Associations between paraspinal muscles fatty infiltration and lumbar vertebral bone mineral density - An investigation by fast kVp switching dual-energy CT and QCT

Purpose: To investigate the relationship between paraspinal muscles fat content and lumbar bone mineral density (BMD). Methods: A total of 119 participants were enrolled in our study (60 males, age: 50.88 +/- 17.79 years, BMI: 22.80 +/- 3.80 kg.m(-2;) 59 females, age: 49.41 +/- 17.69 years, BMI: 22.22 +/- 3.12 kg.m(-2)). Fat content of paraspinal muscles (erector spinae (ES), multifidus (MS), and psoas (PS)) were measured at (ES L1/2-L4/5; MS L2/3-L5/S1; PS L2/3-L5/S1) levels using dual-energy computed tomography (DECT). Quantitative computed tomography (QCT) was used to assess BMD of L1 and L2. Linear regression analysis was used to assess the relationship between BMD of the lumbar spine and paraspinal muscles fat content with age, sex, and BMI. The variance inflation factor (VIF) was used to detect the degree of multicollinearity among the variables. P < .05 was considered to indicate a statistically significant difference. Results: The paraspinal muscles fat content had a fairly significant inverse association with lumbar BMD after controlling for age, sex, and BMI (adjusted R-2 = 0.584-0.630, all P < .05). Conclusion: Paraspinal muscles fat content was negatively associated with BMD. Paraspinal muscles fatty infiltration may be considered as a potential marker to identify BMD loss.