Associations of sarcopenia with graft failure and mortality in patients undergoing living donor liver transplantation.

Recent studies have reported that sarcopenia influences morbidity and mortality in surgical patients. However, few studies have investigated the associations of sarcopenia with short-term and long-term graft failure in recipients after living donor liver transplantation (LDLT). In this study, we investigated the associations between sarcopenia and graft failure/mortality in patients undergoing LDLT. We retrospectively examined 2816 recipients who underwent LDLT between January 2008 and January 2018. Cox regression analysis was performed to evaluate the associations between sarcopenia and graft failure/mortality in recipients at 60 days, 180 days, and 1 year and overall. Sarcopenia in the recipient was significantly associated with 60-day graft failure (adjusted hazard ratio [HR], 1.98; 95% confidence interval [CI], 1.09-3.61; p = 0.03), 180-day graft failure (HR, 1.85; 95% CI, 1.19-2.88; p = 0.01), 1-year graft failure (HR, 1.45; 95% CI, 1.01-2.17; p = 0.05), and overall graft failure (HR, 1.42; 95% CI, 1.08-1.87; p = 0.01). In addition, recipient sarcopenia was associated with 180-day mortality (HR, 1.88; 95% CI, 1.17-3.01; p = 0.01), 1-year mortality (HR, 1.53; 95% CI, 1.01-2.29; p = 0.04), and overall mortality (HR, 1.43; 95% CI, 1.08-1.90; p = 0.01). Preoperative sarcopenia was associated with high rates of graft failure and mortality in LDLT recipients. Therefore, preoperative sarcopenia may be a strong predictor of the surgical prognosis in LDLT recipients.

Longitudinal Changes in Body Composition of Long-Term Survivors of Pancreatic Head Cancer and Factors Affecting the Changes.

Previous studies on changes in body composition of pancreatic cancer patients have only focused on short-term survivors. We studied longitudinal body composition changes and factors affecting them in long-term survivors by analyzing many abdominal computed tomography images using artificial intelligence technology. Of 302 patients who survived for >36 months after surgery were analyzed. Multivariate logistic regression analysis for factors affecting body composition changes and repeated-measures analysis of variance to observe differences in the course of change according to each factor were performed. In logistic analysis, preoperative sarcopenia and recurrence were the main factors influencing body composition changes at 1 and 3 years after surgery, respectively. In changes of longitudinal body composition, the decrease in body composition was the greatest at 3-6 months postoperatively, and the preoperative status did not recover even 3 years after surgery. Especially, males showed a greater reduction in skeletal muscle (SKM) after surgery than females (p < 0.01). In addition, SKM (p < 0.001) and subcutaneous adipose tissue (p < 0.05) mass rapidly decreased in case of recurrence. In conclusion, long-term survivors of pancreatic cancer did not recover their preoperative body composition status, and preoperative sarcopenia and recurrence influenced body composition changes.

Impact of Sarcopenia on Acute Kidney Injury after Infrarenal Abdominal Aortic Aneurysm Surgery: A Propensity Matching Analysis.

BACKGROUND: Sarcopenia contributes to increased morbidity and mortality in patients undergoing surgery for abdominal aortic aneurysms (AAA). However, few reports have demonstrated whether sarcopenia would affect the development of postoperative acute kidney injury (AKI) in these patients. This study aimed to examine whether sarcopenia is associated with AKI and morbidity and mortality after infrarenal AAA operation. METHODS: We retrospectively analysed 379 patients who underwent infrarenal AAA surgery. The diagnosis of sarcopenia was performed using the skeletal muscle index, which was calculated from axial computed tomography at the level of L3. The patients were separated into those with sarcopenia (n = 104) and those without sarcopenia (n = 275). We applied multivariable and Cox regression analyses to evaluate the risk factors for AKI and overall mortality. A propensity score matching (PSM) evaluation was done to assess the postoperative results. RESULTS: The incidence of AKI was greater in sarcopenia than non-sarcopenia group before (34.6% vs. 15.3%; p < 0.001) and after the PSM analysis (34.6% vs. 15.4%; p = 0.002). Multivariable analysis revealed sarcopenia to be associated with AKI before (p = 0.010) and after PSM (p = 0.016). Sarcopenia was also associated with overall mortality before (p = 0.048) and after PSM (p = 0.032). A Kaplan-Meier analysis revealed that overall mortality was elevated patients with sarcopenia before and after PSM than in those without (log-rank test, p < 0.001, p = 0.022). CONCLUSIONS: Sarcopenia was associated with increased postoperative AKI incidence and overall mortality among individuals who underwent infrarenal AAA operation.

