肌营养不良和肌肉流失影响男性肝细胞癌患者的肝移植预后。

IF 9.4 1区 医学 Q1 GERIATRICS & GERONTOLOGY Journal of Cachexia Sarcopenia and Muscle Pub Date : 2024-08-27 DOI:10.1002/jcsm.13554
Di Lu, Zhihang Hu, Hao Chen, Abid Ali Khan, Qingguo Xu, Zuyuan Lin, Huigang Li, Jianyong Zhuo, Chiyu He, Li Zhuang, Zhe Yang, Siyi Dong, Jinzhen Cai, Shusen Zheng, Xiao Xu
{"title":"肌营养不良和肌肉流失影响男性肝细胞癌患者的肝移植预后。","authors":"Di Lu,&nbsp;Zhihang Hu,&nbsp;Hao Chen,&nbsp;Abid Ali Khan,&nbsp;Qingguo Xu,&nbsp;Zuyuan Lin,&nbsp;Huigang Li,&nbsp;Jianyong Zhuo,&nbsp;Chiyu He,&nbsp;Li Zhuang,&nbsp;Zhe Yang,&nbsp;Siyi Dong,&nbsp;Jinzhen Cai,&nbsp;Shusen Zheng,&nbsp;Xiao Xu","doi":"10.1002/jcsm.13554","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>Sarcopenia is associated with unfavourable long-term survival in patients undergoing liver transplantation (LT) for hepatocellular carcinoma (HCC). However, the impact of myosteatosis and muscle loss on patient prognosis has not been investigated.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>Seven hundred fifty-six HCC patients who received LT at 3 transplant centres were included. Computed tomography (CT) images of recipients were collected to measure skeletal muscle index (SMI) and skeletal muscle radiodensity (SMRA). The impact of myosteatosis on the prognosis of sarcopenic and non-sarcopenic patients was studied separately. Muscle status was evaluated based on the presence of sarcopenia and myosteatosis. The muscle loss of 342 males was calculated as the relative change of SMI between pre- and post-LT evaluations. Cox regression models were used to identify predictors of overall survival (OS) and recurrence-free survival (RFS).</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>The study comprised 673 males and 83 females. The median follow-up time was 31 months (interquartile range, 19–43 months). Prior to LT, 267 (39.7%) and 187 (27.8%) males were defined as sarcopenic (low-SMI) and myosteatotic (low-SMRA), respectively. For sarcopenic recipients, the presence of myosteatosis was followed by a 23.6% decrease in 5 year OS (<i>P</i> &lt; 0.001) and a 15.0% decrease in 5 year RFS (<i>P</i> = 0.014). Univariate and multivariate analyses revealed that muscle status was an independent predictor of OS [hazard ratio (HR), 1.569; 95% confidence interval (CI), 1.317–1.869; <i>P</i> &lt; 0.001] and RFS (HR, 1.369; 95% CI, 1.182–1.586; <i>P</i> &lt; 0.001). Postoperatively, a muscle loss &gt;14.2% was an independent risk factor for poor OS (HR, 2.286; 95% CI, 1.358–3.849; <i>P</i> = 0.002) and RFS (HR, 2.219; 95% CI, 1.418–3.471; <i>P</i> &lt; 0.001) in non-sarcopenic recipients (<i>N</i> = 209).</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Pre-transplant myosteatosis aggravated the adverse impact of sarcopenia on liver transplant outcomes in male HCC patients. Post-transplant muscle loss might assist in prognostic stratification of recipients without pre-existing sarcopenia, intriguing new insights into individualized management.</p>\n </section>\n </div>","PeriodicalId":48911,"journal":{"name":"Journal of Cachexia Sarcopenia and Muscle","volume":null,"pages":null},"PeriodicalIF":9.4000,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11446693/pdf/","citationCount":"0","resultStr":"{\"title\":\"Myosteatosis and muscle loss impact liver transplant outcomes in male patients with hepatocellular carcinoma\",\"authors\":\"Di Lu,&nbsp;Zhihang Hu,&nbsp;Hao Chen,&nbsp;Abid Ali Khan,&nbsp;Qingguo Xu,&nbsp;Zuyuan Lin,&nbsp;Huigang Li,&nbsp;Jianyong Zhuo,&nbsp;Chiyu He,&nbsp;Li Zhuang,&nbsp;Zhe Yang,&nbsp;Siyi Dong,&nbsp;Jinzhen Cai,&nbsp;Shusen Zheng,&nbsp;Xiao Xu\",\"doi\":\"10.1002/jcsm.13554\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background</h3>\\n \\n <p>Sarcopenia is associated with unfavourable long-term survival in patients undergoing liver transplantation (LT) for hepatocellular carcinoma (HCC). However, the impact of myosteatosis and muscle loss on patient prognosis has not been investigated.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>Seven hundred fifty-six HCC patients who received LT at 3 transplant centres were included. Computed tomography (CT) images of recipients were collected to measure skeletal muscle index (SMI) and skeletal muscle radiodensity (SMRA). The impact of myosteatosis on the prognosis of sarcopenic and non-sarcopenic patients was studied separately. Muscle status was evaluated based on the presence of sarcopenia and myosteatosis. The muscle loss of 342 males was calculated as the relative change of SMI between pre- and post-LT evaluations. Cox regression models were used to identify predictors of overall survival (OS) and recurrence-free survival (RFS).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>The study comprised 673 males and 83 females. The median follow-up time was 31 months (interquartile range, 19–43 months). Prior to LT, 267 (39.7%) and 187 (27.8%) males were defined as sarcopenic (low-SMI) and myosteatotic (low-SMRA), respectively. For sarcopenic recipients, the presence of myosteatosis was followed by a 23.6% decrease in 5 year OS (<i>P</i> &lt; 0.001) and a 15.0% decrease in 5 year RFS (<i>P</i> = 0.014). Univariate and multivariate analyses revealed that muscle status was an independent predictor of OS [hazard ratio (HR), 1.569; 95% confidence interval (CI), 1.317–1.869; <i>P</i> &lt; 0.001] and RFS (HR, 1.369; 95% CI, 1.182–1.586; <i>P</i> &lt; 0.001). Postoperatively, a muscle loss &gt;14.2% was an independent risk factor for poor OS (HR, 2.286; 95% CI, 1.358–3.849; <i>P</i> = 0.002) and RFS (HR, 2.219; 95% CI, 1.418–3.471; <i>P</i> &lt; 0.001) in non-sarcopenic recipients (<i>N</i> = 209).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>Pre-transplant myosteatosis aggravated the adverse impact of sarcopenia on liver transplant outcomes in male HCC patients. Post-transplant muscle loss might assist in prognostic stratification of recipients without pre-existing sarcopenia, intriguing new insights into individualized management.</p>\\n </section>\\n </div>\",\"PeriodicalId\":48911,\"journal\":{\"name\":\"Journal of Cachexia Sarcopenia and Muscle\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":9.4000,\"publicationDate\":\"2024-08-27\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11446693/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Cachexia Sarcopenia and Muscle\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1002/jcsm.13554\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"GERIATRICS & GERONTOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Cachexia Sarcopenia and Muscle","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/jcsm.13554","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"GERIATRICS & GERONTOLOGY","Score":null,"Total":0}
引用次数: 0

