Hepatology research : the official journal of the Japan Society of Hepatology · 2025
Prognostic significance of skeletal muscle mass in patients with alcohol-related cirrhosis.
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Shibamoto Akihiko, Namisaki Tadashi, Iwai Satoshi, Tomooka Fumimasa, Kubo Takahiro, Koizumi Aritoshi, Tanaka Misako, Matsuda Takuya, Inoue Takashi, Tsuji Yuki, Fujinaga Yukihisa, Nishimura Norihisa, Sato Shinya, Kitagawa Koh, Kaji Kosuke, Mitoro Akira, Asada Kiyoshi, Takaya Hiroaki, Akahane Takemi, Yoshiji Hitoshi
Аннотация
AIM: This study aimed to assess the prognostic significance of hand grip strength (HGS) and skeletal muscle mass index (SMI) in patients with alcohol-related cirrhosis.
METHODS: 535 patients with liver cirrhosis (LC) were assessed for HGS and computed tomography (CT)-based SMI. They were categorized into alcohol-related liver disease (ARLD; n = 226), metabolic dysfunction-associated steatohepatitis (MASH; n = 119), and virus-related cirrhosis (VC, n = 190) groups.
RESULTS: Overall prevalence of sarcopenia was 16.4%, 11.8%, and 27.4% in the ARLD, MASH, and VC groups, respectively. Three factors including low SMI, low albumin (Alb) levels, low sodium (Na) levels, and two factors including low HGS and low Alb levels, and three factors including the presence of ascites, low cholinesterase (Ch-E) levels, and low HGS were identified as prognostic factors for mortality in the ARLD, MASH and VC groups, respectively. In the ARLD group, overall survival (OS) was significantly lower in low SMI + low HGS and normal HGS + low SMI (pre-sarcopenia) than in normal SMI and HGS. OS was significantly lower in sarcopenia than in normal SMI + low HGS (dynapenia). In the MASH group, OS was significantly lower in sarcopenia and dynapenia than in normal SMI and HGS. In the VC group, OS was significantly lower in sarcopenia and dynapenia than in normal SMI and HGS; OS was significantly lower in sarcopenia than in pre-sarcopenia.
CONCLUSIONS: In the ARLD group, SMI could serve as a more powerful predictor of survival than HGS.
METHODS: 535 patients with liver cirrhosis (LC) were assessed for HGS and computed tomography (CT)-based SMI. They were categorized into alcohol-related liver disease (ARLD; n = 226), metabolic dysfunction-associated steatohepatitis (MASH; n = 119), and virus-related cirrhosis (VC, n = 190) groups.
RESULTS: Overall prevalence of sarcopenia was 16.4%, 11.8%, and 27.4% in the ARLD, MASH, and VC groups, respectively. Three factors including low SMI, low albumin (Alb) levels, low sodium (Na) levels, and two factors including low HGS and low Alb levels, and three factors including the presence of ascites, low cholinesterase (Ch-E) levels, and low HGS were identified as prognostic factors for mortality in the ARLD, MASH and VC groups, respectively. In the ARLD group, overall survival (OS) was significantly lower in low SMI + low HGS and normal HGS + low SMI (pre-sarcopenia) than in normal SMI and HGS. OS was significantly lower in sarcopenia than in normal SMI + low HGS (dynapenia). In the MASH group, OS was significantly lower in sarcopenia and dynapenia than in normal SMI and HGS. In the VC group, OS was significantly lower in sarcopenia and dynapenia than in normal SMI and HGS; OS was significantly lower in sarcopenia than in pre-sarcopenia.
CONCLUSIONS: In the ARLD group, SMI could serve as a more powerful predictor of survival than HGS.