背景：牛皮癣和身体脂肪（或肥胖）之间的联系已经很好地确定。然而,没有报告详细说明银屑病与骨骼肌脂肪浸润之间的可能关系，也被称为肌肉骨化病。最近的一项研究报道了牛皮癣之间的可能关联，关节炎,和肌肉减少症（骨骼肌质量或功能的丧失）。本研究旨在探讨慢性斑块型银屑病与肌萎缩症和肌肉减少症的可能关联。方法：采用病例对照研究。回顾性招募慢性斑块型银屑病住院患者。前瞻性和连续招募健康对照。使用Mimics软件分析第12胸椎水平未增强的横截面胸部计算机断层扫描图像。骨骼肌面积(SMA),骨骼肌放射密度（SMD），测量肌间脂肪组织(IMAT)。骨骼肌指数(SMI)计算为SMA/高度2。IMAT的百分比(IMAT%)计算为IMAT/SMAX100%。肌骨形成由SMD或IMAT%定义，而肌少症由SMI定义。进行倾向得分匹配以调整主要混杂因素。采用Logistic回归模型评价银屑病与肌萎缩症和肌肉减少症的相关性。结果：我们纳入了155例银屑病患者和512例健康对照。在倾向得分匹配后，我们保留了310个控件。银屑病组和对照组之间肌肉减少症的患病率没有显着差异（男性：9.8％vs.14.4%,p=0.244；女性：7.0%vs.11.7%,p=0.548)。银屑病患者更容易发生SMD定义的肌骨形成（男性：39.3%vs.20.8%；女性：46.5%vs.16.0%；均p<0.001）和IMAT%-定义的肌萎缩症（男性：21.4%vs.12.5%,p=0.034；女性：46.5vs.28.7%,p=0.042)比对照组。在调整了潜在的混杂因素后，银屑病与肌肉减少症无显著相关性(比值比[OR]0.51,95%置信区间[CI]0.25-1.19,p=0.136).然而,银屑病与SMD定义的肌骨化(OR3.16,95%CI1.86-5.37,p<0.001)和IMAT%定义的肌骨化(OR1.76,95%CI1.04-3.00;p=0.037)相关.结论：慢性斑块型银屑病与肌骨形成独立相关，但与肌肉减少无关。由于脂肪和肌肉被认为是内分泌器官，可以驱动炎症过程，进一步的研究详细说明了牛皮癣之间的相互作用，脂肪，和骨骼肌是有保证的。
Background: The link between psoriasis and body fat (or obesity) has been well established. However, there are no
reports detailing the possible relationship between psoriasis and fat infiltration in skeletal muscle, also known as
myosteatosis. A recent study reported the possible association between psoriasis, arthritis, and sarcopenia (the loss of skeletal muscle mass or function). The present study aimed to explore the possible associations of chronic plaque psoriasis with myosteatosis and sarcopenia. Methods: We conducted a
case-control study. In-patients with chronic plaque psoriasis were retrospectively recruited. Healthy controls were prospectively and continuously recruited. Unenhanced cross-sectional chest computed tomography images at the 12th thoracic vertebral level were analyzed using Mimics software. Skeletal muscle area (SMA), skeletal muscle radiodensity (SMD), and intermuscular adiposity tissue (IMAT) were measured. The skeletal muscle index (SMI) was calculated as SMA/height2. The percentage of IMAT (IMAT%) was calculated as IMAT/SMA × 100%.
Myosteatosis was defined by SMD or IMAT%, whereas sarcopenia was defined by SMI. Propensity score matching was performed to adjust for the main confounders. Logistic regression models were used to evaluate the associations of psoriasis with myosteatosis and sarcopenia. Results: We included 155 psoriasis patients and 512 healthy controls. After propensity score matching, we retained 310 controls. The prevalence of sarcopenia was not significantly different between the psoriasis and control groups (men: 9.8% vs. 14.4%, p = 0.244; women: 7.0% vs. 11.7%, p = 0.548). Psoriasis patients were more prone to SMD-defined myosteatosis (men: 39.3% vs. 20.8%; women: 46.5% vs. 16.0%; both p < 0.001) and IMAT%-defined myosteatosis (men: 21.4% vs. 12.5%, p = 0.034; women: 46.5 vs. 28.7%, p = 0.042) than the control group. After adjustment for potential confounders, psoriasis was not significantly associated with sarcopenia (odds ratio [OR] 0.51, 95% confidence interval [CI] 0.25-1.19, p = 0.136). However, psoriasis was associated with SMD-defined myosteatosis (OR 3.16, 95% CI 1.86-5.37, p < 0.001) and IMAT%-defined
myosteatosis (OR 1.76, 95% CI 1.04-3.00; p = 0.037). Conclusions: Chronic plaque psoriasis is independently associated with myosteatosis but not sarcopenia. Since fat and muscle are considered endocrine organs and can drive the inflammatory process, further studies detailing the interaction between psoriasis, fat, and skeletal muscle are warranted.
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