Association between Sasang constitutional types with obesity factors and sleep quality.

BACKGROUND: The purpose of this study was to investigate differences in obesity factors according to Sasang constitutional types and quality of sleep among Korean female college students. METHODS: Surveys using Sasang-types questionnaires(QSCCⅡ) and quality of sleep questionnaires(PSQI; Pittsburgh Sleep Quality Index) were conducted with 339 Korean female college students. Additionally, obesity factors, including weight, fat mass, fat percent, abdominal fat percent, body mass index (BMI) and obesity rates were measured. All data analyses were performed using one-way ANOVA and two-way ANOVA. RESULTS: The interaction between Sasang types and quality of sleep was presented in the quality of sleep status, subjective quality of sleep (domain 1), sleep duration (domain 3) and sleep disturbance (domain 5). Variables with interaction effects had significant differences in terms of obesity factors between groups with different quality of sleep according to the Sasang types. Moreover, significant differences in obesity factors between different Sasang types according to the quality of sleep were also observed. CONCLUSION: This study characterized the reduction effect of improvement in quality of sleep on the fat mass of So-Yang type individuals and obesity factors in Tae-Eum type individuals. The results of this study will be used in improving sleep quality according to the Sasang types.

Validation of the Sasang Personality Questionnaire in high school students.

BACKGROUND: The Sasang Personality Questionnaire (SPQ) is an objective measure of Yin-Yang temperament of Sasang typology with proven clinical and structural validity; however, it has not been validated in people younger than 20 years. The purpose of this study was to examine the biopsychological structure of the SPQ in high school students. METHODS: A total of 670 Korean high school students (365 boys and 305 girls) completed the SPQ, Junior version of Temperament and Character Inventory (JTCI), and weight and height measures. The correlation between the SPQ and JTCI subscales was investigated, and the differences of these subscales, body mass index, and Pondera Index between the high (30%), middle (40%), and low (30%) SPQ total score groups were examined with analysis of variance. The profile analysis was also performed to compare JTCI subscale profiles of the three SPQ total score groups. RESULTS: The SPQ total score significantly correlated positively with JTCI novelty seeking (r = 0.548 and r = 0.540) and negatively with JTCI harm avoidance (r = -0.393 and r = -0.395) in boys and girls, respectively. The JTCI novelty-seeking score is significantly higher in the high SPQ total score group (24.12 ± 5.27 and 24.15 ± 5.17 for boys and girls, respectively) than in the low SPQ total score group (16.49 ± 5.08 and 17.24 ± 4.83, respectively), and the JTCI harm-avoidance score is significantly higher in the low SPQ total score group (25.34 ± 6.08 and 26.64 ± 5.77 for boys and girls, respectively) than in the high SPQ total score group (19.27 ± 6.62 and 19.23 ± 6.00, respectively). The JTCI subscale profiles for the three SPQ total score groups were significantly different for boys (degrees of freedom = 3.416, F = 292.16, p < 0.001) and girls (degrees of freedom = 3.4, F = 230.51, p < 0.001). There were no significant correlations or differences in body mass index and Pondera Index among the SPQ total score groups. CONCLUSION: The results showed that the biopsychological structure of the SPQ in adolescents is robust, similar to that in the adult population. The SPQ might be useful for the application of Sasang typology in pediatrics.

Comparisons of physical fitness and body composition among Sasang types with and without body mass index as a covariate.

BACKGROUND: The purpose of this study was to examine the difference of physical fitness and body composition among Sasang types with BMI as covariate, which is reported to have influence on physical fitness and body composition. METHODS: We measured the physical fitness and body composition of 930 korean female college students, and compared the differences among Sasang type groups with or without considering Body Mass Index (BMI). We evaluated muscle strength, agility, muscle endurance, power and flexibility for the physical fitness, and total body water, protein, muscle mass, mineral, lean body mass and fat mass for the body composition. RESULTS: We got 352 So-Yang (SY), 385 So-Eum (SE), and 193 Tae-Eum (TE) Sasang types, and there were significant differences among Sasang types in height, weight and BMI. The significant differences among TE and SY types were disappeared in muscle strength, total body water, protein when BMI is used as a covariate. In ANOVA, there were significant differences that TE was higher on the mineral and fat mass compared to the SY type and SE type. However it disappeared when we introduced BMI as covariate. CONCLUSION: The results demonstrated that the BMI should be considered as an important element for studying physical characteristics of Sasang typology.