Function Area Clinical Nutrition, Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
Department of Clinical Science Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
Nutrition. 2019 May;61:93-98. doi: 10.1016/j.nut.2018.10.031. Epub 2018 Nov 14.
The aim of this study was to perform intermethod comparisons between the following three measures of muscle mass depletion in patients eligible for liver transplantation: 1) fat-free mass index (FFMI) measured by dual-energy x-ray absorptiometry (DXA), 2) appendicular skeletal muscle mass index (ASMI) measured by DXA, and 3) skeletal muscle index (SMI) measured at the third lumbar level by computed tomography (CT).
The medical records of patients who received liver transplants between 2009 and 2012 at Karolinska University Hospital were retrospectively reviewed. Adult patients with a chronic liver disease who had both DXA and CT scans performed within a 30-d period during their pretransplant workup were included.
Appendicular skeletal muscle mass index measured by DXA (ASMI) and skeletal mass index measured by computed tomography (SMI) provide similar results when assessing the presence of muscle mass depletion in patients with chronic liver diseases and FFMI can be falsely high in patients with ascites. Both ASMI and SMI thus appear to be useful methods in the pretransplant evaluation of muscle mass depletion both for patients with and without ascites.
ASMI measured with DXA is a useful alternative method to SMI measured with CT when a CT scan is not clinically indicated or available.
本研究旨在对以下三种适用于肝移植患者的肌肉减少症测量方法进行方法间比较：1）双能 X 射线吸收法（DXA）测量的去脂体重指数（FFMI），2）DXA 测量的四肢骨骼肌质量指数（ASMI），3）计算机断层扫描（CT）测量的第 3 腰椎水平的骨骼肌指数（SMI）。
回顾性分析 2009 年至 2012 年期间在卡罗林斯卡大学医院接受肝移植的患者的病历。纳入在移植前评估期间的 30 天内同时进行 DXA 和 CT 扫描的慢性肝病成年患者。
DXA 测量的四肢骨骼肌质量指数（ASMI）和 CT 测量的骨骼肌指数（SMI）在评估慢性肝病患者肌肉减少症的存在方面提供相似的结果，而腹水患者的 FFMI 可能会偏高。因此，ASMI 和 SMI 似乎都是腹水患者和非腹水患者移植前肌肉减少症评估的有用方法。
当 CT 扫描临床指征不明确或不可用时，DXA 测量的 ASMI 是 CT 测量的 SMI 的有用替代方法。
