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Clinical usefulness of psoas muscle thickness for the diagnosis of sarcopenia in patients with liver cirrhosisopen access

Authors
Gu, Dae HoeKim, Moon YoungSeo, Yeon SeokKim, Sang GyuneLee, Han AhKim, Tae HyungJung, Young KulKandemir, AltayKim, Ji HoonAn, HyungginYim, Hyung JoonYeon, Jong EunByun, Kwan SooUm, Soon Ho
Issue Date
Sep-2018
Publisher
대한간학회
Keywords
Sarcopenia; Cirrhosis; Prognosis; Psoas muscle
Citation
Clinical and Molecular Hepatology, v.24, no.3, pp.319 - 330
Indexed
SCOPUS
KCI
Journal Title
Clinical and Molecular Hepatology
Volume
24
Number
3
Start Page
319
End Page
330
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/3211
DOI
10.3350/cmh.2017.0077
ISSN
2287-2728
Abstract
Background/Aims 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. Methods 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. Results 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). Conclusions 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.
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