Skeletal muscle mass index as a predictor of long-term cirrhosis onset in young non-cirrhotic males with acute-on-chronic liver failure

作者全名："Bai, Jie; Xu, Manman; Peng, Fengling; Gong, Junwei; Zhao, Jinqiu; Song, Xiaodong; Li, Yongguo"

作者地址："[Bai, Jie; Peng, Fengling; Zhao, Jinqiu; Li, Yongguo] Chongqing Med Univ, Dept Infect Dis, Affiliated Hosp 1, Chongqing, Peoples R China; [Xu, Manman] Capital Med Univ, Difficult & Complicated Liver Dis & Artificial Liv, Dept Liver Dis 4, Beijing Youan Hosp, Beijing, Peoples R China; [Gong, Junwei] Chongqing Med Univ, Dept Radiol, Affiliated Hosp 1, Chongqing, Peoples R China; [Song, Xiaodong] Peking Univ Peoples Hosp, Dept Neurol, Beijing, Peoples R China"

通信作者："Li, YG (通讯作者)，Chongqing Med Univ, Dept Infect Dis, Affiliated Hosp 1, Chongqing, Peoples R China.; Song, XD (通讯作者)，Peking Univ Peoples Hosp, Dept Neurol, Beijing, Peoples R China."

来源：FRONTIERS IN NUTRITION

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:000907696700001

JCR分区：Q2

影响因子：5

年份：2022

卷号：9

期号：　

开始页：　

结束页：　

文献类型：Article

关键词：acute-on-chronic liver failure; skeletal muscle mass index; cirrhosis; prognosis; long-term; male

摘要："BackgroundThe relationship between skeletal muscle mass index (SMI) and cirrhosis incidence in patients with non-cirrhotic acute-on-chronic (ACLF) has not been clarified. This study aimed to assess the predictive value of SMI on the incidence of long-term cirrhosis in male non-cirrhotic ACLF patients. Materials and methodsMale ACLF patients who were free of liver cirrhosis were retrospectively included in this study. Univariate and multivariate logistic analyses were conducted to determine the risk factors for the long-term (1-year) development of cirrhosis. The receiver operating characteristic curves (ROC) were used to assess the ability of SMI levels to predict the incidence of cirrhosis. Restricted triple spline (RCS) described the dose-response relationship between SMI and the risk of cirrhosis. Subgroup analysis was stratified by age (<= 40 years and > 40 years). ResultsA total of 230 subjects were included in this study, of whom 45.2% (104/230) were diagnosed with cirrhosis within 360 days. Patients who progressed to cirrhosis had a lower SMI [46.1 +/- 6.9 versus 49.2 +/- 6.5 cm(2)/m(2), P = 0.001] and a higher proportion of sarcopenia (19.2% versus 6.3%, P = 0.003). In multivariate logistic regression, SMI remained a protective agent against 360-days progression to cirrhosis in males with ACLF after adjustment (OR 0.950, 95% CI: 0.908-0.994, P < 0.05). SMI exerted a non-linear dose-dependent effect on the risk of cirrhosis. The area under the ROC curve (AUC) for the L3-SMI to predict the incidence of cirrhosis in male non-cirrhotic ACLF patients was 0.636 (P < 0.001). We observed significant differences in SMI among male ACLF patients in different age groups. Further subgroup analysis by age revealed that lower SMI was associated with the 1-year incidence of cirrhosis in male ACLF patients aged less than 40 years (OR 0.908, 95% CI: 0.842-0.979, P < 0.05), whereas SMI did not affect the 1-year risk of cirrhosis in older subjects (age > 40 years). ConclusionA higher SMI represents an independent protective factor for developing long-term cirrhosis in male ACLF patients who do not experience cirrhosis, especially in those under 40 years of age."

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