Nishikawa Hiroki, Yoh Kazunori, Enomoto Hirayuki, Nishimura Takashi, Nishiguchi Shuhei, Iijima Hiroko
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan.
Center for Clinical Research and Education, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan.
Hepatol Res. 2021 May;51(5):603-613. doi: 10.1111/hepr.13639. Epub 2021 Apr 5.
To elucidate the relationship between the finger-circle test (Yubi-wakka [in Japanese] test; three levels of bigger, just-fits, and smaller) and sarcopenia-related factors and anthropometric parameters in patients with chronic liver disease (n = 202, 99 men, mean age 61 years).
Patients with both grip strength decline (<26 kg for men and <18 kg for women) and skeletal muscle index (SMI) decline (<7.0 kg/m in men and <5.7 kg/m in female) were diagnosed as sarcopenia.
Liver cirrhosis was found in 56 patients (27.7%). The proportions of bigger, just-fits, and smaller in liver cirrhosis versus non-liver cirrhosis patients were 51.8%, 21.4%, and 26.8% versus 77.4%, 11.4%, and 8.2% (p < 0.01). The proportions of grip strength decline in patients with bigger, just-fits, and smaller were 12.0% (77/142), 21.2% (7/33), and 40.7% (11/27; overall p < 0.01). The proportions of SMI decline in patients with bigger, just-fits, and smaller were 9.9% (14/142), 45.5% (15/33), and 77.8% (21/27; overall p < 0.01). The proportions of sarcopenia in patients with bigger, just-fits, and smaller were 3.5% (5/142), 18.2% (6/33), and 33.3% (9/27; overall p < 0.01). In both sexes, arm circumference, triceps skinfold thickness, calf circumference, and waist circumference were significantly stratified according to the finger-circle test. In the multivariate analysis, smaller was an independent predictor for SMI decline (p < 0.01, risk ratio 8.188, bigger as a reference), and body mass index was an independent predictor for both SMI decline and sarcopenia.
The finger-circle test can be helpful for the screening of sarcopenia in chronic liver disease and is closely linked to body composition.
阐明手指圈测试（日语为“指わか”测试；分为较大、刚好合适和较小三个等级）与慢性肝病患者（n = 202，男性99例，平均年龄61岁）的肌肉减少症相关因素及人体测量参数之间的关系。
握力下降（男性<26 kg，女性<18 kg）且骨骼肌指数（SMI）下降（男性<7.0 kg/m²，女性<5.7 kg/m²）的患者被诊断为肌肉减少症。
56例患者（27.7%）发现肝硬化。肝硬化患者与非肝硬化患者中，较大、刚好合适和较小的比例分别为51.8%、21.4%和26.8%，而非肝硬化患者分别为77.4%、11.4%和8.2%（p<0.01）。较大、刚好合适和较小的患者中握力下降的比例分别为12.0%（77/142）、21.2%（7/33）和40.7%（11/27；总体p<0.01）。较大、刚好合适和较小的患者中SMI下降的比例分别为9.9%（14/142）、45.5%（15/33）和77.8%（21/27；总体p<0.01）。较大、刚好合适和较小的患者中肌肉减少症的比例分别为3.5%（5/142）、18.2%（6/33）和33.3%（9/27；总体p<0.01）。在男女两性中，臂围、肱三头肌皮褶厚度、小腿围和腰围根据手指圈测试有显著分层。在多变量分析中，较小是SMI下降的独立预测因素（p<0.01，风险比8.188，以较大为参照），而体重指数是SMI下降和肌肉减少症的独立预测因素。
手指圈测试有助于慢性肝病患者肌肉减少症的筛查，且与身体组成密切相关。
