Association Between Fat Depletion and Prognosis of Amyotrophic Lateral Sclerosis: CT-Based Body Composition Analysis

IF 8.1 1区医学 Q1 CLINICAL NEUROLOGY

Annals of Neurology Pub Date : 2023-08-23 DOI:10.1002/ana.26775

Seok-Jin Choi MD, Soon Ho Yoon MD, PhD, Jung-Joon Sung MD, PhD, Jong Hyuk Lee MD, PhD

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引用次数: 0

Abstract

Objective

The purpose of this study was to present the results of our investigation of the prognostic value of adipopenia and sarcopenia in patients with amyotrophic lateral sclerosis (ALS).

Methods

Consecutive patients with ALS with abdominal computed tomography (CT) were retrospectively identified at a single tertiary hospital between January 2010 and July 2021. Deep learning-based volumetric CT body composition analysis software was used to obtain abdominal waist fat volume, fat attenuation, and skeletal muscle area at the L3 level, then normalized to the fat volume index (FVI) and skeletal muscle index (SMI). Adipopenia and sarcopenia were defined as the sex-specific lowest quartile and SMI reference values, respectively. The associations of CT-derived body composition parameters with clinical variables, such as body mass index (BMI) and creatinine, were evaluated by Pearson correlation analyses, and associations with survival were assessed using the multivariable Cox regression analysis.

Results

Eighty subjects (40 men, 65.5 ± 9.4 years of age) were investigated (median interval between disease onset and CT examination = 25 months). The mean BMI at the CT examination was 20.3 ± 4.3 kg/m². The BMI showed a positive correlation with both FVI (R = 0.70, p < 0.001) and SMI (R = 0.63, p < 0.001), and the serum creatinine level was associated with SMI (R = 0.68, p < 0.001). After adjusting for sex, age, King's stage, BMI, creatinine, progression rate, and sarcopenia, adipopenia was associated with shorter survival (hazard ratio [HR] = 5.94, 95% confidence interval [CI] = 1.01, 35.0, p = 0.049). In a subgroup analysis for subjects with nutritional failure (stage 4a), the HR of adipopenia was 15.1 (95% CI = 2.45, 93.4, p = 0.003).

Interpretation

Deep learning-based CT-derived adipopenia in patients with ALS is an independent poor prognostic factor for survival. ANN NEUROL 2023;94:1116–1125

查看原文本刊更多论文

脂肪消耗与肌萎缩侧索硬化预后的关系:基于ct的体成分分析。

目的:本研究的目的是介绍我们对肌萎缩侧索硬化症(ALS)患者脂肪减少和肌肉减少的预后价值的研究结果。方法:回顾性分析2010年1月至2021年7月在一家三级医院连续进行腹部计算机断层扫描(CT)的ALS患者。采用基于深度学习的体积CT体成分分析软件，获取腹腰脂肪体积、脂肪衰减、骨骼肌L3层面积，归一化为脂肪体积指数(FVI)和骨骼肌指数(SMI)。脂肪减少症和肌肉减少症分别被定义为性别特异性最低四分位数和SMI参考值。通过Pearson相关分析评估ct衍生的身体组成参数与临床变量(如体重指数(BMI)和肌酐)的相关性，并使用多变量Cox回归分析评估与生存率的相关性。结果:共调查80例患者(男性40例，年龄65.5±9.4岁)(发病至CT检查的中位间隔为25个月)。CT检查时BMI平均值为20.3±4.3 kg/m2。BMI与两项FVI呈正相关(R = 0.70, p)解释:基于深度学习的ct衍生脂肪减少症是ALS患者生存的独立不良预后因素。神经学报[j]; 2009; 44(4): 516 - 525。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of Neurology 医学-临床神经学

CiteScore

18.00

自引率

1.80%

发文量

270

审稿时长

3-8 weeks

期刊介绍： Annals of Neurology publishes original articles with potential for high impact in understanding the pathogenesis, clinical and laboratory features, diagnosis, treatment, outcomes and science underlying diseases of the human nervous system. Articles should ideally be of broad interest to the academic neurological community rather than solely to subspecialists in a particular field. Studies involving experimental model system, including those in cell and organ cultures and animals, of direct translational relevance to the understanding of neurological disease are also encouraged.