Nishikawa Hiroki, Enomoto Hirayuki, Ishii Akio, Iwata Yoshinori, Miyamoto Yuho, Ishii Noriko, Yuri Yukihisa, Hasegawa Kunihiro, Nakano Chikage, Nishimura Takashi, Yoh Kazunori, Aizawa Nobuhiro, Sakai Yoshiyuki, Ikeda Naoto, Takashima Tomoyuki, Takata Ryo, Iijima Hiroko, Nishiguchi Shuhei
Department of Hepatobiliary and Pancreatic disease, Department of Internal Medicine, Hyogo College of Medicine, 1-1, Mukogawacho, Nishinomiyashi, Hyogo 663-8501, Japan.
Nutrients. 2017 Jun 12;9(6):595. doi: 10.3390/nu9060595.
To investigate the influence of skeletal muscle mass index (SMI) as determined by bioimpedance analysis (BIA) (appendicular skeletal muscle mass/(height)²) on survival by comparing the Child-Pugh score in patients with liver cirrhosis (LC, 383, average age = 65.2 years).
In terms of comparison of the effects of SMI and other markers on survival, we used time-dependent receiver operating characteristics (ROC) analysis.
The average SMI for male was 7.4 cm²/m² whereas that for female was 6.0 cm²/m² ( < 0.0001). As for the Child-Pugh score, five points were in the majority, both in males (51.7%, (106/205)) and females (44.9%, (80/178)). For both genders, the survival curve was well stratified according to SMI ( < 0.0001 for males and = 0.0056 for females). In the multivariate analysis for survival, SMI and Child-Pugh scores were found to be significant both in males and females. In time-dependent ROC analyses, all area under the ROCs (AUROCs) for SMI in each time point were higher than those for Child-Pugh scores in males, while in females AUROCs for Child-Pugh scores at each time point were higher than those for SMI.
SMI using BIA can be helpful for predicting outcomes, at least in male LC patients.
通过比较肝硬化（LC，383例，平均年龄 = 65.2岁）患者的Child-Pugh评分，研究生物电阻抗分析（BIA）测定的骨骼肌质量指数（SMI）（四肢骨骼肌质量/身高²）对生存率的影响。
在比较SMI和其他标志物对生存率的影响方面，我们使用了时间依赖性受试者工作特征（ROC）分析。
男性的平均SMI为7.4 cm²/m²，而女性为6.0 cm²/m²（P < 0.0001）。关于Child-Pugh评分，五分的占大多数，男性（51.7%，106/205）和女性（44.9%，80/178）均如此。对于两性，生存曲线均根据SMI进行了良好分层（男性P < 0.0001，女性P = 0.0056）。在生存的多因素分析中，发现SMI和Child-Pugh评分在男性和女性中均具有显著性。在时间依赖性ROC分析中，男性各时间点SMI的ROC曲线下面积（AUROC）均高于Child-Pugh评分的AUROC，而女性各时间点Child-Pugh评分的AUROC高于SMI的AUROC。
使用BIA测定的SMI至少在男性LC患者中有助于预测预后。
