Loss of skeletal muscle mass in patients with chronic liver disease is related to decrease in bone mineral density and exercise tolerance
Loss of skeletal muscle mass in patients with chronic liver disease is related to decrease in bone mineral density and exercise tolerance
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慢性肝病患者骨骼肌质量的损失与骨密度和运动耐量的降低有关
DOI：
10.1111/hepr.13000
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发表时间：
2018
影响因子：
4.2
通讯作者：
Habu Daiki
中科院分区：
文献类型：
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作者：
Hayashi Fumikazu;Kaibori Masaki;Sakaguchi Tatsuma;Matsui Kosuke;Ishizaki Morihiko;Kwon A-Hon;Iwasaka Junji;Kimura Yutaka;Habu Daiki
目的本研究旨在确定慢性肝病患者骨骼肌质量损失与骨质疏松等临床因素之间的关系。方法研究对象为112名计划接受肝切除术的肝细胞癌患者（85名男性和27名女性）。骨骼肌减少是根据亚洲人骨骼质量指数（SMI）的截止水平（男性<7.0 kg/m2，女性<5.4 kg/m2）来诊断的。根据T评分≤−2.5标准差诊断骨质疏松症。使用双能 X 射线吸收结果评估 SMI 和 T 分数。峰值耗氧量（PeakVO2）是运动耐量的一个指标，通过心肺运动试验进行评估。将低SMI患者（低SMI组）的特征与SMI不低的患者（对照组）的特征进行比较。结果以中位数（四分位距）表示。结果低 SMI 组的 T 分数显着较低（对照组与低 SMI -1.1 [1.8] vs. -1.6 [1.9]，P= 0.049）。 T-score与SMI呈正相关（r = 0.409，P< 0.0001）。低 SMI 组的 PeakVO2 显着降低（17.7 [6.3] vs. 14.4 [4.5]，P= 0.006）。在多变量逻辑回归分析中，T 分数（比值比 [OR]，3.508；95% 置信区间 [CI]，1.074–11.456；P= 0.038）和 PeakVO2（OR，3.512；95% CI，1.114–11.066；P= 0.032）与 SMI 显着相关，独立于年龄和性别。结论骨骼肌 慢性肝病的减少与运动耐量和骨质疏松症密切相关，而这些因素被认为与日常生活中缺乏身体活动有关。
AimThis study aimed to identify the relationship between loss of skeletal muscle mass and clinical factors such as osteoporosis in patients with chronic liver disease.MethodsThe subjects were 112 patients (85 men and 27 women) with hepatocellular carcinoma who were scheduled to undergo hepatectomy. Skeletal muscle reduction was diagnosed according to the cut‐off level of the skeletal mass index (SMI) for Asians (men <7.0 kg/m2, women <5.4 kg/m2). Osteoporosis was diagnosed according to T‐score ≤−2.5 standard deviation. The SMI and T‐score were assessed using the results of dual‐energy X‐ray absorption. Peak oxygen consumption (PeakVO2), an index of exercise tolerance, was evaluated using the cardiopulmonary exercise test. The characteristics of patients with low SMI (low SMI group) were compared with those of patients whose SMI was not low (control group). Outcomes are presented as median (interquartile range).ResultsThe T‐score was significantly lower in the low SMI group (control vs. low SMI −1.1 [1.8]vs. −1.6 [1.9],P= 0.049). T‐score positively correlated with SMI (r = 0.409,P< 0.0001). PeakVO2was significantly decreased in the low SMI group (17.7 [6.3] vs. 14.4 [4.5],P= 0.006). In multivariate logistic regression analysis, T‐score (odds ratio [OR], 3.508; 95% confidence interval [CI], 1.074–11.456;P= 0.038) and PeakVO2(OR, 3.512; 95% CI, 1.114–11.066;P= 0.032) were significantly related to SMI, independent of age and sex.ConclusionsSkeletal muscle reduction in chronic liver disease is closely related to exercise tolerance and osteoporosis, and these factors are believed to be associated with physical inactivity in daily life.