摘要

背景:肌肉疏松症与因肝细胞癌(HCC)而接受肝移植(LT)的患者的长期生存不利有关。然而,肌骨营养不良和肌肉流失对患者预后的影响尚未得到研究:方法:纳入在 3 个移植中心接受 LT 治疗的 756 名 HCC 患者。收集受者的计算机断层扫描(CT)图像,测量骨骼肌指数(SMI)和骨骼肌放射密度(SMRA)。分别研究了肌骨营养不良对肌肉疏松和非肌肉疏松患者预后的影响。根据肌肉疏松症和肌骨软化症的存在情况来评估肌肉状态。342 名男性的肌肉损失量被计算为肌肉疏松指数(SMI)在长程负荷治疗前后的相对变化。采用 Cox 回归模型确定总生存期(OS)和无复发生存期(RFS)的预测因素:研究对象包括 673 名男性和 83 名女性。中位随访时间为31个月(四分位间范围为19-43个月)。在接受LT治疗前,分别有267名(39.7%)和187名(27.8%)男性被定义为肌无力(低SMI)和肌骨软化(低SMRA)。对于肌肉疏松的受者,肌骨质疏松症会导致其5年OS下降23.6%(P=14.2%),是OS(HR,2.286;95% CI,1.358-3.849;P=0.002)和RFS(HR,2.219;95% CI,1.418-3.471;P=0.002)较差的独立风险因素:移植前肌骨质疏松症加重了肌肉疏松症对男性HCC患者肝移植预后的不利影响。移植后肌肉流失可能有助于对无肌肉疏松症的受者进行预后分层,为个体化管理提供新的见解。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

