Clinical usefulness of psoas muscle thickness for the diagnosis of sarcopenia in patients with liver cirrhosis.
Clinical usefulness of psoas muscle thickness for the diagnosis of sarcopenia in patients with liver cirrhosis.
复制标题
DOI：
10.3350/cmh.2017.0077
复制
发表时间：
2018-09
影响因子：
8.9
通讯作者：
Um SH
中科院分区：
文献类型：
--
作者：
Gu DH;Kim MY;Seo YS;Kim SG;Lee HA;Kim TH;Jung YK;Kandemir A;Kim JH;An H;Yim HJ;Yeon JE;Byun KS;Um SH
诊断肌肉减少症最广泛使用的方法是骨骼肌指数（SMI）。一些研究表明腰肌厚度/身高（PMTH）对于检测肝硬化患者的肌肉减少症和预测预后也是有效的。本研究的目的是评估经旁生殖激素检测肝硬化患者肌肉减少症的最佳临界值。所有接受腹部计算机断层扫描（CT）扫描的肝硬化患者，包括L3和脐带水平，分别测量SMI和腰肌横断面厚度。肌少症的两种定义：(1)SMI的性别特异性截断值（男性≤52.4 cm2 /m2，女性≤38.5 cm2 /m2）用于SMI-肌少症；(2)PMTH的截断值（<16.8 mm/m）用于PMTH-肌少症。共纳入653例患者。平均年龄53.6±10.2岁，男性499例（76.4%）。在男性和女性中，经前甲状腺激素与重度精神分裂症相关（P<0.001）。241例（36.9%）患者符合重度肌少症标准。预测重度肌肉减少症的最佳PMTH临界值男性为17.3 mm/m，女性为10.4 mm/m，这些临界值被定义为性别特异性PMTH临界值（SsPMTH）。先前发表的PMTH切断被定义为性别非特异性PMTH切断（SnPMTH）。230例（35.2%）患者被诊断为sspmth -肌减少症，280例（44.4%）患者被诊断为snpmth -肌减少症。在多变量Cox回归分析中，sspth -肌肉减少症（风险比[HR]， 1.944； 95%可信区间[CI]， 1.144-3.304； P=0.014）与死亡率显著相关，而snpmth -肌肉减少症与死亡率无显著相关（风险比，1.446;95% CI, 0.861-2.431； P=0.164）。经旁生殖激素与肝硬化患者重度精神分裂症有良好的相关性。sspmth -肌肉减少症是这些患者死亡率的独立预测因子，与snpmth -肌肉减少症相比，sspmth -肌肉减少症更准确地预测死亡率。
The most widely used method for diagnosing sarcopenia is the skeletal muscle index (SMI). Several studies have suggested that psoas muscle thickness per height (PMTH) is also effective for detecting sarcopenia and predicting prognosis in patients with cirrhosis. The aim of this study was to evaluate the optimal cutoff values of PMTH for detecting sarcopenia in cirrhotic patients. All cirrhotic patients who underwent abdominal computed tomography (CT) scan including L3 and umbilical levels for measuring SMI and transverse psoas muscle thickness, respectively, were included. Two definitions of sarcopenia were used: (1) sex-specific cutoffs of SMI (≤52.4 cm2 /m2 in men and ≤38.5 cm2 /m2 in women) for SMI-sarcopenia and (2) cutoff of PMTH (<16.8 mm/m) for PMTH-sarcopenia. Six hundred fifty-three patients were included. The average age was 53.6 ± 10.2 years, and 499 patients (76.4%) were men. PMTH correlated well with SMI in both men and women (P<0.001). Two hundred forty-one (36.9%) patients met the criteria for SMI-sarcopenia. The best PMTH cutoff values for predicting SMI-sarcopenia were 17.3 mm/m in men and 10.4 mm/m in women, and these were defined as sex-specific cutoffs of PMTH (SsPMTH). The previously published cutoff of PMTH was defined as sex-nonspecific cutoff of PMTH (SnPMTH). Two hundred thirty (35.2%) patients were diagnosed with SsPMTH-sarcopenia, and 280 (44.4%) patients were diagnosed with SnPMTH-sarcopenia. On a multivariate Cox regression analysis, SsPMTH-sarcopenia (hazard ratio [HR], 1.944; 95% confidence interval [CI], 1.144–3.304; P=0.014) was significantly associated with mortality, while SnPMTH-sarcopenia was not (HR, 1.446; 95% CI, 0.861–2.431; P=0.164). PMTH was well correlated with SMI in cirrhotic patients. SsPMTH-sarcopenia was an independent predictor of mortality in these patients and more accurately predicted mortality compared to SnPMTH-sarcopenia.
登录
查看更多内容
影响因子：
6.3
作者：
Campillo, B;Paillaud, E;Bories, PN
通讯作者：
Bories, PN
影响因子：
2.7
作者：
ANDERSON, JE;BRESSLER, BH;OVALLE, WK
通讯作者：
OVALLE, WK
影响因子：
--
作者：
Auyeung, Tung Wai;Lee, Jenny Shun Wah;Woo, Jean
通讯作者：
Woo, Jean
影响因子：
4.6
作者：
DiMartini, Andrea;Cruz, Ruy J., Jr.;Fontes, Paulo
通讯作者：
Fontes, Paulo
DOI：
10.1097/meg.0000000000000274
发表时间：
2015-03-01
影响因子：
2.1
作者：
Giusto, Michela;Lattanzi, Barbara;Merli, Manuela
通讯作者：
Merli, Manuela