Thoracic skeletal muscle quantification: low muscle mass is related with worse prognosis in idiopathic pulmonary fibrosis patients
Abstract Background Sarcopenia can contribute to negative outcomes in patients with various lung diseases. However, whether sarcopenia affects prognosis in patients with idiopathic pulmonary fibrosis (IPF) has not been reported. Simple measures of muscle mass, derived from chest computed tomography...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2019-02-01
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| Series: | Respiratory Research |
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| Online Access: | http://link.springer.com/article/10.1186/s12931-019-1001-6 |
| _version_ | 1818524039786790912 |
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| author | Sung Woo Moon Ji Soo Choi Sang Hoon Lee Kyung Soo Jung Ji Ye Jung Young Ae Kang Moo Suk Park Young Sam Kim Joon Chang Song Yee Kim |
| author_facet | Sung Woo Moon Ji Soo Choi Sang Hoon Lee Kyung Soo Jung Ji Ye Jung Young Ae Kang Moo Suk Park Young Sam Kim Joon Chang Song Yee Kim |
| author_sort | Sung Woo Moon |
| collection | DOAJ |
| description | Abstract Background Sarcopenia can contribute to negative outcomes in patients with various lung diseases. However, whether sarcopenia affects prognosis in patients with idiopathic pulmonary fibrosis (IPF) has not been reported. Simple measures of muscle mass, derived from chest computed tomography (CT), are increasingly being used to identify patients with sarcopenia. We hypothesized that skeletal muscle mass could be a predictor of prognosis in IPF patients. Methods We retrospectively evaluated 180 patients diagnosed with IPF between January 2010 and December 2015 at a tertiary care hospital in South Korea. We measured thoracic muscle volume by using the cross-sectional area (CSA) of the pectoralis, paraspinal, serratus, and latissimus muscles at the 4th vertebral region (T4CSA) and the erector spinae muscle (ESMCSA) at the 12th vertebral region. CT scans at the time of diagnosis were used for analysis and respective CSA were divided by height squared to normalize for stature. Survival times were estimated with the Kaplan–Meier method and compared with the log-rank test. Multivariate Cox proportional hazards models were performed to investigate relationships between clinical parameters and mortality. Results Male patients in the lowest quartile of T4CSA divided by height squared (m2) (T4MI) and in the lowest quartile of ESMCSA divided by height squared (m2) (T12MI) were more likely to have higher Gender-Age-Physiology Index scores (T4MI, 3.3 ± 1.3 vs 4.0 ± 1.6, P = 0.012; T12MI, 3.2 ± 1.3 vs 4.1 ± 1.6, P = 0.002). Male patients in the lowest quartile of T4MI exhibited a significantly lower survival rate (P = 0.035). After multivariate Cox proportional hazards analysis, T4MI was a significant risk factor for all-cause mortality (HR, 0.955; 95% CI, 0.913–0.998; P = 0.041), whereas T12MI was not (HR, 0.980; 95% CI, 0.856–1.121; P = 0.766). Conclusions Low skeletal mass normalized for stature at the level of 4th vertebrae which can be acquired by quantifying thoracic skeletal muscle on single-slice axial chest CT, may be a strong risk factor for all-cause mortality in patients with IPF. Trial registration The research protocol was approved by the Institutional Review Board of Severance Hospital, South Korea (IRB No.4–2018-0454). |
| first_indexed | 2024-12-11T05:52:15Z |
| format | Article |
| id | doaj.art-5936c719841b42bf88e0cae44b81557d |
| institution | Directory Open Access Journal |
| issn | 1465-993X |
| language | English |
| last_indexed | 2024-12-11T05:52:15Z |
| publishDate | 2019-02-01 |
| publisher | BMC |
| record_format | Article |
| series | Respiratory Research |
| spelling | doaj.art-5936c719841b42bf88e0cae44b81557d2022-12-22T01:18:47ZengBMCRespiratory Research1465-993X2019-02-012011910.1186/s12931-019-1001-6Thoracic skeletal muscle quantification: low muscle mass is related with worse prognosis in idiopathic pulmonary fibrosis patientsSung Woo Moon0Ji Soo Choi1Sang Hoon Lee2Kyung Soo Jung3Ji Ye Jung4Young Ae Kang5Moo Suk Park6Young Sam Kim7Joon Chang8Song Yee Kim9Division of Pulmonary Medicine Department of Internal Medicine, Yonsei University College of MedicineDivision of Pulmonary Medicine Department of Internal Medicine, Yonsei University College of MedicineDivision of Pulmonary Medicine Department of Internal Medicine, Yonsei University College of MedicineDivision of Pulmonary Medicine Department of Internal