Department of Internal Medicine B, University Hospital Münster, Germany; Department of Internal Medicine I, University Hospital Bonn, Germany.
Department of Internal Medicine I, University Hospital Bonn, Germany.
Dig Liver Dis. 2023 Nov;55(11):1543-1547. doi: 10.1016/j.dld.2023.08.037. Epub 2023 Aug 14.
Primary Sclerosing Cholangitis (PSC) is a progressive cholestatic liver disease with liver transplantation (LT) as the only curative therapy. Some regions use body-weight-loss as standard-exception criteria for organ allocation but data on the impact of body composition on survival of patients with PSC is scarce.
Abdominal MRI of PSC patients were quantitatively analyzed for intramuscular fat fraction (IMFF) as surrogate of myosteatosis. Clinical and laboratory data were retrieved from patient records. Primary outcome was transplant-free survival (TFS).
116 PSC patients were included. Median age was 38 (18-71) years with 74 (64%) male patients. 15 (13%) patients had significant weigh loss. IMFF was significantly associated with survival. Multivariate regression analysis showed IMFF ≥ 15% as independent predictor for TFS (p = 0.032, HR 3.215 CI 1.104-9.366), but not significant weight loss (p = 0.618).
IMFF is independently associated with TFS in patients with PSC and may identify patients with more urgent need for LT. NCT03584204.
原发性硬化性胆管炎（PSC）是一种进行性胆汁淤积性肝病，肝移植（LT）是唯一的治愈性治疗方法。一些地区将体重减轻作为器官分配的标准例外标准，但关于身体成分对 PSC 患者生存的影响的数据很少。
对 PSC 患者的腹部 MRI 进行定量分析，以获得肌内脂肪分数（IMFF）作为肌减少症的替代指标。从患者记录中检索临床和实验室数据。主要结果是无移植生存率（TFS）。
共纳入 116 例 PSC 患者。中位年龄为 38（18-71）岁，74 例（64%）为男性患者。15 例（13%）患者有明显的体重减轻。IMFF 与生存显著相关。多变量回归分析显示，IMFF≥15%是 TFS 的独立预测因子（p=0.032，HR 3.215 CI 1.104-9.366），但体重减轻不显著（p=0.618）。
IMFF 与 PSC 患者的 TFS 独立相关，可能识别出更需要 LT 的患者。NCT03584204。
