肝细胞癌患者肌脂肪变性的患病率及其对预后的影响：一项系统评价和荟萃分析
Prevalence of and Impact on the Outcome of Myosteatosis in Patients with Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis.
作者信息
Kamiliou Aikaterini, Lekakis Vasileios, Xynos George, Cholongitas Evangelos
机构信息
First Department of Internal Medicine, Laiko General Hospital, Medical School of National and Kapodistrian University of Athens, 11527 Athens, Greece.
Academic Department of Gastroenterology, Laiko General Hospital, Medical School of National and Kapodistrian University of Athens, 11527 Athens, Greece.
出版信息
Cancers (Basel). 2024 Feb 27;16(5):952. doi: 10.3390/cancers16050952.
BACKGROUND
Limited data exist on the prevalence of myosteatosis (i.e., excess accumulation of fat in skeletal muscles) in hepatocellular carcinoma (HCC) patients, and no systematic review or meta-analysis has been conducted in this context.
METHODS
We searched for articles published from inception until November 2023 to assess the prevalence of myosteatosis in patients with HCC.
RESULTS
Ten studies with 3316 patients focusing on myosteatosis and HCC were included. The overall prevalence of myosteatosis in HCC patients was 50% [95% Confidence Interval (CI): 35-65%]. Using the body mass index-based criteria (two studies), the prevalence was 34%, while gender-based criteria (eight studies) yielded 54% ( = 0.31). In Asian studies (n = 8), the prevalence was 45%, compared to 69% in non-Asian countries (two studies) ( = 0.02). For viral-associated HCC (eight studies), the prevalence was 49%, rising to 65% in non-alcoholic fatty liver disease-associated cases (three studies) and 86% in alcoholic liver disease-associated cases (three studies) ( < 0.01). The prevalence of myosteatosis was higher in Child-Pugh class C (3 studies, 91%) than in A (7 studies, 73%) or B (6 studies, 50%) ( = 0.02), but with no difference between Barcelona Clinic Liver Cancer stage A (3 studies, 66%), B (4 studies, 44%) and C (3 studies, 62%) ( = 0.80). Patients with myosteatosis had a significantly higher mortality (six studies) (Relative Risk: 1.35 (95%CI: 1.13-1.62, < 0.01).
CONCLUSION
The prevalence of myosteatosis is high in HCC patients and is associated with more severe liver disease and higher mortality rates.
背景
关于肝细胞癌（HCC）患者中肌脂肪变性（即骨骼肌中脂肪过度蓄积）的患病率数据有限，且尚未在此背景下进行系统评价或荟萃分析。
方法
我们检索了从创刊至2023年11月发表的文章，以评估HCC患者中肌脂肪变性的患病率。
结果
纳入了10项研究，共3316例关注肌脂肪变性和HCC的患者。HCC患者中肌脂肪变性的总体患病率为50%[95%置信区间（CI）：35 - 65%]。采用基于体重指数的标准（2项研究），患病率为34%，而基于性别的标准（8项研究）得出的患病率为54%（P = 0.31）。在亚洲的研究（n = 8）中，患病率为45%，相比之下，非亚洲国家的研究（2项）中患病率为69%（P = 0.02）。对于病毒相关性HCC（8项研究），患病率为49%，在非酒精性脂肪性肝病相关性病例（3项研究）中升至65%，在酒精性肝病相关性病例（3项研究）中为86%（P < 0.01）。Child-Pugh C级（3项研究，91%）患者的肌脂肪变性患病率高于A级（7项研究，73%）或B级（6项研究，50%）（P = 0.02），但巴塞罗那临床肝癌分期A期（3项研究，66%）、B期（4项研究，44%）和C期（3项研究，62%）之间无差异（P = 0.80）。有肌脂肪变性的患者死亡率显著更高（6项研究）（相对风险：1.35（95%CI：1.13 - 1.62，P < 0.01）。
结论
HCC患者中肌脂肪变性的患病率较高，且与更严重的肝病和更高的死亡率相关。
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