Sarcopenia in liver cirrhosis: the role of computed tomography scan for the assessment of muscle mass compared with dual-energy X-ray absorptiometry and anthropometry
Sarcopenia in liver cirrhosis: the role of computed tomography scan for the assessment of muscle mass compared with dual-energy X-ray absorptiometry and anthropometry
复制标题
DOI：
10.1097/meg.0000000000000274
复制
发表时间：
2015-03-01
影响因子：
2.1
通讯作者：
Merli, Manuela
中科院分区：
文献类型：
--
作者：
Giusto, Michela;Lattanzi, Barbara;Merli, Manuela
背景评估在腰椎部位的计算机断层扫描（CT）扫描的肌肉减少症已被确定为发病率和死亡率的一个危险因素在cirrhosis.Aim本研究的目的是比较通过CT扫描的肌肉质量的测量，被认为是金标准，与其他可靠的技术，以评估不同的可用方法之间的协议率肝硬化肌肉质量的评估。肌肉质量和肌肉力量的测量之间的相关性也investigated.Patients和方法成人患者符合肝移植进行了研究。通过CT测量腰椎骨骼肌横截面积，并使用先前发表的截止值定义肌肉消耗。根据人体测量结果计算上臂肌围。使用双能X线吸收测量法计算无脂肪质量指数和肩胛骨肌肉指数。肌肉力量进行了评价，使用手握test.Results五十九肝硬化患者。根据CT评估，76%的患者被诊断为肌肉减少症。在42-52%的患者中观察到无脂肪质量指数和肩胛骨肌指数显著降低，而52%的患者显示上臂肌围小于第10百分位数。通过CT进行的骨骼肌质量评估与双能X线吸收测量法和人体测量学评估仅弱相关。CT测量的肌肉质量和握力test.Conclusion之间没有相关性观察CT扫描可以识别最高百分比的肌减少症肝硬化和没有其他技术实际上是可用的作为替代。未来的努力应集中在评估骨骼肌质量和功能的方法，以提供更好的评估骨骼肌减少症患者。版权所有（C）2015威科医疗集团All rights reserved.
Background Sarcopenia evaluated by computed tomography (CT) scan at the lumbar site has been identified as a risk factor for morbidity and mortality in cirrhosis.Aim The aim of this study was to compare the measurement of muscle mass through CT scan, considered the gold standard, with other reliable techniques to evaluate the rate of agreement between different available methods for the assessment of muscle mass in cirrhosis. The correlation between measurements of muscle mass and of muscle strength was also investigated.Patients and methods Adult patients eligible for liver transplantation were studied. Lumbar skeletal muscle cross-sectional area was measured by CT and muscle depletion was defined using previously published cut-offs. Mid-arm muscle circumference was calculated following anthropometric measures. The Fat-Free Mass Index and the Appendicular Skeletal Muscle Index were calculated using dual-energy X-ray absorptiometry. Muscle strength was evaluated using the Hand Grip test.Results Fifty-nine patients with cirrhosis were included. Sarcopenia was diagnosed in 76% of the patients according to CT evaluation. A significant reduction in Fat-Free Mass Index and Appendicular Skeletal Muscle Index was observed in 42-52% of the patients, whereas 52% showed a mid-arm muscle circumference less than 10th percentile. Skeletal muscle mass evaluation through CT was only weakly correlated with dual-energy X-ray absorptiometry and anthropometry evaluation. No correlation was observed between CT measurement of muscle mass and Hand Grip test.Conclusion CT scan can identify the highest percentage of sarcopenia in cirrhosis and no other techniques are actually available as a replacement. Future efforts should focus on approaches for assessing both skeletal muscle mass and function to provide a better evaluation of sarcopenia in cirrhotic patients. Copyright (C) 2015 Wolters Kluwer Health, Inc. All rights reserved.