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Impacts of muscle mass dynamics on prognosis of outpatients with cirrhosisopen access

Authors
Kim, Tae HyungJung, Young KulYim, Hyung JoonBaik, Joo WonYim, Sun YoungLee, Young-SunSeo, Yeon SeokKim, Ji HoonYeon, Jong EunByun, Kwan Soo
Issue Date
Oct-2022
Publisher
대한간학회
Keywords
Sarcopenia; Liver cirrhosis; Prognosis; Survival
Citation
Clinical and Molecular Hepatology, v.28, no.4, pp.876 - 889
Indexed
SCIE
SCOPUS
KCI
Journal Title
Clinical and Molecular Hepatology
Volume
28
Number
4
Start Page
876
End Page
889
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/61869
DOI
10.3350/cmh.2022.0231
ISSN
2287-2728
Abstract
Background/Aims Sarcopenia negatively affects the prognosis of cirrhotic patients, but clinical implications of changes in muscle mass remain unclear. We aimed to elucidate its role in the prognosis of outpatients with cirrhosis. Methods Patients with cirrhosis who underwent annual abdominal computed tomography (CT) for hepatocellular carcinoma surveillance were included in the prospective cohort. The L3 skeletal muscle index (SMI) was adopted as a proxy for the amount of skeletal muscle, and the rate of SMI change between inclusion and after 1 year (ΔSMI/yr%) was calculated. Results In total, 595 patients underwent a second CT after 1 year. Among them, 109 and 64 patients had sarcopenia and Child-Pugh class B/C decompensation at inclusion, which changed to 103 and 45 at the 1-year follow-up, respectively. During a median follow-up of 30.1 months after 1 year, 86 patients had at least one cirrhosis complication, and 18 died or received liver transplantation. In the development of cirrhosis complications, ΔSMI/yr% was independently associated, even after adjusting for the Child-Pugh and model for end stage liver disease (MELD)-Na scores. In addition, ΔSMI/yr% showed a good predictive performance for the development of cirrhosis complications within 6 months after 1-year follow-up in all subgroups, with a cut-off of -2.62 (sensitivity, 83.9%; specificity, 74.5%) in the overall population. SMI at 1-year and Child-Pugh score were independent factors associated with survival. In addition, changes in sarcopenia status significantly stratified survival. Conclusions ΔSMI/yr% was a good predictor of the development of cirrhosis complications in outpatients with cirrhosis, independent of Child-Pugh and MELD scores.
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Guro Hospital (Department of Gastroenterology and Hepatology, Guro Hospital)
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