Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Nutrition. 2022 Nov-Dec;103-104:111777. doi: 10.1016/j.nut.2022.111777. Epub 2022 Jun 17.
The presence of myosteatosis is one factor associated with poor prognosis for patients with cirrhosis; however, the factors contributing to worsening myosteatosis are, to our knowledge, unknown. The aim of this study was to clarify the changes in myosteatosis, and the factors involved in these changes.
The present study enrolled 178 patients with cirrhosis who underwent computed tomography twice to measure changes in skeletal muscle attenuation (SMA) at the L3 level. Factors associated with SMA and those associated with changes in SMA were examined.
Using linear multiple regression analysis, age (β = -0.22), skeletal muscle index (SMI; skeletal muscle area divided by height squared; β = 0.25), and visceral and subcutaneous fat indices (VFI and SFI; the visceral and subcutaneous fat areas at the umbilical level divided by height squared; β = -0.08, β = -0.06, respectively) were identified as associated with SMA. The 100-d change in SMA was -0.21 ± 1.29 Hounsfield units (HU). Changes in SMI and SMA were positively associated (R = 0.183, P = 0.014), whereas those in VFI and SMA were negatively associated (R = -0.172, P = 0.022). No association was noted between the 100-d changes in SFI and SMA. In patients whose SMI increased and VFI decreased, the 100-d change in SMA was 0.24 ± 1.82 HU, which was marginally different from that in patients whose SMI decreased and VFI increased (-0.44 ± 1.32 HU, P = 0.077).
In patients with cirrhosis, myosteatosis progressed, and decreases in SMI and increases in VFI were correlated with its progression.
肌内脂肪增多与肝硬化患者预后不良有关；然而，导致肌内脂肪增多恶化的因素我们并不清楚。本研究旨在阐明肌内脂肪增多的变化及其相关因素。
本研究纳入了 178 例接受两次腰椎 3 水平骨骼肌衰减值（SMA）计算机断层扫描检查以测量 SMA 变化的肝硬化患者。检查了与 SMA 相关的因素以及与 SMA 变化相关的因素。
使用线性多元回归分析，年龄（β=-0.22）、骨骼肌指数（SMI；骨骼肌面积除以身高的平方；β=0.25）和内脏及皮下脂肪指数（VFI 和 SFI；脐水平内脏及皮下脂肪面积除以身高的平方；β=-0.08，β=-0.06）被确定与 SMA 相关。SMA 的 100 天变化为-0.21±1.29 亨斯菲尔德单位（HU）。SMI 和 SMA 的变化呈正相关（R=0.183，P=0.014），而 VFI 和 SMA 的变化呈负相关（R=-0.172，P=0.022）。SFI 的 100 天变化与 SMA 无相关性。在 SMI 增加和 VFI 减少的患者中，SMA 的 100 天变化为 0.24±1.82 HU，与 SMI 减少和 VFI 增加的患者（-0.44±1.32 HU）相比，差异无统计学意义（P=0.077）。
在肝硬化患者中，肌内脂肪增多，SMI 减少和 VFI 增加与肌内脂肪增多的进展相关。
