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Prognostic significance of low skeletal muscle mass compared with protein–energy malnutrition in liver cirrhosis
Author(s) -
Nishikawa Hiroki,
Enomoto Hirayuki,
Ishii Akio,
Iwata Yoshinori,
Miyamoto Yuho,
Ishii Noriko,
Yuri Yukihisa,
Takata Ryo,
Hasegawa Kunihiro,
Nakano Chikage,
Nishimura Takashi,
Yoh Kazunori,
Aizawa Nobuhiro,
Sakai Yoshiyuki,
Ikeda Naoto,
Takashima Tomoyuki,
Iijima Hiroko,
Nishiguchi Shuhei
Publication year - 2017
Publication title -
hepatology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.123
H-Index - 75
eISSN - 1872-034X
pISSN - 1386-6346
DOI - 10.1111/hepr.12843
Subject(s) - cirrhosis , medicine , gastroenterology , hepatocellular carcinoma , cohort , body mass index , protein–energy malnutrition , receiver operating characteristic , multivariate analysis , malnutrition
Aims To investigate the impact of low skeletal muscle mass (LSMM) on survival as compared with protein–energy malnutrition (PEM) in patients with liver cirrhosis (LC). Methods A total of 206 individuals with LC were analyzed. We retrospectively examined the impact of LSMM, as defined by psoas muscle mass at the third lumber on computed tomography, on survival as compared with PEM. In terms of comparison of the effects of LSMM and PEM on survival, we used time‐dependent receiver operating characteristics (ROC) analysis. Results Our study cohort included 115 men and 91 women with a median age of 67 years. There were 140 patients with Child–Pugh A, 62 with Child–Pugh B, and 4 with Child–Pugh C. A total of 117 patients (56.8%) had LSMM and 52 patients (25.2%) had PEM. The proportion of PEM in patients with LSMM (31.62%, 37/117) was significantly higher than in patients without LSMM (16.85%, 15/89) ( P = 0.0229). In the multivariate analysis for the entire cohort, the presence of hepatocellular carcinoma, lower body mass index, presence of LSMM, lower triglyceride value, poorer renal function, and higher des‐γ‐carboxy prothrombin value were found to be significant adverse predictors linked to overall survival, while presence of PEM tended to be significant. In the time‐dependent ROC analysis, all area under the ROCs for survival in LSMM at each time point were higher than those in PEM except for Child‐Pugh B patients. Conclusion In this comparison of LSMM and PEM on clinical outcomes in LC patients, it was shown that LSMM may have stronger prognostic impact than PEM.