摘要图片

查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
Myosteatosis and muscle loss impact liver transplant outcomes in male patients with hepatocellular carcinoma

Background

Sarcopenia is associated with unfavourable long-term survival in patients undergoing liver transplantation (LT) for hepatocellular carcinoma (HCC). However, the impact of myosteatosis and muscle loss on patient prognosis has not been investigated.

Methods

Seven hundred fifty-six HCC patients who received LT at 3 transplant centres were included. Computed tomography (CT) images of recipients were collected to measure skeletal muscle index (SMI) and skeletal muscle radiodensity (SMRA). The impact of myosteatosis on the prognosis of sarcopenic and non-sarcopenic patients was studied separately. Muscle status was evaluated based on the presence of sarcopenia and myosteatosis. The muscle loss of 342 males was calculated as the relative change of SMI between pre- and post-LT evaluations. Cox regression models were used to identify predictors of overall survival (OS) and recurrence-free survival (RFS).

Results

The study comprised 673 males and 83 females. The median follow-up time was 31 months (interquartile range, 19–43 months). Prior to LT, 267 (39.7%) and 187 (27.8%) males were defined as sarcopenic (low-SMI) and myosteatotic (low-SMRA), respectively. For sarcopenic recipients, the presence of myosteatosis was followed by a 23.6% decrease in 5 year OS (P < 0.001) and a 15.0% decrease in 5 year RFS (P = 0.014). Univariate and multivariate analyses revealed that muscle status was an independent predictor of OS [hazard ratio (HR), 1.569; 95% confidence interval (CI), 1.317–1.869; P < 0.001] and RFS (HR, 1.369; 95% CI, 1.182–1.586; P < 0.001). Postoperatively, a muscle loss >14.2% was an independent risk factor for poor OS (HR, 2.286; 95% CI, 1.358–3.849; P = 0.002) and RFS (HR, 2.219; 95% CI, 1.418–3.471; P < 0.001) in non-sarcopenic recipients (N = 209).

Conclusions

Pre-transplant myosteatosis aggravated the adverse impact of sarcopenia on liver transplant outcomes in male HCC patients. Post-transplant muscle loss might assist in prognostic stratification of recipients without pre-existing sarcopenia, intriguing new insights into individualized management.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Journal of Cachexia Sarcopenia and Muscle
Journal of Cachexia Sarcopenia and Muscle MEDICINE, GENERAL & INTERNAL-
CiteScore
13.30
自引率
12.40%
发文量
234
审稿时长
16 weeks
期刊介绍: The Journal of Cachexia, Sarcopenia and Muscle is a peer-reviewed international journal dedicated to publishing materials related to cachexia and sarcopenia, as well as body composition and its physiological and pathophysiological changes across the lifespan and in response to various illnesses from all fields of life sciences. The journal aims to provide a reliable resource for professionals interested in related research or involved in the clinical care of affected patients, such as those suffering from AIDS, cancer, chronic heart failure, chronic lung disease, liver cirrhosis, chronic kidney failure, rheumatoid arthritis, or sepsis.
期刊最新文献
Issue Information Neuromuscular impairment at different stages of human sarcopenia The impact of mobility limitations on geriatric rehabilitation outcomes: Positive effects of resistance exercise training (RESORT) Artificial neural network inference analysis identified novel genes and gene interactions associated with skeletal muscle aging Hydrogen sulfide inhibits skeletal muscle ageing by up-regulating autophagy through promoting deubiquitination of adenosine 5’-monophosphate (AMP)-activated protein kinase α1 via ubiquitin specific peptidase 5
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1