Relationship between sarcopenia, six-minute walk distance and health-related quality of life in liver transplant candidates
Relationship between sarcopenia, six-minute walk distance and health-related quality of life in liver transplant candidates
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DOI：
10.1111/ctr.12493
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发表时间：
2015-02-01
影响因子：
2.1
通讯作者：
Carey, Elizabeth J.
中科院分区：
文献类型：
--
作者：
Yadav, Anitha;Chang, Yu-Hui;Carey, Elizabeth J.
骨质疏松症，或骨骼肌块的丧失，与肝移植(LT)候选患者死亡率和发病率的增加有关。6分钟步行距离(6MWD)和由简明36评分(SF-36)评估的健康相关生活质量(HRQOL)也影响这些患者的临床结果。这项研究探讨了LT患者的石棺减少、6MWD和HRQOL之间的关系。根据腹部计算机断层扫描测量的骨骼肌质量指数(SMI)评估骨骼肌减少。对患者进行跟踪，直到死亡、从等待名单中移除或研究结束。共纳入213名接受肝移植的患者。平均SMI为54.3+/-9.7，6MWD为370.5m，平均步速为1m/S。22.2%的LT患者出现骨质疏松症。骨质疏松症、6MWD和SF-36评分之间无相关性。6MWD是死亡率的独立预测因子(危险比=2.1[0.9-4.7])，但不是石棺减少症。综上所述，骨质疏松症并不是等待死亡的重要预测指标，也不能与LT患者的功能能力或HRQOL相关。在等待肝移植的ESLD患者中，6MWD似乎是一个比石棺减少更有用的预后指标。
Sarcopenia, or loss of skeletal muscle mass, is associated with increased mortality and morbidity in liver transplant (LT) candidates. Six-minute walk distance (6MWD) and health-related quality of life (HRQOL) as assessed by short form 36 scores (SF-36) also impact clinical outcomes in these patients. This study explored the relationship between the sarcopenia, 6MWD, and HRQOL in LT candidates. Sarcopenia was evaluated based on skeletal muscle mass index (SMI) quantified from abdominal computed tomography. Patients were followed until death, removal from the wait list or the end of the study period. Two hundred and thirteen patients listed for LT were included. The mean SMI, 6MWD and mean gait speed were 54.3 +/- 9.7, 370.5m and 1m/s, respectively. Sarcopenia was noted in 22.2% of LT candidates. There was no correlation between sarcopenia, 6MWD, and SF-36 scores. The 6MWD, but not sarcopenia, was an independent predictor of mortality (hazard ratio=2.1 [0.9-4.7]). In summary, sarcopenia did not emerge as a significant predictor of waitlist mortality and also failed to correlate with either functional capacity or HRQOL in LT candidates. In patients with ESLD awaiting LT, 6MWD appears to be a more useful prognostic indicator than the presence of sarcopenia.