Department of Gastroenterology and Hepatology, Graduate School of Medical Sciences, Kumamoto University, Honjo 1-1-1, Chuo-ku, Kumamoto, 860-8556, Japan.
Kumamoto Rosai Hospital, 1670 Takeharatyo, Yatsushiro City, Kumamoto, Japan.
BMC Gastroenterol. 2020 Nov 9;20(1):371. doi: 10.1186/s12876-020-01501-x.
Sarcopenia is a syndrome characterized by progressive and systemic decreases in skeletal muscle mass and muscle strength. The influence or prognosis of various liver diseases in this condition have been widely investigated, but little is known about whether sarcopenia and/or muscle mass loss are related to minimal hepatic encephalopathy (MHE).
To clarify the relationship between MHE and sarcopenia and/or muscle mass loss in patients with liver cirrhosis.
Ninety-nine patients with liver cirrhosis were enrolled. MHE was diagnosed by a neuropsychiatric test. Skeletal mass index (SMI) and Psoas muscle index (PMI) were calculated by dividing skeletal muscle area and psoas muscle area at the third lumbar vertebra by the square of height in meters, respectively, to evaluate muscle volume.
This study enrolled 99 patients (61 males, 38 females). MHE was detected in 48 cases (48.5%) and sarcopenia in 6 cases (6.1%). Patients were divided into two groups, with or without MHE. Comparing groups, no significant differences were seen in serum ammonia concentration or rate of sarcopenia. SMI was smaller in patients with MHE (46.4 cm/m) than in those without (51.2 cm/m, P = 0.027). Similarly, PMI was smaller in patients with MHE (4.24 cm/m) than in those without (5.53 cm/m, P = 0.003). Skeletal muscle volume, which is represented by SMI or PMI was a predictive factor related to MHE (SMI ≥ 50 cm/m; odds ratio 0.300, P = 0.002, PMI ≥ 4.3 cm/m; odds ratio 0.192, P = 0.001).
Muscle mass loss was related to minimal hepatic encephalopathy, although sarcopenia was not. Measurement of muscle mass loss might be useful to predict MHE.
肌少症是一种以骨骼肌质量和肌肉力量进行性和系统性下降为特征的综合征。各种肝脏疾病在这种情况下的影响或预后已经被广泛研究，但对于肌少症和/或肌肉质量损失是否与轻微肝性脑病（MHE）有关知之甚少。
为了阐明肝硬化患者 MHE 与肌少症和/或肌肉质量损失之间的关系。
共纳入 99 例肝硬化患者。通过神经心理测试诊断 MHE。通过将第三腰椎处的骨骼肌面积和腰大肌面积除以身高的平方来计算骨骼肌指数（SMI）和腰大肌指数（PMI），以评估肌肉体积。
本研究共纳入 99 例患者（61 例男性，38 例女性）。48 例（48.5%）检测到 MHE，6 例（6.1%）存在肌少症。将患者分为有或无 MHE 两组。比较两组，血清氨浓度或肌少症发生率无显著差异。有 MHE 的患者 SMI（46.4 cm/m）小于无 MHE 的患者（51.2 cm/m，P=0.027）。同样，有 MHE 的患者 PMI（4.24 cm/m）小于无 MHE 的患者（5.53 cm/m，P=0.003）。SMI 或 PMI 代表的骨骼肌体积是与 MHE 相关的预测因素（SMI≥50 cm/m；优势比 0.300，P=0.002，PMI≥4.3 cm/m；优势比 0.192，P=0.001）。
肌肉质量损失与轻微肝性脑病有关，尽管肌少症没有。肌肉质量损失的测量可能有助于预测 MHE。
