Plasma free amino acids are associated with sarcopenia in the course of hepatocellular carcinoma recurrence
Plasma free amino acids are associated with sarcopenia in the course of hepatocellular carcinoma recurrence
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DOI：
10.1016/j.nut.2020.111007
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发表时间：
2021-03-15
期刊：
影响因子：
4.4
通讯作者：
Masamune, Atsushi
中科院分区：
文献类型：
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作者：
Sano, Akitoshi;Tsuge, Shunichi;Masamune, Atsushi
目的：原发性肝细胞癌（HCC）患者肌肉减少与预后密切相关。本研究的目的是阐明血浆游离氨基酸（PFAAs）与HCC复发过程中的肌肉减少症或肌肉脂肪变性。方法：在这项横断面研究中，187例患者进行了回顾性研究。所有患者均因肝癌复发而住院治疗1次以上（平均2.65次）。通过第三腰椎（L3）的横向计算机断层扫描（CT）扫描图像测量骨骼肌指数（SMI）和肌肉衰减（MA）。将同一患者复发之间24种PFAAs、SMI和MA浓度的变化定义为Delta。通过逻辑回归模型评估肌肉减少症、肌肉脂肪变性和PFAAs之间的关系。比较了接受支链氨基酸（BCAAs）制剂的患者与未接受BCAAs制剂的患者之间的Δ SMI和Δ MA。结果：肌肉减少症患者的生存率较低，1年、3年和5年生存率分别为85%、42%和9%。多因素分析显示，总支链氨基酸水平与肌肉减少症显著相关。PFAAs中亮氨酸变化量（Δ Leu）与Δ SMI的相关系数最高（R = 0.256; P < 0.001）。在Child-Pugh分级B或C中，使用BCAAs制剂的患者比未使用BCAAs制剂的患者更能显著抑制SMI的降低（Δ SMI：平均变化-0.98 vs-3.45 cm（2）/m（2）; P = 0.038）。结论：在PFAAs中，BCAAs水平与HCC复发过程中的肌肉减少症相关。(C)2020爱思唯尔公司All rights reserved.
Objective: Sarcopenia worsens the prognosis of patients with hepatocellular carcinoma (HCC). The aim of this study was to elucidate the plasma free amino acids (PFAAs) associated with sarcopenia or myosteatosis in the course of HCC recurrence.Methods: In this cross-sectional study, 187 patients were enrolled retrospectively. All patients experienced more than one hospitalization (mean times, 2.65) owing to HCC recurrence. The skeletal muscle index (SMI) and muscle attenuation (MA) were measured by a transverse computed tomography (CT) scan image at the third lumbar vertebra (L3). The changes in the concentration of 24 PFAAs, SMI, and MA in the same patient between recurrences were defined as Delta. The associations between sarcopenia, myosteatosis, and PFAAs were evaluated by a logistic regression model. The Delta SMI and Delta MA were compared between the patients who received branched-chain amino acids (BCAAs) formulation and those who did not.Results: Patients with sarcopenia showed lower survival rate; the 1-, 3-, and 5-y survival rates were 85%, 42%, and 9%, respectively. Multivariate analysis revealed that the level of total BCAAs was significantly associated with sarcopenia. The correlation coefficient value between the change of leucine (Delta Leu) and Delta SMI was highest (R = 0.256; P < 0.001) among the PFAAs. In the Child-Pugh grade B or C, the decrease of SMI was significantly more suppressed in the patients with the BCAAs formulation than in those without BCAAs formulation (Delta SMI: mean change -0.98 versus -3.45 cm(2)/m(2); P = 0.038).Conclusion: Among the PFAAs, the level of BCAAs was associated with sarcopenia in the course of HCC recurrence. (C) 2020 Elsevier Inc. All rights reserved.