Characterization of body composition and definition of sarcopenia in patients with alcoholic cirrhosis: A computed tomography based study
Characterization of body composition and definition of sarcopenia in patients with alcoholic cirrhosis: A computed tomography based study
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DOI：
10.1111/liv.13509
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发表时间：
2017-11-01
影响因子：
6.7
通讯作者：
Sarin, Shiv Kumar
中科院分区：
文献类型：
--
作者：
Benjamin, Jaya;Shasthry, Varsha;Sarin, Shiv Kumar
背景随着脂肪和肌肉质量的减少（肌肉减少症）而发生的身体成分（BC）变化与酒精性肝硬化（ALC）的不良预后相关。肌肉减少症的患病率取决于评估方法。计算机断层扫描 (CT) 是评估 BC 的黄金标准工具。目的是使用 CT 表征 BC 并定义 ALC 患者的肌肉减少症。方法分析健康对照 (HC) - 器官移植捐献者和 ALC 患者的 L3 椎骨的单片 CT 图像，以给出标准化高度骨骼肌指数 (SMI; cm(2)/m(2))、皮下面积的五块骨骼肌的横截面积(SAT;cm(2)) 和内脏脂肪组织 (VAT;cm(2))。定义肌肉减少症的临界值设定为低于 HC 平均值的 2SD。将 HC 与儿童 A 代偿 (C) 和儿童 B+C 失代偿 (DC) 患者进行比较。结果 HC 衍生的 SMI 截止值（n=275；M：50%；年龄 32.29.8 岁；BMI 24.2 +/- 3.2Kg/m(2)）男性为 36.54，女性为 30.21。 12.8% 的 ALC 患者发现肌肉减少症 [n=148； C（31.8%）：DC（68.2%）；中：100%；年龄 46.6 +/- 9.7 岁；体重指数 24.5 +/- 4.4]。与 HC 相比，代偿患者的肥胖程度更高，肌肉发达程度相当；与 HC 和代偿患者相比，失代偿患者的肌肉和脂肪量明显较低。 HC、C、DC：SAT（140 +/- 82 与 177.3 +/- 11 与 112 +/- 8.2）； VAT（96.5 +/- 6.5 vs 154.9 +/- 8.7 vs 87.5 +/- 6.5）和SMI（52.1 +/- 0.9 vs 49.6 +/- 1.2 vs 46 +/- 0.9）。结论代偿性ALC增加了肥胖并相对保留了肌肉，但失代偿导致肌肉和脂肪量的损失。根据种族界限，肌肉减少症的患病率为 12.8%。
BackgroundAlterations in body composition (BC) as loss of fat and muscle mass (sarcopenia) are associated with poor outcome in alcoholic cirrhosis (ALC). Prevalence of sarcopenia depends upon the method of assessment. Computed Tomography (CT) is a gold standard tool for assessing BC.AimTo characterize BC and define sarcopenia in ALC patients using CT.MethodsSingle slice CT images at L3 vertebrae of healthy controls (HC) - organ transplant donors and ALC patients were analysed to give cross-sectional area of five skeletal muscles normalized for height -skeletal muscle index (SMI; cm(2)/m(2)), area of subcutaneous (SAT;cm(2)) and visceral adipose tissue (VAT;cm(2)). Cut-offs for defining sarcopenia was established at 2SD below the mean of HC. HC were compared with Child Acompensated (C) and Child B+Cdecompensated (DC) patients.ResultsCut-offs of SMI derived from HC (n=275; M: 50%; age 32.29.8years; BMI 24.2 +/- 3.2Kg/m(2)) were 36.54 in males and 30.21 in females. Sarcopenia was found in 12.8% of ALC patients [n=148; C (31.8%): DC (68.2%); M: 100%; age 46.6 +/- 9.7years; BMI 24.5 +/- 4.4]. Compared to HC, compensated patients had higher adiposity and comparable muscularity; decompensated patients had significantly lower muscle and also fat mass compared to both HC and compensated patients. HC vs C vs DC: SAT (140 +/- 82 vs 177.3 +/- 11 vs 112 +/- 8.2); VAT (96.5 +/- 6.5 vs 154.9 +/- 8.7 vs 87.5 +/- 6.5) and SMI (52.1 +/- 0.9 vs 49.6 +/- 1.2 vs 46 +/- 0.9).ConclusionsCompensated ALC have increased adiposity and relatively preserved muscularity but decompensation leads to loss of both muscle and fat mass. Prevalence of sarcopenia, based on derived ethnic cut-offs was 12.8%.