A multicenter study to define sarcopenia in patients with end-stage liver disease.
A multicenter study to define sarcopenia in patients with end-stage liver disease.
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DOI：
10.1002/lt.24750
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发表时间：
2017-05
期刊：
影响因子：
--
通讯作者：
Fitness, Life Enhancement, and Exercise in Liver Transplantation Consortium
中科院分区：
文献类型：
--
作者：
Carey EJ;Lai JC;Wang CW;Dasarathy S;Lobach I;Montano-Loza AJ;Dunn MA;Fitness, Life Enhancement, and Exercise in Liver Transplantation Consortium
骨骼肌减少症与等候名单死亡率增加有关，但缺乏标准定义。在这项回顾性研究中，我们试图确定等待肝移植的终末期肝病（ESLD）患者肌肉减少症的最佳定义。纳入了2012年在北美5个移植中心新列入肝移植的396例患者。所有计算机断层扫描由2个人阅读，观察者之间的相关性为98%。利用图像分析软件测量第三腰椎腹部骨骼肌总横截面积（cm2）。然后计算骨骼肌指数（SMI），将肌肉面积与患者身高标准化。主要结果是等候名单死亡率，定义为等候名单上的死亡或因临床恶化而从等候名单上除名。定义肌肉减少症的性别特异性潜在截止值由log-rank检验统计量指导的网格搜索确定。最优搜索方法确定了潜在的截止点，以检测各组之间的生存差异。总体SMI中位数为47.6 cm2/m2：男性为50.0，女性为42.0。在平均8.8个月的随访中，男性死亡率为25%，女性死亡率为36%。死亡患者的SMI低于存活患者（45.6 vs 48.5 cm2/m2; P < 0.001）， SMI与等候名单死亡率相关（风险比，0.95;P < 0.001）。最优搜索方法得出的SMI截止值为男性50 cm2/m2，女性39 cm2/m2；这些截止值最好地将统计显著性与足够数量的事件结合起来，以检测组间的生存差异。总之，我们建议用男性SMI < 50 cm2/m2和女性SMI < 39 cm2/m2来定义等待肝移植的ESLD患者肌肉减少症。
Sarcopenia is associated with increased wait-list mortality, but a standard definition is lacking. In this retrospective study, we sought to determine the optimal definition of sarcopenia in end-stage liver disease (ESLD) patients awaiting liver transplantation (LT). Included were 396 patients newly listed for LT in 2012 at 5 North American transplant centers. All computed tomography scans were read by 2 individuals with interobserver correlation of 98%. Using image analysis software, the total cross-sectional area (cm2) of abdominal skeletal muscle at the third lumbar vertebra was measured. The skeletal muscle index (SMI), which normalizes muscle area to patient height, was then calculated. The primary outcome was wait-list mortality, defined as death on the waiting list or removal from the waiting list for reasons of clinical deterioration. Sex-specific potential cutoff values to define sarcopenia were determined with a grid search guided by log-rank test statistics. Optimal search methods identified potential cutoffs to detect survival differences between groups. The overall median SMI was 47.6 cm2/m2: 50.0 in men and 42.0 in women. At a median of 8.8 months follow-up, mortality was 25% in men and 36% in women. Patients who died had lower SMI than those who survived (45.6 versus 48.5 cm2/m2; P < 0.001), and SMI was associated with wait-list mortality (hazard ratio, 0.95; P < 0.001). Optimal search method yielded SMI cutoffs of 50 cm2/m2 for men and 39 cm2/m2 for women; these cutoff values best combined statistical significance with a sufficient number of events to detect survival differences between groups. In conclusion, we recommend that an SMI < 50 cm2/m2 for men and < 39 cm2/m2 for women be used to define sarcopenia in patients with ESLD awaiting LT.
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DOI：
10.1016/j.jamcollsurg.2010.03.039
发表时间：
2010-08
影响因子：
5.2
作者：
Englesbe, Michael J.;Patel, Shaun P.;He, Kevin;Lynch, Raymond J.;Schaubel, Douglas E.;Harbaugh, Calista;Holcombe, Sven A.;Wang, Stewart C.;Segev, Dorry L.;Sonnenday, Christopher J.
通讯作者：
Sonnenday, Christopher J.
DOI：
10.1002/jcsm.12076
发表时间：
2016-06
期刊：
Journal of cachexia, sarcopenia and muscle
影响因子：
--
作者：
Tyrovolas S;Koyanagi A;Olaya B;Ayuso-Mateos JL;Miret M;Chatterji S;Tobiasz-Adamczyk B;Koskinen S;Leonardi M;Haro JM
通讯作者：
Haro JM
影响因子：
3.3
作者：
Shen, W;Punyanitya, M;Heshka, S
通讯作者：
Heshka, S
影响因子：
4.6
作者：
DiMartini, Andrea;Cruz, Ruy J., Jr.;Fontes, Paulo
通讯作者：
Fontes, Paulo
影响因子：
2.1
作者：
Yadav, Anitha;Chang, Yu-Hui;Carey, Elizabeth J.
通讯作者：
Carey, Elizabeth J.