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肌少症指数是预测肝硬化患者营养不良的有效指标。

The sarcopenia index is an effective predictor for malnutrition in patients with liver cirrhosis.

机构信息

Department of General Surgery, Renmin Hospital of Wuhan University, Wuhan, China.

Department of Anesthesiology, The People's Hospital of China Three Gorges University, Yichang, China.

出版信息

Nutr Diet. 2022 Nov;79(5):563-571. doi: 10.1111/1747-0080.12738. Epub 2022 Apr 17.

Abstract

AIM

Reliable and valid predictors of malnutrition in patients with cirrhosis remain scarce, especially easily accessible blood indicators. Thus, this study aimed to investigate the validity of the sarcopenia index (serum creatinine/serum cystatin C × 100) as a tool in assessing the nutritional status of patients with cirrhosis.

METHODS

This prospective cohort study included 109 patients with cirrhosis who were hospitalised in Renmin Hospital of Wuhan University from August 2020 to June 2021. Malnutrition was diagnosed by the Global Leadership Initiative on Malnutrition criteria. Multivariable logistic regression was used to examine the relationship between sarcopenia index and malnutrition. The area under the receiver operating characteristic curve was used to evaluate the diagnostic performance of sarcopenia index. By contrast, we evaluated the subjective global assessment and traditional nutrition-related indicators.

RESULTS

Of the 109 included patients, 71 (65.1%) were diagnosed with malnutrition. The sarcopenia index was significantly lower in malnourished patients (56.39 ± 15.23) compared with well-nourished patients (74.95 ± 13.18, p < 0.001). In addition, the sarcopenia index was independently correlated with malnutrition (p < 0.001). The sarcopenia index was a good tool to predict malnutrition (area under curve = 0.833), which performed better than the subjective global assessment (area under curve = 0.782) and cholinesterase (area under curve = 0.812). A low sarcopenia index indicated longer hospital stay and higher risk of 90-day re-hospitalisation.

CONCLUSION

Malnutrition is highly prevalent in this population. The sarcopenia index seems to be a good predictor in nutritional assessment of patients with cirrhosis.

摘要

目的

肝硬化患者营养不良的可靠和有效的预测指标仍然稀缺,尤其是易于获得的血液指标。因此,本研究旨在探讨肌少症指数(血清肌酐/血清胱抑素 C×100)作为评估肝硬化患者营养状况的工具的有效性。

方法

这项前瞻性队列研究纳入了 2020 年 8 月至 2021 年 6 月期间在武汉大学人民医院住院的 109 例肝硬化患者。营养不良根据全球营养不良倡议标准进行诊断。多变量逻辑回归用于检查肌少症指数与营养不良之间的关系。接受者操作特征曲线下面积用于评估肌少症指数的诊断性能。相比之下,我们评估了主观全面评估和传统的营养相关指标。

结果

在纳入的 109 例患者中,71 例(65.1%)被诊断为营养不良。与营养良好的患者(74.95±13.18,p<0.001)相比,营养不良患者的肌少症指数显著较低。此外,肌少症指数与营养不良独立相关(p<0.001)。肌少症指数是预测营养不良的良好工具(曲线下面积=0.833),优于主观全面评估(曲线下面积=0.782)和胆碱酯酶(曲线下面积=0.812)。低肌少症指数表明住院时间更长,90 天再住院的风险更高。

结论

该人群中营养不良的患病率很高。肌少症指数似乎是评估肝硬化患者营养状况的一个很好的预测指标。

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