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Computed Tomography-based Abdominal Myosteatosis Indicators and Handgrip Strength in Hemodialyzed Patients
1Department of Nephrology, Matsunami General Hospital, Gifu, Japan.
Insights
Computed tomography (CT)-based abdominal myosteatosis indicators, like psoas muscle density (PMD), are linked to muscle quality in hemodialyzed patients. PMD may be the best indicator for assessing muscle quality and detecting low handgrip strength in this population.
Area of Science:
- Nephrology
- Radiology
- Muscle Physiology
Background:
- Muscle quality is crucial for hemodialyzed patients, but its assessment remains challenging.
- Myosteatosis, or fat infiltration in muscle, is a potential contributor to reduced muscle quality.
- The relationship between myosteatosis and muscle strength in hemodialyzed patients is not well understood.
Purpose of the Study:
- To investigate the association between computed tomography (CT)-based abdominal myosteatosis indicators and handgrip strength (HGS) in hemodialyzed patients.
- To evaluate the diagnostic performance of CT-derived myosteatosis measures in identifying low muscle strength.
Main Methods:
- 128 hemodialyzed patients underwent CT scans, bioimpedance analysis (BIA), and HGS measurements.
- CT-based myosteatosis indicators, including psoas muscle density (PMD), paraspinous muscle density (PSMD), and abdominal skeletal muscle density (ASMD), were quantified.
- Statistical analyses explored correlations between myosteatosis indicators and HGS, and their ability to detect low muscle strength.
Main Results:
- PMD, PSMD, and ASMD were independently correlated with HGS, but not with BIA-derived skeletal muscle index.
- 48.4% of patients exhibited low HGS.
- CT-based indicators demonstrated good diagnostic ability for low HGS, with PMD showing a significant association with reduced risk of low HGS.
Conclusions:
- CT-derived abdominal myosteatosis indicators are associated with muscle quality (HGS) in hemodialyzed patients.
- These indicators, particularly PMD, show potential for assessing muscle quality and detecting low muscle strength in this population.
- PMD may be the most recommended indicator for evaluating muscle quality in hemodialyzed patients.
Objective:
The relationship between myosteatosis and muscle quality in hemodialyzed patients remains unknown. This study aimed to investigate the relationship between computed tomography (CT)-based abdominal myosteatosis indicators and handgrip strength (HGS) in these patients.
Methods:
This study enrolled 128 hemodialyzed patients who underwent CT, bioimpedance analysis (BIA), and HGS measurement. CT-based abdominal myosteatosis indicators were measured, including psoas muscle density (PMD), paraspinous muscle density (PSMD), and abdominal skeletal muscle density (ASMD), defined as the mean CT value of each muscle at the third lumbar vertebral level. The association between these indicators and HGS was analyzed, and the diagnostic abilities of these indicators to detect low muscle strength, as defined by HGS cutoff values (male, <28 kg; female, <18 kg), were investigated.
Results:
The PMD, PSMD, and ASMD were independently correlated with HGS (β = 0.310, P = .0041; β = 0.210, P = .033; and β = 0.252, P = .011, respectively), but not with BIA-estimated skeletal muscle index. Sixty-two (48.4%) patients had low HGS. After adjusting for confounding factors, the adjusted C-statistics of PMD, PSMD, and ASMD for detecting low HGS were 0.845 (reference), 0.836 (P = .56), and 0.837 (P = .50), respectively. Moreover, an increase in the PMD alone was independently associated with a decrease in the risk of low HGS (adjusted odds ratio: 0.912 (95% confidence interval 0.841-0.982), P = .015).
Conclusions:
CT-based abdominal myosteatosis indicators were independently associated with HGS, but not with BIA-estimated skeletal muscle index, and may aid in detecting clinically acceptable low HGS in hemodialyzed patients. The PMD may be the most recommended myosteatosis indicator for assessing muscle quality in this population.
