Sciences Applied to Adult Health Care Post-Graduate Programme, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil.
Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil.
Nutr Clin Pract. 2024 Jun;39(3):568-578. doi: 10.1002/ncp.11141. Epub 2024 Mar 6.
There is neither a gold standard definition nor a universal consensus to diagnose sarcopenia in patients with chronic hepatitis C. Thus, we aimed to compare the prevalence of sarcopenia and the agreement and discrepancies between European Working Group on Sarcopenia in Older People (EWGSOP1), EWGSOP2, and Foundation for the National Institutes of Health Biomarkers Consortium Sarcopenia Project (FNIH) definitions in chronic hepatitis C.
Dual-energy x-ray absorptiometry was used to assess muscle mass by quantifying appendicular lean mass (ALM) adjusted for squared height (ALM/ht) or for body mass index (ALM). Muscle function was evaluated by handgrip strength. Subjective Global Assessment was used to assess the nutrition status.
This cross-sectional study included 103 outpatients (mean age, 50.6 ± 11.3 years; 33.0% with compensated cirrhosis). Sarcopenia prevalence was 8.7%, 9.7%, and 9.7%, according to EWGSOP1, EWGSOP2, and FNIH definitions, respectively. There was neither a sex- nor a liver disease severity-specific difference in the prevalence of sarcopenia between the criteria applied. Sixteen (15.5%) patients fulfilled at least one of these criteria, and 3 out of 16 (18.8%) simultaneously had sarcopenia by consensus of the three criteria. Sarcopenic obesity was identified in 9 out of 16 (56.3%) patients, and 6 out of 9 (66.7%) of these only met FNIH consensus.
In patients without cirrhosis or with compensated cirrhosis, and with chronic hepatitis C, the agreement between EWGSOP1 and EWGSOP2 classifications was substantial for sarcopenia diagnosis. Concerning EWGSOP and FNIH criteria, a fair agreement and limited overlap were found in these patients.
目前尚无金标准定义或普遍共识来诊断慢性丙型肝炎患者的肌肉减少症。因此，我们旨在比较欧洲老年人肌肉减少症工作组（EWGSOP1）、EWGSOP2 和美国国立卫生研究院生物标志物联盟肌肉减少症项目（FNIH）定义诊断慢性丙型肝炎患者肌肉减少症的患病率，以及这些定义之间的一致性和差异。
使用双能 X 射线吸收法通过定量四肢瘦组织（ALM）来评估肌肉量，ALM 根据身高的平方（ALM/ht）或身体质量指数（ALM）进行调整。肌肉功能通过握力进行评估。主观全面评估用于评估营养状况。
这项横断面研究纳入了 103 名门诊患者（平均年龄 50.6±11.3 岁；33.0%为代偿性肝硬化）。根据 EWGSOP1、EWGSOP2 和 FNIH 定义，肌肉减少症的患病率分别为 8.7%、9.7%和 9.7%。在应用这些标准时，性别或肝脏疾病严重程度与肌肉减少症的患病率之间均无差异。16 名（15.5%）患者符合至少一项标准，其中 3 名（18.8%）患者同时符合三项标准的共识，存在肌肉减少性肥胖。在 16 名患者中发现 9 名（56.3%）患有肌肉减少性肥胖，其中 6 名（66.7%）仅符合 FNIH 共识。
在无肝硬化或代偿性肝硬化的慢性丙型肝炎患者中，EWGSOP1 和 EWGSOP2 分类诊断肌肉减少症的一致性较高。在这些患者中，EWGSOP 和 FNIH 标准之间的一致性为中等，重叠有限。
