Prognostic impacts of the change in muscle mass on patients with cirrhosis

초록

Background and aims:Sarcopenia has a negative impact on theprognosis of patients with cirrhosis. Although muscle mass changesare also expected to be an important factor, available data are limitedyet. Method:Adults with cirrhosis were included from the prospectivecohort who received the abdomen CT annually for HCC surveillance.L3 skeletal muscle index (SMI) was adopted as a proxy of skeletalmuscle mass, and we calculated a change of SMI between baselineand one-year (ΔSMI/yr). Results:Among a total of 155 patients,113 and 21 had sarcopenia andChild-Pugh class B/C decompensation, respectively. During a medianfollow-up of 36 months, five patients died and 19 had undergonecomplications of cirrhosis. Multivariate Cox regression analysesshowed 1% decrease inΔSMI/yr was associated with a 1.15–1.19-fold increased risk of complication occurrence even adjusted forChild-Pugh or MELD score. In addition,ΔSMI/yr showed goodprediction of aggravation of liver function (Child-Pugh score at 2years after baseline), especially in female patients (n = 46), with acut-off of−2.5% (sensitivity 57.1%, specificity 94.9%). Conclusion:ΔSMI/yr was significantly associated with prognosis ofpatients with cirrhosis independent of baseline Child-Pugh andMELD scores.