%), and rectus femoris CSA (61%) were smaller in the denervated group (p < 0.05). Leg lean mass was also lower (28%) in the denervated group (p < 0.05). Whole muscle intramuscular fat (IMF%; 15.5%), knee extensor IMF% (22%), and % fat mass (10.9%) were significantly greater in the denervated group (p < 0.05). Knee distal femur and proximal tibia BMD were lower in the denervated group, 18-22% and 17-23%; p < 0.05. Certain indices of metabolic profile were more favorable in the denervated group though were not significant.ConclusionsSCI results in skeletal muscle atrophy and dramatic changes in body composition. Lower motor neuron (LMN) injury results in denervation of the lower extremity muscles which exacerbates atrophy. Denervated participants exhibited lower leg lean mass and muscle CSA, greater muscle IMF, and reduced knee BMD compared to innervated participants. Future research is needed to explore therapeutic treatments for the denervated muscles after SCI.