Imaging-based diagnosis of sarcopenia for transplant-free survival in primary sclerosing cholangitis.
BMC Gastroenterol
; 24(1): 145, 2024 Apr 25.
Article
em En
| MEDLINE
| ID: mdl-38664624
ABSTRACT
BACKGROUND:
Imaging-based assessment of sarcopenia is a well-validated prognostic tool for patients with chronic liver disease. However, little is known about its value in patients with primary sclerosing cholangitis (PSC). This cross-sectional study aimed to investigate the predictive value of the cross-sectional imaging-based skeletal muscle index (SMI) for transplant-free survival (TFS) in patients with PSC.METHODS:
A total of 95 patients with PSC who underwent abdominal cross-sectional imaging between 2008 and 2022 were included in this retrospective study. SMI was measured at the third lumbar vertebra level (L3-SMI). The cut-off values to define sarcopenia were < 50 cm²/m² in male patients and < 39 cm²/m² in female patients. The primary outcome of this study was TFS, which was defined as survival without liver transplantation or death from any cause.RESULTS:
Our study indicates that L3-SMI sarcopenia impairs TFS in patients with PSC (5-year TFS 33.9% vs. 83.3%, p = 0.001, log-rank test). L3-SMI sarcopenia was independently associated with reduced TFS via multivariate Cox regression analysis (HR = 2.749; p = 0.028). Body mass index reduction > 10% at 12 months, which is used as MELD standard exception (SE) criterion in Eurotransplant (in Germany only until September 2023), was not significantly associated with TFS in the multivariate Cox regression analysis (HR = 1.417; p = 0.330). Substitution of BMI reduction with L3-SMI in the German SE criteria improved the predictive accuracy of TFS compared to the established SE criteria (multivariable Cox regressionanalysis:
HR = 4.007, p < 0.001 vs. HR = 1.691, p = 0.141).CONCLUSION:
Imaging-based diagnosis of sarcopenia via L3-SMI is associated with a low TFS in patients with PSC and may provide additional benefits as a prognostic factor in patient selection for liver transplantation.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Contexto em Saúde:
6_ODS3_enfermedades_notrasmisibles
Base de dados:
MEDLINE
Assunto principal:
Colangite Esclerosante
/
Transplante de Fígado
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Sarcopenia
Limite:
Adult
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Female
/
Humans
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Male
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Middle aged
Idioma:
En
Revista:
BMC Gastroenterol
Ano de publicação:
2024
Tipo de documento:
Article