Abstract：
OBJECTIVE: Patients with gout are at elevated risk of multiple vascular and metabolic comorbidities. Whether they are also at risk of sarcopenia, which is known to affect patients with other rheumatic diseases, has not been previously assessed. We examined whether patients with gout have decreased lumbar muscle quality and quantity, indicating an association between gout and sarcopenia.
METHODS: Fifty gout subjects and 25 controls, ages 45-80, underwent computed tomography imaging of the lumbosacral spine. We measured muscle quantity (skeletal muscle area [SMA] and index [SMI]) and quality (skeletal muscle radiation attenuation [SMRA] and intermuscular adipose tissue [IMAT] area and index [IMATI]) of the psoas and erector spinae muscles at the L3 level.
RESULTS: Seventy subjects (45 gout and 25 controls) were included in the analysis. Gout subjects had higher BMI, more kidney disease and hypertension, lower exercise frequency, and higher mean serum urate and creatinine vs. controls. Lumbar SMRA was significantly lower in gout subjects vs. controls, indicating reduced muscle quality. Lumbar IMAT area was significantly higher in gout subjects vs. controls, as was lumbar IMATI, indicating increased muscle adiposity. These differences persisted after adjusting for potential confounders. In contrast, there was no significant difference between gout and control groups in lumbar SMA or lumbar SMI, suggesting that muscle quantity may not be routinely affected by the diagnosis of gout.
CONCLUSIONS: Gout patients exhibit decreased lumbar muscle quality compared with controls, consistent with an association between gout and sarcopenia.
METHODS: Fifty gout subjects and 25 controls, ages 45-80, underwent computed tomography imaging of the lumbosacral spine. We measured muscle quantity (skeletal muscle area [SMA] and index [SMI]) and quality (skeletal muscle radiation attenuation [SMRA] and intermuscular adipose tissue [IMAT] area and index [IMATI]) of the psoas and erector spinae muscles at the L3 level.
RESULTS: Seventy subjects (45 gout and 25 controls) were included in the analysis. Gout subjects had higher BMI, more kidney disease and hypertension, lower exercise frequency, and higher mean serum urate and creatinine vs. controls. Lumbar SMRA was significantly lower in gout subjects vs. controls, indicating reduced muscle quality. Lumbar IMAT area was significantly higher in gout subjects vs. controls, as was lumbar IMATI, indicating increased muscle adiposity. These differences persisted after adjusting for potential confounders. In contrast, there was no significant difference between gout and control groups in lumbar SMA or lumbar SMI, suggesting that muscle quantity may not be routinely affected by the diagnosis of gout.
CONCLUSIONS: Gout patients exhibit decreased lumbar muscle quality compared with controls, consistent with an association between gout and sarcopenia.
摘要：
目的：痛风患者发生多种血管和代谢合并症的风险升高。他们是否也有肌肉减少症的风险，已知会影响其他风湿病患者，以前没有评估过。我们检查了痛风患者是否腰肌质和数量下降，表明痛风和肌肉减少症之间的关联。
方法：50名痛风受试者和25名对照，年龄45-80岁，接受了腰骶椎的计算机断层扫描成像。我们测量了腰肌和竖脊肌的肌肉数量（骨骼肌面积[SMA]和指数[SMI]）和质量（骨骼肌辐射衰减[SMRA]和肌间脂肪组织[IMAT]面积和指数[IMATI]）在L3水平。
结果：70名受试者（45名痛风和25名对照）纳入分析。痛风受试者的BMI较高，更多的肾脏疾病和高血压，较低的运动频率，和较高的平均血清尿酸和肌酐与controls.痛风受试者的腰椎SMRA显着降低。controls,表明肌肉质量下降。痛风受试者的腰椎IMAT面积明显高于controls,腰椎IMATI也是如此，表明肌肉肥胖增加。在调整了潜在的混杂因素后，这些差异仍然存在。相比之下,痛风组和对照组在腰椎SMA或腰椎SMI方面没有显着差异，提示肌肉数量可能不会受到痛风诊断的常规影响。
结论：痛风患者与对照组相比，腰肌质量下降，与痛风和肌肉减少症之间的关联一致。
方法：50名痛风受试者和25名对照，年龄45-80岁，接受了腰骶椎的计算机断层扫描成像。我们测量了腰肌和竖脊肌的肌肉数量（骨骼肌面积[SMA]和指数[SMI]）和质量（骨骼肌辐射衰减[SMRA]和肌间脂肪组织[IMAT]面积和指数[IMATI]）在L3水平。
结果：70名受试者（45名痛风和25名对照）纳入分析。痛风受试者的BMI较高，更多的肾脏疾病和高血压，较低的运动频率，和较高的平均血清尿酸和肌酐与controls.痛风受试者的腰椎SMRA显着降低。controls,表明肌肉质量下降。痛风受试者的腰椎IMAT面积明显高于controls,腰椎IMATI也是如此，表明肌肉肥胖增加。在调整了潜在的混杂因素后，这些差异仍然存在。相比之下,痛风组和对照组在腰椎SMA或腰椎SMI方面没有显着差异，提示肌肉数量可能不会受到痛风诊断的常规影响。
结论：痛风患者与对照组相比，腰肌质量下降，与痛风和肌肉减少症之间的关联一致。
