Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Eur J Gastroenterol Hepatol. 2019 Dec;31(12):1550-1556. doi: 10.1097/MEG.0000000000001472.
Sarcopenia is associated with poor health-related quality of life (HRQOL) in the general population. However, in cirrhotic patients, as the development of sarcopenia is closely related to declined liver function, which also impairs HRQOL, whether sarcopenia deteriorates HRQOL independently from declined liver function remains unclear. The aim of this study was to clarify the impact of sarcopenia on HRQOL impairment in cirrhotic patients.
A total of 88 cirrhotic patients [median age, 69 years; range: 31-79 years; 49 male (55.7%), 45 with hepatocellular carcinoma (51.1%)] were analyzed. We measured HRQOL using the 36-item Short-Form Health Survey version 2 questionnaire and identified factors contributing to scores lower than 50 in physical component summary (PCS), mental component summary, and role-social component summary (RCS) scores.
Twenty-four (27.2%) patients had sarcopenia. PCS and RCS scores were significantly lower in patients with sarcopenia compared with those without sarcopenia. Patients with Child-Pugh (CP) classification B or C showed significantly lower scores in PCS and RCS than those with CP classification A. On multivariate analysis, the presence of sarcopenia was the only factor associated with low PCS scores [odds ratio (OR): 11.6; P = 0.031]. Female sex (OR: 3.34; P = 0.034), CP classification B or C (OR: 3.19; P = 0.037), and presence of sarcopenia (OR: 4.64; P = 0.016) were identified as independent factors for low RCS scores.
Sarcopenia independently impairs physical and role-social HRQOL in cirrhotic patients.
在普通人群中，肌肉减少症与健康相关生活质量（HRQOL）较差相关。然而，在肝硬化患者中，由于肌肉减少症的发展与肝功能下降密切相关，而肝功能下降也会损害 HRQOL，因此肌肉减少症是否独立于肝功能下降而进一步恶化 HRQOL尚不清楚。本研究旨在阐明肌肉减少症对肝硬化患者 HRQOL 损害的影响。
共分析了 88 例肝硬化患者[中位年龄 69 岁；范围：31-79 岁；49 名男性（55.7%），45 名患有肝细胞癌（51.1%）]。我们使用 36 项简短健康调查量表 2 版本问卷测量 HRQOL，并确定导致生理成分综合评分（PCS）、心理成分综合评分和角色-社会成分综合评分（RCS）评分低于 50 的因素。
24 例（27.2%）患者患有肌肉减少症。与无肌肉减少症的患者相比，有肌肉减少症的患者的 PCS 和 RCS 评分显著降低。CP 分级为 B 或 C 的患者的 PCS 和 RCS 评分明显低于 CP 分级为 A 的患者。多变量分析显示，存在肌肉减少症是导致低 PCS 评分的唯一因素[比值比（OR）：11.6；P = 0.031]。女性（OR：3.34；P = 0.034）、CP 分级 B 或 C（OR：3.19；P = 0.037）和存在肌肉减少症（OR：4.64；P = 0.016）是 RCS 评分较低的独立因素。
肌肉减少症独立损害肝硬化患者的生理和角色-社会 HRQOL。
