{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T03:45:49Z","timestamp":1789443949463,"version":"build-2803163510"},"reference-count":42,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,9,18]],"date-time":"2023-09-18T00:00:00Z","timestamp":1694995200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82100721"],"award-info":[{"award-number":["82100721"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82241047"],"award-info":[{"award-number":["82241047"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82070735"],"award-info":[{"award-number":["82070735"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82230022"],"award-info":[{"award-number":["82230022"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002858","name":"China Postdoctoral Science Foundation","doi-asserted-by":"publisher","award":["2022M710686"],"award-info":[{"award-number":["2022M710686"]}],"id":[{"id":"10.13039\/501100002858","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J cachexia sarcopenia muscle"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Skeletal muscle mass and quality assessed by computed tomography (CT) images of the third lumbar vertebra (L3) level have been established as risk factors for poor clinical outcomes in several illnesses, but the relevance for dialysis patients is unclear. A few studies have suggested a correlation between CT\u2010determined skeletal muscle mass and quality at the first lumbar vertebra (L1) level and adverse outcomes. Generally, chest CT does not reach beyond L1. We aimed to determine whether opportunistic CT scan (chest CT)\u2010determined skeletal muscle mass and quality at L1 are associated with mortality in initial\u2010dialysis patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This 3\u2010year multicentric retrospective study included initial\u2010dialysis patients from four centres between 2014 and 2017 in China. Unenhanced CT images of the L1 and L3 levels were obtained to assess skeletal muscle mass [by skeletal muscle index, (SMI), cm<jats:sup>2<\/jats:sup>\/m<jats:sup>2<\/jats:sup>] and quality [by skeletal muscle density (SMD), HU]. Skeletal muscle measures at L1 were compared with those at L3. The sex\u2010specific optimal cutoff values of L1 SMI and L1 SMD were determined in relation to all\u2010cause mortality. The outcomes were all\u2010cause death and cardiac death. Cox regression models were applied to investigate the risk factors for death.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 485 patients were enrolled, of whom 257 had both L1 and L3 images. Pearson's correlation coefficient between L1 and L3 SMI was 0.84 (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001), and that between L1 and L3 SMD was 0.90 (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001). No significant association between L1 SMI and mortality was observed (<jats:italic>P<\/jats:italic>\u00a0&gt;\u00a00.05). Low L1 SMD (<jats:italic>n<\/jats:italic>\u00a0=\u00a0280, 57.73%) was diagnosed based on the optimal cutoff value (&lt;39.56 HU for males and &lt;33.06 HU for females). Multivariate regression analysis revealed that the low L1 SMD group had higher risks of all\u2010cause death (hazard ratio 1.80; 95% confidence interval 1.05\u20133.11, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.034) and cardiac death (hazard ratio 3.74; 95% confidence interval 1.43\u20139.79, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.007).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In initial\u2010dialysis patients, there is high agreement between the L1 and L3 measures for SMI and SMD. Low SMD measured at L1, but not low SMI, is an independent predictor of both all\u2010cause death and cardiac death.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jcsm.13331","type":"journal-article","created":{"date-parts":[[2023,9,19]],"date-time":"2023-09-19T01:09:35Z","timestamp":1695085775000},"page":"2569-2578","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Computed tomography\u2010determined skeletal muscle density predicts 3\u2010year mortality in initial\u2010dialysis patients in China"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1348-0501","authenticated-orcid":false,"given":"Ming\u2010jie","family":"Sheng","sequence":"first","affiliation":[{"name":"Department of Nephrology, Zhong Da Hospital Southeast University School of Medicine  Nanjing China"},{"name":"Department of Nephrology The Affiliated Kunshan Hospital of Jiangsu University  Kunshan 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