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临床意义上的疲劳和抑郁与非酒精性脂肪性肝病患者的肌肉减少症相关。

Clinically Meaningful Fatigue and Depression Are Associated with Sarcopenia in Patients with Non-Alcoholic Fatty Liver Disease.

作者信息

Sheptulina Anna F, Yafarova Adel A, Golubeva Julia A, Mamutova Elvira M, Kiselev Anton R, Drapkina Oxana M

机构信息

National Medical Research Center for Therapy and Preventive Medicine, Moscow 101990, Russia.

Department of Therapy and Preventive Medicine, A.I. Evdokimov Moscow State University of Medicine and Dentistry, Moscow 127473, Russia.

出版信息

J Pers Med. 2023 May 31;13(6):932. doi: 10.3390/jpm13060932.

Abstract

BACKGROUND

Sarcopenia is thought to be related to an increased risk of non-alcoholic steatohepatitis and advanced liver fibrosis. Our cross-sectional single-center study was designed to analyze the prevalence of sarcopenia in patients with NAFLD and possible influencing factors.

METHODS

A survey on the presence of sarcopenia, fatigue, anxiety, and depression, along with a quality-of-life (QoL) assessment, was forwarded by email to 189 outpatients. Demographics, anthropometric and clinical data (laboratory test results and abdomen complete ultrasound protocol), performed within 2-4 weeks prior to the enrollment, were obtained.

RESULTS

Sarcopenia (defined as SARC-F score ≥ 4) was identified in 17 (15.7%) patients, all of them (100%) females, with median age (interquartile range) 56 (51-64) years. These patients had a poorer metabolic state (greater values of waist and hip circumferences, body mass index, and HOMA-IR) and significantly poorer QoL, specifically, regarding the physical component of health, compared with NAFLD patients without sarcopenia. Multivariate analysis showed that depression (OR = 1.25, 95% CI: 1.02-1.53, = 0.035) and clinically meaningful fatigue (OR = 1.14, 95% CI: 1.04-1.26, = 0.008) were the factors independently associated with sarcopenia in patients with NAFLD.

CONCLUSION

Sarcopenia is associated with depression and fatigue rather than with the severity of liver disease alone and may negatively affect QoL in patients with NAFLD.

摘要

背景

肌肉减少症被认为与非酒精性脂肪性肝炎和晚期肝纤维化风险增加有关。我们的横断面单中心研究旨在分析非酒精性脂肪性肝病(NAFLD)患者中肌肉减少症的患病率及可能的影响因素。

方法

通过电子邮件向189名门诊患者发送了关于肌肉减少症、疲劳、焦虑和抑郁情况的调查问卷以及生活质量(QoL)评估。获取了入组前2 - 4周内的人口统计学、人体测量学和临床数据(实验室检查结果及腹部完整超声检查方案)。

结果

17名(15.7%)患者被诊断为肌肉减少症(定义为SARC - F评分≥4),所有患者(100%)均为女性,中位年龄(四分位间距)为56(51 - 64)岁。与无肌肉减少症的NAFLD患者相比,这些患者的代谢状态较差(腰围、臀围、体重指数和HOMA - IR值更高),生活质量明显较差,尤其是在健康的身体方面。多因素分析显示,抑郁(OR = 1.25,95%CI:1.02 - 1.53,P = 0.035)和具有临床意义的疲劳(OR = 1.14,95%CI:1.04 - 1.26,P = 0.008)是NAFLD患者中与肌肉减少症独立相关的因素。

结论

肌肉减少症与抑郁和疲劳有关,而非仅与肝病严重程度相关,可能对NAFLD患者的生活质量产生负面影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7421/10302668/ba455206f750/jpm-13-00932-g001.jpg

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