Development of an Algorithm to Predict Appendicular Lean Mass Index From Regional Spine and Hip Dxa Scans

IF 1.7 4区 医学 Q4 ENDOCRINOLOGY & METABOLISM
Krista Rossum , Mackenzie R. Alexiuk , Clara Bohm , William D. Leslie , Navdeep Tangri
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引用次数: 0

Abstract

Introduction: Sarcopenia is characterized by progressive muscle loss with reduced physical function and/or reduced muscle strength. Operational definitions of sarcopenia include a measurement of muscle mass, most often from dual-energy X-ray absorptiometry (DXA)-derived appendicular lean mass. Appendicular lean mass can be derived from whole-body dual-DXA scans; however, these scans are performed less commonly than hip and spine scans as part of clinical care. The objective of our study was to develop an algorithm to predict appendicular lean mass index (ALMI) from regional spine and hip dual-energy X-ray absorptiometry (DXA) scans.
Methods: We performed a retrospective cross-sectional study using a subset of patients from the Manitoba Bone Mineral Density Registry who had hip, spine, and whole-body DXA scans at the same visit. We developed the algorithm using the following candidate covariates: age, sex, height, weight, DXA-derived spine and hip fat fraction, DXA-derived spine and hip tissue thickness. We internally validated the algorithm using the bootstrap method. Mean bootstrap parameter estimates were used as the final equation.
Results: DXA scans from 676 patients were included in the analytic dataset. Mean ALMI was 6.73 (SD 1.43) kg/m2. The final predictive model included sex, age, height, weight, spine fat fraction and hip fat fraction. Sex also acted as an interaction term on weight and hip fat fraction. After bootstrap validation, model adjusted R2 was 0.863, root mean square error was 0.529 kg/m2, and AUROC to predict low ALMI per the European Working Group on Sarcopenia version 2 was 0.88.
Conclusion: Hip and spine DXA scans can be used to predict appendicular lean mass index. Future studies should test whether these predictions can be used to assess relationships between sarcopenia and other clinical conditions.
从区域脊柱和髋关节Dxa扫描中预测阑尾瘦质量指数的算法开发
肌肉减少症的特征是进行性肌肉损失,身体功能下降和/或肌肉力量下降。肌少症的操作定义包括测量肌肉质量,最常见的是通过双能x线吸收仪(DXA)衍生的阑尾瘦质量。阑尾瘦肿块可以通过全身双dxa扫描得到;然而,作为临床护理的一部分,这些扫描不如髋关节和脊柱扫描常见。本研究的目的是开发一种算法,通过区域脊柱和髋关节双能x线吸收仪(DXA)扫描预测阑尾瘦质量指数(ALMI)。方法:我们对马尼托巴骨密度登记处的一组患者进行了回顾性横断面研究,这些患者在同一次就诊时进行了髋部、脊柱和全身DXA扫描。我们使用以下候选协变量开发了该算法:年龄、性别、身高、体重、dxa衍生的脊柱和臀部脂肪比例、dxa衍生的脊柱和臀部组织厚度。我们使用bootstrap方法在内部验证了算法。平均自举参数估计被用作最终方程。结果:676例患者的DXA扫描被纳入分析数据集。平均ALMI为6.73 (SD 1.43) kg/m2。最终的预测模型包括性别、年龄、身高、体重、脊柱脂肪分数和臀部脂肪分数。性别也是体重和臀部脂肪比例的交互因素。bootstrap验证后,模型调整后的R2为0.863,均方根误差为0.529 kg/m2,根据欧洲肌肉减少症工作组版本2预测低ALMI的AUROC为0.88。结论:髋关节和脊柱DXA扫描可用于预测阑尾瘦质量指数。未来的研究应该测试这些预测是否可以用于评估肌肉减少症和其他临床疾病之间的关系。
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来源期刊
Journal of Clinical Densitometry
Journal of Clinical Densitometry 医学-内分泌学与代谢
CiteScore
4.90
自引率
8.00%
发文量
92
审稿时长
90 days
期刊介绍: The Journal is committed to serving ISCD''s mission - the education of heterogenous physician specialties and technologists who are involved in the clinical assessment of skeletal health. The focus of JCD is bone mass measurement, including epidemiology of bone mass, how drugs and diseases alter bone mass, new techniques and quality assurance in bone mass imaging technologies, and bone mass health/economics. Combining high quality research and review articles with sound, practice-oriented advice, JCD meets the diverse diagnostic and management needs of radiologists, endocrinologists, nephrologists, rheumatologists, gynecologists, family physicians, internists, and technologists whose patients require diagnostic clinical densitometry for therapeutic management.
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