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已发表论文
多发性骨髓瘤患者肌肉脂肪浸润情况：一项病例对照研究
Authors Zhu T, Zhou H, Zhang D , Chen X, Lu X
Received 23 June 2025
Accepted for publication 2 October 2025
Published 15 October 2025 Volume 2025:18 Pages 6255—6264
DOI https://doi.org/10.2147/IJGM.S549030
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Woon-Man Kung
Tianshu Zhu,1,* Hao Zhou,2,* Dingzhe Zhang,2 Xiao Chen,2 Xuzhang Lu1
1Department of Hematology, the Second People’s Hospital of Changzhou, the Third Affiliated Hospital of Nanjing Medical University, Changzhou, People’s Republic of China; 2Department of Radiology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Xiao Chen, Department of Radiology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, 210029, People’s Republic of China, Email chxwin@163.com Xuzhang Lu, Department of Hematology, the Second People’s Hospital of Changzhou, the Third Affiliated Hospital of Nanjing Medical University, Changzhou, People’s Republic of China, Email xzlu008@outlook.com
Background: Sarcopenia in patients with hematologic malignancies has gained attention. However, muscle fat infiltration in patients with multiple myeloma (MM) has not been well studied. In this study, we showed the prevalence of computed tomography (CT)-based muscle fat infiltration in newly diagnosed MM patients.
Methods: A total of 966 participants, 138 MM patients and 828 controls, who underwent CT examinations were involved in this study. Clinical parameters, such as participants’ age, sex, weight, height and laboratory test results, such as serum lipids, liver and renal function, were collected. The CT radiation attenuation of the bilateral erector spinae (ESRA) muscles and cross-sectional axial skeletal muscle (SMRA) at the medium level of the T11 vertebra were measured on axial CT images. Logistic regression analyses were performed to assess the association between MM and the risk of low muscle CT attenuation. Receiver operating characteristic curve was used to show the performance of muscle CT attenuation in identifying MM.
Results: Muscle CT attenuation in the MM group was significantly lower than in controls (p < 0.001). The prevalence of low muscle CT attenuation in MM patients was significantly higher than those in controls (66.7% vs 19.6%; 60.1% vs 20.4%, p < 0.001). MM was significantly associated with the risk of low ESRA (< 36 HU) (odds ratio (OR) = 15.11, 95% confidence interval (CI): 7.76– 29.39) and SMRA (< 34 HU) (OR = 12.00, 95% CI: 5.91– 24.39) in the fully adjusted models. Subgroup analyses in men and women both showed similar results with the overall population. The area under the curve was 0.827 for ESRA and 0.790 for SMRA in identifying MM patients.
Conclusion: Muscle fat infiltration is common in patients with MM. MM is significantly associated with the risk of muscle fat infiltration.
Keywords: multiple myeloma, muscle fat infiltration, muscle CT attenuation
1Department of Hematology, the Second People’s Hospital of Changzhou, the Third Affiliated Hospital of Nanjing Medical University, Changzhou, People’s Republic of China; 2Department of Radiology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Xiao Chen, Department of Radiology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, 210029, People’s Republic of China, Email chxwin@163.com Xuzhang Lu, Department of Hematology, the Second People’s Hospital of Changzhou, the Third Affiliated Hospital of Nanjing Medical University, Changzhou, People’s Republic of China, Email xzlu008@outlook.com
Background: Sarcopenia in patients with hematologic malignancies has gained attention. However, muscle fat infiltration in patients with multiple myeloma (MM) has not been well studied. In this study, we showed the prevalence of computed tomography (CT)-based muscle fat infiltration in newly diagnosed MM patients.
Methods: A total of 966 participants, 138 MM patients and 828 controls, who underwent CT examinations were involved in this study. Clinical parameters, such as participants’ age, sex, weight, height and laboratory test results, such as serum lipids, liver and renal function, were collected. The CT radiation attenuation of the bilateral erector spinae (ESRA) muscles and cross-sectional axial skeletal muscle (SMRA) at the medium level of the T11 vertebra were measured on axial CT images. Logistic regression analyses were performed to assess the association between MM and the risk of low muscle CT attenuation. Receiver operating characteristic curve was used to show the performance of muscle CT attenuation in identifying MM.
Results: Muscle CT attenuation in the MM group was significantly lower than in controls (p < 0.001). The prevalence of low muscle CT attenuation in MM patients was significantly higher than those in controls (66.7% vs 19.6%; 60.1% vs 20.4%, p < 0.001). MM was significantly associated with the risk of low ESRA (< 36 HU) (odds ratio (OR) = 15.11, 95% confidence interval (CI): 7.76– 29.39) and SMRA (< 34 HU) (OR = 12.00, 95% CI: 5.91– 24.39) in the fully adjusted models. Subgroup analyses in men and women both showed similar results with the overall population. The area under the curve was 0.827 for ESRA and 0.790 for SMRA in identifying MM patients.
Conclusion: Muscle fat infiltration is common in patients with MM. MM is significantly associated with the risk of muscle fat infiltration.
Keywords: multiple myeloma, muscle fat infiltration, muscle CT attenuation