Iacob Speranta, Mina Victor, Mandea Matei, Iacob Razvan, Vadan Roxana, Boar Voichita, Ionescu Georgeta, Buzescu Dan, Gheorghe Cristian, Gheorghe Liana
"Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
Center for Digestive Diseases and Liver Transplant, Fundeni Clinical Institute, Bucharest, Romania.
Front Nutr. 2022 Feb 25;9:774044. doi: 10.3389/fnut.2022.774044. eCollection 2022.
Sarcopenia, malnutrition, physical deconditioning, and frailty contribute to a significantly altered quality of life (QoL) in patients with cirrhosis and sarcopenia.
To investigate the sarcopenia-linked alterations of QoL by SarQoL® questionnaire in patients with end-stage liver disease.
Consecutive patients with liver cirrhosis, admitted to our department between May and August 2021, completed the SarQoL® questionnaire by themselves. They were evaluated for sarcopenia according to the 2019 European Working Group on Sarcopenia in Older People (EWGSOP) definition [hand grip cut-offs and skeletal muscle index (SMI) calculation at CT scan].
A total of 71 patients with liver cirrhosis were included in the study, with a median age of 54 years. Sarcopenia was present in 31.2% of patients with Child-Pugh class A, in 58.3% with class B, and in 93.5% with class C. The SarQoL® score was statistically significant and lower in Child-Pugh class C vs. class B and class A (70.2 vs. 66.5 vs. 52.5 points, = 0.0002). The SarQoL® score was evaluated according to different complications of cirrhosis, with statistically significant lower scores in patients with sarcopenia ( < 0.0001), in patients with ascites requiring paracentesis ( = 0.0006), and in patients with hepatic encephalopathy ( < 0.0001). A cut-off level of 75.9 points for SarQoL® score can accurately detect sarcopenia in patients with end-stage liver disease [area under the receiver operating characteristic (AUROC) curve of.823, SE of 92.1%, SP of 45.5%, positive predictive value (PPV) and negative predictive value (NPV) of 66 and 83.3%, respectively, correctly classified 73.2% of cirrhotic patients with sarcopenia].
The use of SarQoL® questionnaire in cirrhotic patients can, at the same time, evaluate the quality of life and identify subjects with sarcopenia and altered QoL.
肌肉减少症、营养不良、身体机能下降和衰弱会导致肝硬化和肌肉减少症患者的生活质量(QoL)显著改变。
通过SarQoL®问卷调查终末期肝病患者中与肌肉减少症相关的生活质量改变情况。
2021年5月至8月间连续入住我科的肝硬化患者自行完成SarQoL®问卷。根据2019年欧洲老年人肌肉减少症工作组(EWGSOP)的定义[握力临界值及CT扫描时骨骼肌指数(SMI)计算]对他们进行肌肉减少症评估。
本研究共纳入71例肝硬化患者,中位年龄为54岁。Child-Pugh A级患者中肌肉减少症的发生率为31.2%,B级为58.3%,C级为93.5%。Child-Pugh C级患者的SarQoL®评分在统计学上显著低于B级和A级(分别为70.2分、66.5分和52.5分,P = 0.0002)。根据肝硬化的不同并发症评估SarQoL®评分,肌肉减少症患者(P < 0.0001)、需要进行腹腔穿刺放腹水的腹水患者(P = 0.0006)以及肝性脑病患者(P < 0.0001)的评分在统计学上显著较低。SarQoL®评分的临界值为75.9分可准确检测终末期肝病患者中的肌肉减少症[受试者工作特征(AUROC)曲线下面积为0.823,灵敏度为92.1%,特异度为45.5%,阳性预测值(PPV)和阴性预测值(NPV)分别为66%和83.3%,正确分类了73.2%的患有肌肉减少症的肝硬化患者]。
在肝硬化患者中使用SarQoL®问卷可同时评估生活质量并识别出患有肌肉减少症和生活质量改变的患者。