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Muscle fat infiltration assessed by total psoas density on computed tomography predicts mortality in cirrhosis
BACKGROUND: Ongoing evidence suggests that sarcopenia adversely affects outcomes in cirrhosis. The aim of this study was to evaluate muscle fat infiltration as a component of sarcopenia and its prognostic value in this setting. METHODS: In 98 consecutive patients with cirrhosis, muscle density was m...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Hellenic Society of Gastroenterology
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6033770/ https://www.ncbi.nlm.nih.gov/pubmed/29991895 http://dx.doi.org/10.20524/aog.2018.0256 |
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author | Kalafateli, Maria Karatzas, Andreas Tsiaoussis, Georgios Koutroumpakis, Efstratios Tselekouni, Paraskevi Koukias, Nikolaos Konstantakis, Christos Assimakopoulos, Stelios Gogos, Charalambos Thomopoulos, Konstantinos Kalogeropoulou, Christina Triantos, Christos |
author_facet | Kalafateli, Maria Karatzas, Andreas Tsiaoussis, Georgios Koutroumpakis, Efstratios Tselekouni, Paraskevi Koukias, Nikolaos Konstantakis, Christos Assimakopoulos, Stelios Gogos, Charalambos Thomopoulos, Konstantinos Kalogeropoulou, Christina Triantos, Christos |
author_sort | Kalafateli, Maria |
collection | PubMed |
description | BACKGROUND: Ongoing evidence suggests that sarcopenia adversely affects outcomes in cirrhosis. The aim of this study was to evaluate muscle fat infiltration as a component of sarcopenia and its prognostic value in this setting. METHODS: In 98 consecutive patients with cirrhosis, muscle density was measured during a computed tomography scan at the level of the fourth to fifth lumbar (L4) vertebrae. Univariate and multivariate Cox regression analysis was used to determine predictors of survival. RESULTS: Body mass index: median 26 (range 17-45.2); model for end-stage liver disease (MELD) score: median 11 (6-29); Child-Pugh (CP) score: median 7 (5-13), CP class: A=49 (50.5%), B=39 (40%), C=10 (9.5%); hepatocellular carcinoma: 14 (14.3%); follow up: median 45 (1-140) months. Median L4 total psoas area (TPA): 2022 (777-3806) mm(2); L4 average total psoas density (ATPD): 42.52 (21.26-59.8) HU. ATPD was significantly correlated with age (r=-0.222, P=0.034), creatinine (r=-0.41, P<0.001), albumin (r=0.224, P=0.035), MELD score (r=-0.218, P=0.034), and TPA (r=0.415, P<0.001). Fifty-four patients (55.1%) died during follow up. In the multivariate analysis, higher CP score (hazard ratio [HR] 1.2, 95% confidence interval [CI] 1.04-1.41), advanced age (HR 1.038, 95%CI 1.006-1.07) and lower ATPD (HR 0.967, 95%CI 0.937-0.997) were predictors of mortality. CONCLUSION: Muscle fat infiltration, as a result of sarcopenia, is a negative predictive factor of survival in cirrhosis, emphasizing the need for early identification of this subgroup of patients. |
format | Online Article Text |
id | pubmed-6033770 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Hellenic Society of Gastroenterology |
record_format | MEDLINE/PubMed |
spelling | pubmed-60337702018-07-10 Muscle fat infiltration assessed by total psoas density on computed tomography predicts mortality in cirrhosis Kalafateli, Maria Karatzas, Andreas Tsiaoussis, Georgios Koutroumpakis, Efstratios Tselekouni, Paraskevi Koukias, Nikolaos Konstantakis, Christos Assimakopoulos, Stelios Gogos, Charalambos Thomopoulos, Konstantinos Kalogeropoulou, Christina Triantos, Christos Ann Gastroenterol Original Article BACKGROUND: Ongoing evidence suggests that sarcopenia adversely affects outcomes in cirrhosis. The aim of this study was to evaluate muscle fat infiltration as a component of sarcopenia and its prognostic value in this setting. METHODS: In 98 consecutive patients with cirrhosis, muscle density was measured during a computed tomography scan at the level of the fourth to fifth lumbar (L4) vertebrae. Univariate and multivariate Cox regression analysis was used to determine predictors of survival. RESULTS: Body mass index: median 26 (range 17-45.2); model for end-stage liver disease (MELD) score: median 11 (6-29); Child-Pugh (CP) score: median 7 (5-13), CP class: A=49 (50.5%), B=39 (40%), C=10 (9.5%); hepatocellular carcinoma: 14 (14.3%); follow up: median 45 (1-140) months. Median L4 total psoas area (TPA): 2022 (777-3806) mm(2); L4 average total psoas density (ATPD): 42.52 (21.26-59.8) HU. ATPD was significantly correlated with age (r=-0.222, P=0.034), creatinine (r=-0.41, P<0.001), albumin (r=0.224, P=0.035), MELD score (r=-0.218, P=0.034), and TPA (r=0.415, P<0.001). Fifty-four patients (55.1%) died during follow up. In the multivariate analysis, higher CP score (hazard ratio [HR] 1.2, 95% confidence interval [CI] 1.04-1.41), advanced age (HR 1.038, 95%CI 1.006-1.07) and lower ATPD (HR 0.967, 95%CI 0.937-0.997) were predictors of mortality. CONCLUSION: Muscle fat infiltration, as a result of sarcopenia, is a negative predictive factor of survival in cirrhosis, emphasizing the need for early identification of this subgroup of patients. Hellenic Society of Gastroenterology 2018 2018-04-04 /pmc/articles/PMC6033770/ /pubmed/29991895 http://dx.doi.org/10.20524/aog.2018.0256 Text en Copyright: © Hellenic Society of Gastroenterology http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Kalafateli, Maria Karatzas, Andreas Tsiaoussis, Georgios Koutroumpakis, Efstratios Tselekouni, Paraskevi Koukias, Nikolaos Konstantakis, Christos Assimakopoulos, Stelios Gogos, Charalambos Thomopoulos, Konstantinos Kalogeropoulou, Christina Triantos, Christos Muscle fat infiltration assessed by total psoas density on computed tomography predicts mortality in cirrhosis |
title | Muscle fat infiltration assessed by total psoas density on computed tomography predicts mortality in cirrhosis |
title_full | Muscle fat infiltration assessed by total psoas density on computed tomography predicts mortality in cirrhosis |
title_fullStr | Muscle fat infiltration assessed by total psoas density on computed tomography predicts mortality in cirrhosis |
title_full_unstemmed | Muscle fat infiltration assessed by total psoas density on computed tomography predicts mortality in cirrhosis |
title_short | Muscle fat infiltration assessed by total psoas density on computed tomography predicts mortality in cirrhosis |
title_sort | muscle fat infiltration assessed by total psoas density on computed tomography predicts mortality in cirrhosis |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6033770/ https://www.ncbi.nlm.nih.gov/pubmed/29991895 http://dx.doi.org/10.20524/aog.2018.0256 |
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