Medicine, Yonsei University College of MedicineDivision of Pulmonary Medicine Department of Internal Medicine, Yonsei University College of MedicineDivision of Pulmonary Medicine Department of Internal Medicine, Yonsei University College of MedicineDivision of Pulmonary Medicine Department of Internal Medicine, Yonsei University College of MedicineDivision of Pulmonary Medicine Department of Internal Medicine, Yonsei University College of MedicineDivision of Pulmonary Medicine Department of Internal Medicine, Yonsei University College of MedicineDivision of Pulmonary Medicine Department of Internal Medicine, Yonsei University College of MedicineAbstract Background Sarcopenia can contribute to negative outcomes in patients with various lung diseases. However, whether sarcopenia affects prognosis in patients with idiopathic pulmonary fibrosis (IPF) has not been reported. Simple measures of muscle mass, derived from chest computed tomography (CT), are increasingly being used to identify patients with sarcopenia. We hypothesized that skeletal muscle mass could be a predictor of prognosis in IPF patients. Methods We retrospectively evaluated 180 patients diagnosed with IPF between January 2010 and December 2015 at a tertiary care hospital in South Korea. We measured thoracic muscle volume by using the cross-sectional area (CSA) of the pectoralis, paraspinal, serratus, and latissimus muscles at the 4th vertebral region (T4CSA) and the erector spinae muscle (ESMCSA) at the 12th vertebral region. CT scans at the time of diagnosis were used for analysis and respective CSA were divided by height squared to normalize for stature. Survival times were estimated with the Kaplan–Meier method and compared with the log-rank test. Multivariate Cox proportional hazards models were performed to investigate relationships between clinical parameters and mortality. Results Male patients in the lowest quartile of T4CSA divided by height squared (m2) (T4MI) and in the lowest quartile of ESMCSA divided by height squared (m2) (T12MI) were more likely to have higher Gender-Age-Physiology Index scores (T4MI, 3.3 ± 1.3 vs 4.0 ± 1.6, P = 0.012; T12MI, 3.2 ± 1.3 vs 4.1 ± 1.6, P = 0.002). Male patients in the lowest quartile of T4MI exhibited a significantly lower survival rate (P = 0.035). After multivariate Cox proportional hazards analysis, T4MI was a significant risk factor for all-cause mortality (HR, 0.955; 95% CI, 0.913–0.998; P = 0.041), whereas T12MI was not (HR, 0.980; 95% CI, 0.856–1.121; P = 0.766). Conclusions Low skeletal mass normalized for stature at the level of 4th vertebrae which can be acquired by quantifying thoracic skeletal muscle on single-slice axial chest CT, may be a strong risk factor for all-cause mortality in patients with IPF. Trial registration The research protocol was approved by the Institutional Review Board of Severance Hospital, South Korea (IRB No.4–2018-0454).http://link.springer.com/article/10.1186/s12931-019-1001-6Idiopathic pulmonary fibrosisSarcopeniaComputed tomographySkeletal muscleMortality |
| spellingShingle | Sung Woo Moon Ji Soo Choi Sang Hoon Lee Kyung Soo Jung Ji Ye Jung Young Ae Kang Moo Suk Park Young Sam Kim Joon Chang Song Yee Kim Thoracic skeletal muscle quantification: low muscle mass is related with worse prognosis in idiopathic pulmonary fibrosis patients Respiratory Research Idiopathic pulmonary fibrosis Sarcopenia Computed tomography Skeletal muscle Mortality |
| title | Thoracic skeletal muscle quantification: low muscle mass is related with worse prognosis in idiopathic pulmonary fibrosis patients |
| title_full | Thoracic skeletal muscle quantification: low muscle mass is related with worse prognosis in idiopathic pulmonary fibrosis patients |
| title_fullStr | Thoracic skeletal muscle quantification: low muscle mass is related with worse prognosis in idiopathic pulmonary fibrosis patients |
| title_full_unstemmed | Thoracic skeletal muscle quantification: low muscle mass is related with worse prognosis in idiopathic pulmonary fibrosis patients |
| title_short | Thoracic skeletal muscle quantification: low muscle mass is related with worse prognosis in idiopathic pulmonary fibrosis patients |
| title_sort | thoracic skeletal muscle quantification low muscle mass is related with worse prognosis in idiopathic pulmonary fibrosis patients |
| topic | Idiopathic pulmonary fibrosis Sarcopenia Computed tomography Skeletal muscle Mortality |
| url | http://link.springer.com/article/10.1186/s12931-019-1001-6 |
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