Department of Gastroenterology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.
Karsh Division of Gastroenterology and Hepatology, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Clin Nutr. 2024 Jan;43(1):84-94. doi: 10.1016/j.clnu.2023.11.008. Epub 2023 Nov 14.
Sarcopenia is associated with poor outcomes in patients with cirrhosis. However, the prevalence of and associated factors for developing sarcopenia in this population remain to be determined.
This study aimed to summarize the prevalence, characteristics, and associated factors of sarcopenia in patients with cirrhosis.
Electronic searches were performed from inception to June 9, 2022 to identify the eligible studies. We meta-analyzed the prevalence of sarcopenia in overall patients with cirrhosis and subgroups. Both crude and adjusted odds ratios (ORs) were pooled using the random effects model.
A total of 55 studies involving 13,158 patients from 17 countries were included. The overall prevalence of sarcopenia was 40.1 % (95 % CI 35.4%-44.9 %) in patients with cirrhosis. The pooled prevalence was higher in males, Child-Pugh class C cirrhosis, decompensated stage, ascites, subjective global assessment class C cirrhosis, and when sarcopenia was defined by L3-SMI (third lumbar-skeletal muscle index) at a higher cutoff. In multivariate analysis, older age (adjusted OR 1.04, 95 % CI 1.00-1.07), male (adjusted OR 4.75, 95 % CI 2.72-8.28), lower body mass index (BMI) (adjusted OR 0.78, 95 % CI 0.73-0.83), alcoholic liver disease (ALD) (adjusted OR 1.43, 95 % CI 1.19-1.72), but not ascites and hepatic encephalopathy, were significantly associated with an increased risk of sarcopenia in patients with cirrhosis.
Sarcopenia is a prevalent complication, and older age, male patients, lower BMI, and patients with ALD are associated with an increased risk of sarcopenia in patients with cirrhosis.
肌少症与肝硬化患者的不良预后相关。然而，该人群中肌少症的患病率和相关因素仍有待确定。
本研究旨在总结肝硬化患者肌少症的患病率、特征和相关因素。
从建库到 2022 年 6 月 9 日，进行电子检索以确定合格的研究。我们对总体肝硬化患者和亚组的肌少症患病率进行了荟萃分析。使用随机效应模型汇总了肌少症的粗比值比（OR）和调整后的 OR。
共纳入了来自 17 个国家的 55 项研究，涉及 13158 例患者。肝硬化患者的肌少症总体患病率为 40.1%（95%CI 35.4%-44.9%）。在男性、Child-Pugh 分级 C 级肝硬化、失代偿期、腹水、主观整体评估 C 级肝硬化以及当肌少症根据 L3-SMI（第三腰椎骨骼肌指数）较高的截定点定义时，患病率更高。多变量分析显示，年龄较大（调整后的 OR 1.04，95%CI 1.00-1.07）、男性（调整后的 OR 4.75，95%CI 2.72-8.28）、较低的体重指数（调整后的 OR 0.78，95%CI 0.73-0.83）、酒精性肝病（ALD）（调整后的 OR 1.43，95%CI 1.19-1.72），但腹水和肝性脑病与肝硬化患者肌少症的风险增加无关。
肌少症是一种常见的并发症，年龄较大、男性患者、较低的 BMI 和患有 ALD 的患者与肝硬化患者肌少症的风险增加相关。
