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  11. Paraspinal Myosteatosis Is Associated With Copd: A Cross-sectional Mri Analysis From The Population-based Kora Cohort

Paraspinal myosteatosis is associated with COPD: a cross-sectional MRI analysis from the population-based KORA cohort

Thierno D Diallo1, Stefan Karrasch2,3,4, Matthias Jung5

  • 1Department of Diagnostic and Interventional Radiology, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Strasse 55, 79106, Freiburg, Germany. thierno.diallo@uniklinik-freiburg.de.

Respiratory Research
|June 14, 2025

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View abstract on PubMed

Summary
This summary is machine-generated.

Increased paraspinal muscle fat is linked to higher chronic obstructive pulmonary disease (COPD) risk. However, a higher proportion of intramyocellular lipids (IMCL) relative to extramyocellular lipids (EMCL) shows protective effects in COPD patients.

Area of Science:

  • Cardiorespiratory Medicine
  • Radiology
  • Metabolic Research

Background:

  • Chronic obstructive pulmonary disease (COPD) is associated with muscle dysfunction beyond the lungs.
  • The role of paraspinal muscle fat infiltration (myosteatosis) in COPD is not well understood.
  • This study aimed to investigate the relationship between paraspinal myosteatosis, its fat distribution patterns, and COPD presence and severity.

Purpose of the Study:

  • To determine if paraspinal myosteatosis is associated with COPD.
  • To explore the link between paraspinal fat distribution patterns (IMCL vs. EMCL) and COPD.
  • To assess the association of paraspinal myosteatosis with pulmonary function, specifically gas exchange capacity.

Main Methods:

  • Utilized data from the population-based KORA cohort (n=214).
Keywords:
Body compositionImaging biomarkerMagnetic resonance imagingMyosteatosis

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  • Performed whole-body magnetic resonance imaging (MRI) to quantify paraspinal myosteatosis using proton density fat fraction (PDFF) at L3.
  • Analyzed intramyocellular lipids (IMCL) and extramyocellular lipids (EMCL) and correlated findings with spirometry-defined COPD and pulmonary function tests (TLCO/VA).

    • Main Results:

    • COPD participants exhibited higher paraspinal PDFF and lower IMCL/EMCL ratios compared to non-COPD individuals.
    • Higher paraspinal PDFF was independently associated with increased COPD odds (OR 1.69).
    • A higher IMCL/EMCL ratio was associated with reduced COPD odds (OR 0.49) and better pulmonary gas exchange (TLCO/VA).

    Conclusions:

    • Increased total paraspinal fat content is linked to higher COPD risk.
    • Distinct fat distribution patterns (higher IMCL/EMCL ratio) may indicate preserved muscle oxidative capacity and offer protective effects.
    • Paraspinal fat distribution patterns could serve as novel imaging biomarkers for metabolic adaptations in COPD, aiding disease monitoring and therapeutic strategies.
    Obstructive lung disease