Assessment of Sarcopenia and Obesity in Patients with Myasthenia Gravis Using Dual-Energy X-ray Absorptiometry: A Cross-Sectional Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Participants and Study Design
2.2. Data Collection and Clinical Measurement
2.3. Body Composition Assessment
2.4. Definition of Sarcopenia, Obesity, and Sarcopenic Obesity
2.5. Statistical Analysis
3. Results
3.1. Clinical Features of Subjects
3.2. Comparison of Body Composition between the MG and Non-MG Groups
3.3. Subgroup Analysis of the MG Group
3.4. Subgroup Analysis of the MG Group Based on Steroid Use
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Variable | MG (n = 35) | Non-MG (n = 175) | p-Value |
---|---|---|---|
Male sex (%) | 13 (37.1) | 65 (37.1) | 1.000 |
Age (years) | 56.1 ± 8.6 | 56.0 ± 8.5 | 0.939 |
Age group (years) | 1.000 | ||
40–49 | 10 (28.6) | 50 (28.6) | |
50–59 | 10 (28.6) | 50 (28.6) | |
60–70 | 15 (42.9) | 75 (42.9) | |
Obesity (%) | 14 (40.0) | 2 (1.1) | <0.001 * |
Sarcopenia (%) | 8 (22.9) | 67 (38.3) | 0.121 |
Sarcopenic obesity (%) | 1 (2.9) | 0 (0.0) | 0.167 |
Medication for MG | - | - | |
Pyridostigmine | 33 (94.2) | ||
Corticosteroid (CS) | 21 (60.0) | ||
CS daily dose in last 6 months (mg) | 5.3 ± 5.7 | ||
CS daily dose (mg/kg) | 0.1 ± 0.1 | ||
Duration of CS exposure (yr) | 7.0 ± 5.3 | ||
Treat with immunosuppressants | 10 (28.6) | ||
AChR-autoantibody positivity (%) | 35 (100) | ||
Comorbid disease (%) | |||
Diabetes | 2 (5.7) | ||
Hypertension | 5 (14.2) | ||
Hyperlipidemia | 3 (12.0) | ||
Cardiovascular disease | 3 (12.0) | ||
Autoimmune disease | 3 (12.0) |
Variable | MG (n = 35) | Non-MG (n = 175) | Mean Difference (95% CI) a | p-Value |
---|---|---|---|---|
Body mass index (kg/m2) | 24.8 ± 4.6 | 23.6 ± 3.7 | 1.17 (−0.19, 2.54) | 0.091 |
Fat mass (kg) | ||||
Arms | 2.1 ± 0.9 | 1.7 ± 0.6 | 0.38 (0.06, 0.69) | 0.018 * |
Legs | 6.7 ± 2.7 | 5.9 ± 2.7 | 0.79 (−0.13, 1.72) | 0.092 |
Appendicular | 8.8 ± 3.4 | 7.6 ± 3.1 | 1.17 (−0.03, 2.37) | 0.055 |
Muscle mass (kg) | ||||
Arms | 4.3 ± 1.5 | 4.2 ± 1.3 | 0.05 (−0.28, 0.39) | 0.751 |
Legs | 13.6 ± 3.1 | 13.0 ± 3.0 | 0.69 (0.01, 1.38) | 0.048 * |
Appendicular | 17.9 ± 4.4 | 17.2 ± 4.2 | 0.75 (−0.22, 1.72) | 0.131 |
Fat adiposity (%) | ||||
Android | 43.2 ± 9.3 | 40.1 ± 8.2 | 3.10 (0.06, 6.15) | 0.046 * |
Gynoid | 39.9 ± 7.5 | 39.1 ± 9.1 | 0.81 (−1.34, 2.96) | 0.460 |
Muscle mass (%) | ||||
Arms | 67.7 ± 10.7 | 70.9 ± 9.5 | −3.11 (−6.01, −0.21) | 0.035 * |
Legs | 67.6 ± 8.4 | 68.8 ± 9.7 | −1.20 (−3.82, 1.42) | 0.370 |
Appendicular | 67.6 ± 8.6 | 69.3 ± 9.5 | −1.66 (−4.19, 0.87) | 0.199 |
Android | 56.8 ± 9.3 | 59.9 ± 8.2 | −3.10 (−6.15, −0.06) | 0.046 * |
Gynoid | 60.1 ± 7.5 | 60.9 ± 9.1 | −0.81 (−2.96, 1.34) | 0.460 |
Whole body | 65.4 ± 9.0 | 67.7 ± 7.7 | −2.28 (−4.97, 0.40) | 0.096 |
Android/gynoid fat ratio | 1.1 ± 0.2 | 0.5 ± 0.2 | 0.59 (0.53, 0.65) | <0.001 * |
Body fat percentage (%) | 34.2 ± 8.4 | 31.0 ± 7.3 | 3.17 (0.48, 5.85) | 0.021 * |
ASMI (kg/m2) | 6.7 ± 1.2 | 6.5 ± 1.1 | 0.18 (−0.07, 0.43) | 0.168 |
Variable | MG (n = 15) | Non-MG (n = 75) | Mean Difference (95% CI) a | p-Value |
---|---|---|---|---|
Body mass index (kg/m2) | 25.8 ± 3.5 | 24.2 ± 3.2 | 1.57 (−0.01–3.16) | 0.052 |
