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评估肝硬化患者肌少症相关的危险因素:一项病例对照研究。

Assessing the risk factors associated with sarcopenia in patients with liver cirrhosis: a case-control study.

机构信息

Deparment of Infectious Diseases, Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, China.

School of Nursing, Zunyi Medical University, Zunyi, 563000, China.

出版信息

Sci Rep. 2023 Dec 9;13(1):21845. doi: 10.1038/s41598-023-48955-z.

Abstract

Sarcopenia is a disease characterized by decreased muscle mass and strength, affecting 20-70% of patients with cirrhosis, and is associated with poor prognosis, complications, and high mortality. At present, the epidemiological investigation of sarcopenia in patients with liver cirrhosis is relatively limited, and because of the differences in population characteristics, regions, diagnostic criteria and diagnostic tools, the prevalence of sarcopenia in various studies varies greatly. The definition of sarcopenia in this study adopted the criteria of the Asian Working Group on Sarcopenia (AWGS 2019), including muscle mass and muscle strength / physical performance. A total of 271 patients with liver cirrhosis were included in this cross-sectional study to explore the influencing factors of sarcopenia in patients with liver cirrhosis. The prevalence of sarcopenia was 27.7%, 27.3% in male and 28.4% in female. The results of binary logistic regression analysis showed that age, physical activity, BMI, mid-upper arm muscle circumference, hepatic encephalopathy, nutritional status, alkaline phosphatase, albumin and total cholesterol were significantly correlated with the occurrence of sarcopenia in patients with liver cirrhosis. After adjusting for the potential influencing factors, it was found that the correlation between age and sarcopenia was weakened (OR = 0.870, 95% CI 0.338-2.239). The current findings show that sarcopenia is common in patients with cirrhosis and is independently associated with age, physical activity, BMI, nutritional status, and albumin, and serum alkaline phosphatase and total cholesterol are associated with the development of sarcopenia. Regular exercise may help maintain the grip strength of patients with cirrhosis and delay the deterioration of liver function.

摘要

肌肉减少症是一种以肌肉质量和力量下降为特征的疾病,影响 20%-70%的肝硬化患者,与预后不良、并发症和高死亡率有关。目前,对肝硬化患者肌肉减少症的流行病学调查相对有限,由于人群特征、地区、诊断标准和诊断工具的差异,各研究中肌肉减少症的患病率差异很大。本研究中肌肉减少症的定义采用亚洲肌肉减少症工作组(AWGS 2019)的标准,包括肌肉质量和肌肉力量/身体表现。本横断面研究共纳入 271 例肝硬化患者,旨在探讨肝硬化患者肌肉减少症的影响因素。肌肉减少症的患病率为 27.7%,男性为 27.3%,女性为 28.4%。二分类逻辑回归分析结果显示,年龄、体力活动、BMI、中上臂肌围、肝性脑病、营养状况、碱性磷酸酶、白蛋白和总胆固醇与肝硬化患者肌肉减少症的发生显著相关。在调整了潜在的影响因素后,发现年龄与肌肉减少症的相关性减弱(OR=0.870,95%CI 0.338-2.239)。目前的研究结果表明,肌肉减少症在肝硬化患者中较为常见,且与年龄、体力活动、BMI、营养状况和白蛋白独立相关,血清碱性磷酸酶和总胆固醇与肌肉减少症的发生有关。定期运动可能有助于维持肝硬化患者的握力,延缓肝功能恶化。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5bab/10710435/724c835ba6e0/41598_2023_48955_Fig1_HTML.jpg

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