血浆戊糖苷作为肝硬化患者肌肉减少症、低步速和死亡率的有用生物标志物。

Plasma pentosidine as a useful biomarker of sarcopenia, low gait speed, and mortality in patients with cirrhosis.

作者信息

Saeki Chisato, Saito Mitsuru, Tsubota Akihito

机构信息

Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan.

Division of Gastroenterology, Department of Internal Medicine, Fuji City General Hospital, Fuji, Shizuoka, Japan.

出版信息

Front Med (Lausanne). 2023 Sep 15;10:1212899. doi: 10.3389/fmed.2023.1212899. eCollection 2023.

DOI:10.3389/fmed.2023.1212899

PMID:37780552

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10541311/

Abstract

PURPOSE

The accumulation of advanced glycation end products (AGEs) is associated with various diseases and age-related impairments, including loss of muscle mass and function. We investigated the association between plasma pentosidine, which is one of the AGEs, and sarcopenia, low gait speed, and mortality in patients with cirrhosis.

METHODS

This retrospective study divided 128 patients with cirrhosis into three groups by 25th and 75th quartiles of baseline plasma pentosidine levels: low (L)-, intermediate (I)-, and high (H)-pentosidine (Pen) groups. Sarcopenia was diagnosed following the Japan Society of Hepatology criteria. Low gait speed was defined as <0.8 m/s. The cumulative survival rates were compared between the three groups. Cox proportional hazards regression analysis was performed to identify independent factors associated with mortality.

RESULTS

Of the 128 patients, 40 (31.3%) and 34 (26.6%) had sarcopenia and low gait speed, respectively. The prevalence of sarcopenia and low gait speed significantly increased stepwise with increasing plasma pentosidine levels, with the highest in the H-Pen group (59.4% [19/32] and 56.3% [18/32], respectively) and lowest in the L-Pen group (18.8% [6/32] and 6.3% [2/32], respectively). Multivariate analysis identified plasma pentosidine levels as a significant and independent factor associated with sarcopenia (odds ratio [OR], 1.07; = 0.036) and low gait speed (OR, 1.06; = 0.036), with the cutoff levels of 0.0792 μg/mL (sensitivity/specificity, 0.600/0.773) and 0.0745 μg/mL (sensitivity/specificity, 0.735/0.691), respectively. The cumulative survival rates were significantly lower in the H-Pen group than in the L-Pen (hazard ratio [HR], 11.7; = 0.001) and I-Pen (HR, 4.03; < 0.001) groups. Plasma pentosidine levels were identified as a significant and independent prognostic factor (HR, 1.07; < 0.001).

CONCLUSION

Plasma pentosidine levels are associated with sarcopenia, low gait speed, and mortality and may serve as a useful surrogate biomarker for these clinical events in patients with cirrhosis.

摘要

目的

晚期糖基化终末产物（AGEs）的积累与多种疾病及年龄相关的功能障碍有关，包括肌肉量和功能的丧失。我们研究了AGEs之一的血浆戊糖苷与肝硬化患者肌肉减少症、低步速和死亡率之间的关联。

方法

这项回顾性研究根据基线血浆戊糖苷水平的第25和第75四分位数将128例肝硬化患者分为三组：低（L）-、中（I）-和高（H）-戊糖苷（Pen）组。根据日本肝脏学会标准诊断肌肉减少症。低步速定义为<0.8米/秒。比较三组的累积生存率。进行Cox比例风险回归分析以确定与死亡率相关的独立因素。

结果

128例患者中，分别有40例（31.3%）和34例（26.6%）患有肌肉减少症和低步速。随着血浆戊糖苷水平的升高，肌肉减少症和低步速的患病率显著逐步增加，H-Pen组最高（分别为59.4%[19/32]和56.3%[18/32]），L-Pen组最低（分别为18.8%[6/32]和6.3%[2/32]）。多变量分析确定血浆戊糖苷水平是与肌肉减少症（比值比[OR]，1.07；P = 0.036）和低步速（OR，1.06；P = 0.036）相关的显著且独立的因素，截断水平分别为0.0792μg/mL（敏感性/特异性，0.600/0.773）和0.0745μg/mL（敏感性/特异性，0.735/0.691）。H-Pen组的累积生存率显著低于L-Pen组（风险比[HR]，11.7；P = 0.001）和I-Pen组（HR，4.03；P < 0.001）。血浆戊糖苷水平被确定为显著且独立的预后因素（HR，1.07；P < 0.001）。