Fat mass (kg) | ||||
Arms | 2.3 ± 0.9 | 1.6 ± 0.6 | 0.64 (0.19–1.08) | 0.005 * |
Legs | 6.5 ± 2.6 | 5.2 ± 2.0 | 1.28 (−0.22–2.78) | 0.096 |
Appendicular | 8.8 ± 3.4 | 6.9 ± 2.5 | 1.91 (0.02–3.80) | 0.047 * |
Muscle mass (kg) | ||||
Arms | 4.5 ± 1.5 | 4.5 ± 1.3 | −0.01 (−0.42–0.41) | 0.978 |
Legs | 14.0 ± 3.3 | 13.6 ± 3.2 | 0.45 (−0.66–1.56) | 0.431 |
Appendicular | 18.5 ± 4.7 | 18.1 ± 4.4 | 0.44 (−1.04–1.92) | 0.560 |
Fat adiposity (%) | ||||
Android | 47.9 ± 8.3 | 40.1 ± 8.8 | 7.86 (3.94–11.78) | <0.001 * |
Gynoid | 39.0 ± 8.2 | 35.9 ± 9.2 | 3.11 (−0.11–6.32) | 0.058 |
Muscle mass (%) | ||||
Arms | 66.4 ± 10.4 | 72.8 ± 9.8 | −6.41 (−9.39–−3.42) | <0.001 * |
Legs | 68.7 ± 8.6 | 72.0 ± 9.4 | −3.34 (−7.63–0.95) | 0.127 |
Appendicular | 68.1 ± 8.6 | 72.2 ± 9.3 | −4.14 (−7.85–−0.42) | 0.029 * |
Android | 52.1 ± 8.3 | 59.9 ± 8.8 | −7.86 (−11.78–−3.94) | <0.001 * |
Gynoid | 61.0 ± 8.2 | 64.1 ± 9.2 | −3.11 (−6.32–0.11) | 0.058 |
Whole body | 63.9 ± 8.4 | 69.3 ± 8.0 | −5.33 (−8.62–−2.04) | 0.001 * |
Android/gynoid fat ratio | 1.3 ± 0.2 | 0.6 ± 0.2 | 0.68 (0.57–0.78) | <0.001 * |
Body fat percentage (%) | 36.4 ± 7.8 | 29.7 ± 7.7 | 6.73 (3.58–9.88) | <0.001 * |
ASMI (kg/m2) | 6.8 ± 1.3 | 6.8 ± 1.2 | −0.07 (−0.41–0.27) | 0.680 |
Variable | MG with Steroids (n = 21) | Non-MG (n = 105) | p-Value | MG without Steroids (n = 14) | Non-MG (n = 70) | p-Value |
---|---|---|---|---|---|---|
Male sex, no. (%) | 9 (42.9) | 45 (42.9) | 1.000 | 4 (28.6) | 20 (28.6) | 1.000 |
Age (years) | 57.1 ± 8.6 | 57.0 ± 8.4 | 0.948 | 54.7 ± 8.7 | 54.7 ± 8.5 | 0.986 |
Age group (years) | ||||||
40–49 | 5 (23.8) | 25 (23.8) | 1.000 | 5 (35.7) | 25 (35.7) | 1.000 |
50–59 | 5 (23.8) | 25 (23.8) | 1.000 | 5 (35.7) | 25 (35.7) | 1.000 |
60–70 | 11 (52.4) | 55 (52.4) | 1.000 | 4 (28.6) | 20 (28.6) | 1.000 |
Obesity | 9 (42.9) | 0 (0.0) | <0.001 * | 5 (35.7) | 0 (0.0) | <0.001 * |
Sarcopenia | 5 (23.8) | 42 (40.0) | 0.218 | 3 (23.1) | 27 (38.6) | 0.359 |
CS daily dose (mg/kg) | 0.2 ± 0.1 | - | - | - | - | - |
Duration of CS (yr) | 7.0 ± 5.3 | - | - | - | - | - |
Prednisolone daily dose during the previous 6 months (mg) | 8.9 ± 4.7 | - | - | - | - | - |
Immune medication used | 7 (33.3) | - | - | 3 (21.4) | - | - |
Disease duration (years) | 15.1 ± 12.4 | - | - | 8.1 ± 4.6 | - | - |
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Chang, C.-C.; Chen, Y.-K.; Chiu, H.-C.; Yeh, J.-H. Assessment of Sarcopenia and Obesity in Patients with Myasthenia Gravis Using Dual-Energy X-ray Absorptiometry: A Cross-Sectional Study. J. Pers. Med. 2021, 11, 1139. https://doi.org/10.3390/jpm11111139
Chang C-C, Chen Y-K, Chiu H-C, Yeh J-H. Assessment of Sarcopenia and Obesity in Patients with Myasthenia Gravis Using Dual-Energy X-ray Absorptiometry: A Cross-Sectional Study. Journal of Personalized Medicine. 2021; 11(11):1139. https://doi.org/10.3390/jpm11111139
Chicago/Turabian StyleChang, Che-Cheng, Yen-Kung Chen, Hou-Chang Chiu, and Jiann-Horng Yeh. 2021. "Assessment of Sarcopenia and Obesity in Patients with Myasthenia Gravis Using Dual-Energy X-ray Absorptiometry: A Cross-Sectional Study" Journal of Personalized Medicine 11, no. 11: 1139. https://doi.org/10.3390/jpm11111139