Ultrasound of the rectus femoris as a novel tool to measure sarcopenia in pediatric chronic liver disease.

IF 5.6 2区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Hepatology Communications Pub Date : 2025-08-15 eCollection Date: 2025-09-01 DOI:10.1097/HC9.0000000000000799

Christopher Chu, Jennifer L Dodge, Patricia Acharya, David Rigual, Norah Terrault

{"title":"Ultrasound of the rectus femoris as a novel tool to measure sarcopenia in pediatric chronic liver disease.","authors":"Christopher Chu, Jennifer L Dodge, Patricia Acharya, David Rigual, Norah Terrault","doi":"10.1097/HC9.0000000000000799","DOIUrl":null,"url":null,"abstract":"Background: Sarcopenia, assessed by psoas muscle CT or MRI, predicts adverse outcomes in adults with advanced chronic liver disease (CLD). However, these radiologic techniques are understudied in children. Ultrasound (US) measures of leg muscle quality and quantity potentially offer a novel, safe, and practical means to assess sarcopenia in pediatric patients.Methods: We prospectively enrolled pediatric patients (age ≤18) with and without CLD. US of the rectus femoris muscle was performed in triplicate for cross-sectional area (CSA), muscle thickness (MT), echogenic intensity (EI), and fascicle length (FL, calculated). Muscle measures were assessed for intra-rater reliability by intraclass correlation coefficients (ICC) and association with CLD, PELD/MELD, and body mass index (BMI) z-score using logistic regression, linear regression, and Pearson correlation, respectively.Results: Among 156 participants (N=69 CLD, N=85 healthy), reliability was excellent for CSA, MT, and EI, with ICC ranging from 0.946 (95% CI 0.929-0.959) for EI-right to 0.998 (95% CI 0.998-0.999) for CSA-left, and good for FL (right 0.823, 95% CI 0.769-0.866; left 0.768, 95% CI 0.698-0.825). In age-adjusted and sex-adjusted logistic regression, CLD likelihood decreased with increasing MT and FL (per unit increase: OR=0.82, 95% CI 0.71-0.96; OR=0.99, 95% CI 0.97-0.99) and CLD likelihood increased with increasing EI (OR=1.04, 95% CI 1.01-1.08) for right-side measures (but not left-side). Among CLD, all muscle measures, except EI, were positively correlated with BMI z-score and negatively associated with PELD/MELD score after age-adjustment and sex-adjustment.Conclusions: Pediatric ultrasound of the rectus femoris muscle demonstrates excellent intra-rater reliability, correlates with measures of malnutrition (BMI) and distinguishes CLD from healthy participants. This may offer a novel tool for assessing sarcopenia and liver disease severity in pediatric CLD.","PeriodicalId":12978,"journal":{"name":"Hepatology Communications","volume":"9 9","pages":""},"PeriodicalIF":5.6000,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12363444/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Hepatology Communications","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/HC9.0000000000000799","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/9/1 0:00:00","PubModel":"eCollection","JCR":"Q1","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Sarcopenia, assessed by psoas muscle CT or MRI, predicts adverse outcomes in adults with advanced chronic liver disease (CLD). However, these radiologic techniques are understudied in children. Ultrasound (US) measures of leg muscle quality and quantity potentially offer a novel, safe, and practical means to assess sarcopenia in pediatric patients.

Methods: We prospectively enrolled pediatric patients (age ≤18) with and without CLD. US of the rectus femoris muscle was performed in triplicate for cross-sectional area (CSA), muscle thickness (MT), echogenic intensity (EI), and fascicle length (FL, calculated). Muscle measures were assessed for intra-rater reliability by intraclass correlation coefficients (ICC) and association with CLD, PELD/MELD, and body mass index (BMI) z-score using logistic regression, linear regression, and Pearson correlation, respectively.

Results: Among 156 participants (N=69 CLD, N=85 healthy), reliability was excellent for CSA, MT, and EI, with ICC ranging from 0.946 (95% CI 0.929-0.959) for EI-right to 0.998 (95% CI 0.998-0.999) for CSA-left, and good for FL (right 0.823, 95% CI 0.769-0.866; left 0.768, 95% CI 0.698-0.825). In age-adjusted and sex-adjusted logistic regression, CLD likelihood decreased with increasing MT and FL (per unit increase: OR=0.82, 95% CI 0.71-0.96; OR=0.99, 95% CI 0.97-0.99) and CLD likelihood increased with increasing EI (OR=1.04, 95% CI 1.01-1.08) for right-side measures (but not left-side). Among CLD, all muscle measures, except EI, were positively correlated with BMI z-score and negatively associated with PELD/MELD score after age-adjustment and sex-adjustment.

Conclusions: Pediatric ultrasound of the rectus femoris muscle demonstrates excellent intra-rater reliability, correlates with measures of malnutrition (BMI) and distinguishes CLD from healthy participants. This may offer a novel tool for assessing sarcopenia and liver disease severity in pediatric CLD.

Abstract Image

查看原文本刊更多论文

股直肌超声作为一种测量儿童慢性肝病肌肉减少症的新工具。

背景：通过腰肌CT或MRI评估肌少症，可预测成人晚期慢性肝病（CLD）的不良结局。然而，这些放射学技术在儿童中的研究还不够充分。超声（US）测量腿部肌肉质量和数量可能提供一种新的、安全的、实用的方法来评估儿科患者的肌肉减少症。方法：我们前瞻性地招募了患有和不患有CLD的儿童患者（年龄≤18岁）。一式三份对股直肌进行超声检查，测量横截面积（CSA）、肌肉厚度（MT）、回声强度（EI）和束长（FL）。通过类内相关系数（ICC）和与CLD、PELD/MELD和体重指数（BMI） z-score的相关性，分别采用logistic回归、线性回归和Pearson相关来评估肌肉测量的组内可靠性。结果：在156名参与者中（N=69 CLD， N=85健康），CSA、MT和EI的信度非常好，EI右侧的ICC范围为0.946 (95% CI 0.929-0.959)， CSA左侧的ICC范围为0.998 (95% CI 0.998-0.999)， FL良好（右侧0.823,95% CI 0.769-0.866；左侧0.768,95% CI 0.698-0.825）。在年龄调整和性别调整的logistic回归中，CLD的可能性随着MT和FL的增加而降低（每单位增加：OR=0.82, 95% CI 0.71-0.96； OR=0.99, 95% CI 0.97-0.99），而右侧测量（但左侧没有）CLD的可能性随着EI的增加而增加（OR=1.04, 95% CI 1.01-1.08）。在CLD中，年龄调整和性别调整后，除EI外，所有肌肉指标均与BMI z-score呈正相关，与PELD/MELD评分负相关。结论：小儿股直肌超声显示了出色的评分内可靠性，与营养不良（BMI）的测量相关，并将CLD与健康参与者区分开来。这可能为评估儿童CLD中肌肉减少症和肝脏疾病严重程度提供一种新的工具。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Hepatology Communications GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

8.00

自引率

2.00%

发文量

248

审稿时长

8 weeks

期刊介绍： Hepatology Communications is a peer-reviewed, online-only, open access journal for fast dissemination of high quality basic, translational, and clinical research in hepatology. Hepatology Communications maintains high standard and rigorous peer review. Because of its open access nature, authors retain the copyright to their works, all articles are immediately available and free to read and share, and it is fully compliant with funder and institutional mandates. The journal is committed to fast publication and author satisfaction.