肝硬化患者握力的截断点：一项多中心研究。
Cutoff points for handgrip strength in patients with liver cirrhosis: a multicenter study.
作者信息
Santos Bárbara Chaves, Alves Bruna Cherubini, Fonseca Ana Luisa Ferreira, Ferreira Samanta Catherine, Mizubuti Yani Gláucia Gomide, Saueressig Camila, Boulhosa Ramona Souza da Silva Baqueiro, Santos Lívia Alves Amaral, Cunha Carla de Magalhães, Lyra Andre Castro, Oliveira Lucivalda Pereira Magalhães, de Jesus Rosângela Passos, Romeiro Fernando Gomes, Dall'Alba Valesca, Luft Vivian Cristine, Correia Maria Isabel Toulson Davisson, Ferreira Lívia Garcia, Anastácio Lucilene Rezende
机构信息
Food Science Graduate Program, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
Gastroenterology and Hepatology Graduate Program, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
出版信息
Eur J Clin Nutr. 2025 May;79(5):484-489. doi: 10.1038/s41430-024-01563-0. Epub 2025 Jan 14.
OBJECTIVES
This study aimed to define handgrip strength (HGS) cutoff points to predict 1-year mortality in adult patients with liver cirrhosis.
METHODS
This is an analysis of cohort databases from four reference centers in Brazil. Inpatients or outpatients with cirrhosis and aged ≥18 years were included. The best cutoff values of HGS (highest value from three attempts with the non-dominant hand) for predicting 1-year mortality, stratified by sex and age, were established based on the sensitivity and specificity analyses. Adjusted Cox regression models were used to test the predictive value of low HGS.
RESULTS
The study included 724 patients with cirrhosis, with a median age of 57.0 years (IQR: 50.0-63.0), 66.4% (n = 481) male. Most patients had alcoholic cirrhosis (n = 281; 38.8%), 400 (55.3%) were classified as Child-Pugh B or C, and 134 (18.5%) patients died after 1-year. The HGS cutoffs were ≤33 kgf and ≤12 kgf for men and women aged <60 years, respectively, and ≤22 kgf and ≤10 kgf for older men and women, respectively (sensitivity: 70.9%; specificity: 61.2%). Low HGS was associated with a 2.5-fold increase in the risk of 1-year mortality.
CONCLUSION
These cutoff points could be used to identify patients with a higher mortality risk.
目的
本研究旨在确定握力（HGS）的临界值，以预测成年肝硬化患者的1年死亡率。
方法
这是一项对巴西四个参考中心队列数据库的分析。纳入年龄≥18岁的肝硬化住院患者或门诊患者。根据敏感性和特异性分析，确定按性别和年龄分层的预测1年死亡率的HGS最佳临界值（用非优势手进行三次尝试中的最高值）。采用校正后的Cox回归模型检验低HGS的预测价值。
结果
该研究纳入了724例肝硬化患者，中位年龄为57.0岁（四分位间距：50.0 - 63.0），男性占66.4%（n = 481）。大多数患者为酒精性肝硬化（n = 281；38.8%），400例（55.3%）被归类为Child-Pugh B级或C级，134例（18.5%）患者在1年后死亡。年龄<60岁的男性和女性的HGS临界值分别为≤33千克力和≤12千克力，年龄较大的男性和女性分别为≤22千克力和≤10千克力（敏感性：70.9%；特异性：61.2%）。低HGS与1年死亡风险增加2.5倍相关。
结论
这些临界值可用于识别死亡风险较高的患者。
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