Centre for Pancreatic Diseases & Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
Centre for Pancreatic Diseases & Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark.
Pancreatology. 2019 Mar;19(2):245-251. doi: 10.1016/j.pan.2019.01.006. Epub 2019 Jan 14.
Objectives: Malnutrition is a well-known complication of chronic pancreatitis and alterations in body composition are common in this context. We investigated the prevalence of sarcopenia in patients with chronic pancreatitis, its associated risk factors and health-related outcome.
This was a prospective cohort study of chronic pancreatitis outpatients. Bioelectric impedance was used to measure body composition, and a handheld dynamometer and the timed-up-and-go test characterized muscle function. Several demographic and disease characteristics, including exocrine pancreatic insufficiency (EPI), were analyzed for their association with sarcopenia. The EORCT QLQ-C30 questionnaire was used to document life quality, and associations between sarcopenia and the number of hospital admissions, the number of in-hospital days and survival over the next 12 months were analyzed.
A total of 182 patients were enrolled in the study. The prevalence of sarcopenia was 17.0% (95% CI; 11.9-23.3) and 74% of sarcopenic patients had a BMI in the normal or overweight range (BMI >18.5 kg/m). EPI was an independent risk factor for sarcopenia (OR 3.8 95% CI [1.2-12.5]; p = 0.03). Several QLQ-C30 scales and items were associated with sarcopenia including physical functioning (p < 0.001) and global health (p = 0.003). During follow-up, sarcopenia was associated with an increased risk of hospitalization (OR 2.2 95% CI [0.9-5.0]; p = 0.07), increased number of in-hospital days (p < 0.001), and reduced survival (HR 6.7 [95% CI; 1.8-25.0]; p = 0.005).
Sarcopenia is a common complication of chronic pancreatitis and associates with adverse health-related outcomes. As sarcopenia is not recognized by conventional anthropometric parameters in the majority of patients, systematic nutritional assessment should be prioritized.
目的：营养不良是慢性胰腺炎的一种众所周知的并发症，而在这种情况下，身体成分的改变是很常见的。我们调查了慢性胰腺炎患者中肌少症的患病率、其相关危险因素和与健康相关的结果。
这是一项针对慢性胰腺炎门诊患者的前瞻性队列研究。生物电阻抗用于测量身体成分，手持式测力计和计时起立行走测试用于评估肌肉功能。分析了几种人口统计学和疾病特征，包括外分泌胰腺功能不全（EPI），以了解其与肌少症的关系。EORCT QLQ-C30 问卷用于记录生活质量，并分析了肌少症与住院次数、住院天数和未来 12 个月内的生存率之间的关系。
共有 182 名患者入组本研究。肌少症的患病率为 17.0%（95%CI；11.9-23.3），74%的肌少症患者 BMI 处于正常或超重范围（BMI＞18.5kg/m）。EPI 是肌少症的独立危险因素（OR 3.8，95%CI[1.2-12.5]；p=0.03）。几个 QLQ-C30 量表和项目与肌少症相关，包括身体功能（p＜0.001）和总体健康（p=0.003）。在随访期间，肌少症与住院风险增加（OR 2.2，95%CI[0.9-5.0]；p=0.07）、住院天数增加（p＜0.001）和生存率降低（HR 6.7，95%CI[1.8-25.0]；p=0.005）相关。
肌少症是慢性胰腺炎的一种常见并发症，与不良的健康相关结果相关。由于大多数患者的常规人体测量参数无法识别肌少症，因此应优先进行系统的营养评估。
