Shim Jung-Woo, Yang Sungwon, Jung Joon-Yong, Choi Ho Joong, Chung Hyun Sik, Hong Sang Hyun, Park Chul Soo, Choi Jong Ho, Chae Min Suk
Department of Anesthesiology and Pain Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Transplant Proc. 2019 Jul-Aug;51(6):1874-1879. doi: 10.1016/j.transproceed.2019.03.034. Epub 2019 Jun 28.
Patients on a waiting list for liver transplantation frequently show core muscle wasting, referred to as sarcopenia, which results in poor prognosis. To date, there has been a lack of research on the association between inflammation mediators, including cytokines, and loss of core muscle mass in cirrhotic patients scheduled for living donor liver transplantation (LDLT).
Cytokines in serum, such as interleukin (IL)-2, IL-6, IL-10, IL-12, IL-17, interferon-γ, and tumor necrosis factor (TNF)-α, were retrospectively investigated in 234 LDLT patients 1 day before surgery. The psoas muscle area was measured using abdominal computed tomography within 1 month before surgery and used to calculate the psoas muscle index (PMI = psoas muscle area/height). The study population was classified into 2 groups according to the interquartile range of PMI: a non-sarcopenia group (> 25th quartile) and a sarcopenia group (≤ 25th quartile) in each sex.
In both sexes, IL-10 and TNF-α levels were significantly higher in the sarcopenia group than the non-sarcopenia group. In a univariate analysis, male patients showed that serum IL-10 and TNF-α levels were potentially associated with sarcopenia. Serum TNF-α was independently associated with sarcopenia in a multivariate analysis. In female patients, TNF-α was significantly associated with sarcopenia in both univariate and multivariate analyses. Male patients with a PMI ≤ 25th quartile had significantly higher TNF-α levels than those in other quartile ranges, and female patients with a PMI ≤ 25th quartile had a significantly higher TNF-α level than those with a PMI > 75th quartile.
Serum levels of TNF-α are inversely associated with skeletal muscle wasting in both male and female patients scheduled for LDLT.
等待肝移植的患者常出现核心肌群萎缩，即肌肉减少症，这会导致预后不良。迄今为止，对于包括细胞因子在内的炎症介质与计划接受活体肝移植（LDLT）的肝硬化患者核心肌肉量减少之间的关联，缺乏相关研究。
回顾性调查了234例LDLT患者术前1天血清中的细胞因子，如白细胞介素（IL）-2、IL-6、IL-10、IL-12、IL-17、干扰素-γ和肿瘤坏死因子（TNF）-α。在术前1个月内使用腹部计算机断层扫描测量腰大肌面积，并用于计算腰大肌指数（PMI =腰大肌面积/身高）。根据PMI的四分位数间距，将研究人群分为2组：非肌肉减少症组（>第25四分位数）和肌肉减少症组（≤第25四分位数），每组按性别划分。
在男性和女性中，肌肉减少症组的IL-10和TNF-α水平均显著高于非肌肉减少症组。在单因素分析中，男性患者显示血清IL-10和TNF-α水平可能与肌肉减少症有关。在多因素分析中，血清TNF-α与肌肉减少症独立相关。在女性患者中，TNF-α在单因素和多因素分析中均与肌肉减少症显著相关。PMI≤第25四分位数的男性患者的TNF-α水平显著高于其他四分位数范围的患者，PMI≤第25四分位数的女性患者的TNF-α水平显著高于PMI>第75四分位数的患者。
对于计划接受LDLT的男性和女性患者，血清TNF-α水平与骨骼肌萎缩呈负相关。
