Psoas Muscle Index Can Be Used to Predict Long-Term Mortality in Young Male Patients With Acute-on-Chronic Liver Failure

Xu, Manman; Li, Tongzeng; Kong, Ming; Geng, Ning; Song, Wenyan; Guo, Guanya; Duan, Zhongping; Han, Ying; Chen, Yu

doi:10.3389/fnut.2022.811826

Cited by 8 publications

(11 citation statements)

References 29 publications

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“…Interestingly, the results of this study detected the predictive value of SMI for the clinical outcome of ACLF in young men up to 40 in age, but not in older men. Similar to this work, our earlier study failed to observe the correlation between PMI and mortality in men older than 40 years with ACLF ( 20 ). The possible reason is that, in older individuals, aging has a greater effect on reducing skeletal muscle mass than liver failure.…”

Section: Discussionsupporting

confidence: 88%

“…Our previous study revealed that muscle loss is particularly pronounced after the age of 40 ( 13 ). Besides, we found that L3-PMI was independently associated with 1-year mortality in male ACLF patients younger than 40 years, which was not observed in male ACLF patients beyond 40 years ( 20 ). Thus, we assessed SMI levels in the age ≤ 40 years and > 40 years groups, respectively.…”

Section: Resultsmentioning

confidence: 91%

“…Sarcopenia contributes to unfavorable outcomes in patients with liver disease, of which ACLF is no exception ( 9 , 12 , 16 , 24 , 25 ). Previous studies have revealed that a high PMI or SMI reduces the risk of death in patients with ACLF ( 12 , 16 , 20 ). Our findings confirmed the predictive value of SMI in long-term progression to cirrhosis for male ACLF patients in the absence of a history of cirrhosis.…”

Section: Discussionmentioning

confidence: 99%

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

Bai

Peng

et al. 2022

Front. Nutr.

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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 cm2/m2, 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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Section: Discussionsupporting

confidence: 88%

Section: Resultsmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

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

Bai

Peng

et al. 2022

Front. Nutr.

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“…A new PMI-based criterion for skeletal muscle mass has been established using data from healthy young Asian adults, which defines a cut-off value for sarcopenia in Asian populations [ 18 ]. In addition to evaluating sarcopenia, PMI can predict long-term mortality in young men with chronic or acute liver failure [ 19 ]. Several other studies have shown that PMI can be applied to Marfan syndrome and the prognosis of different tumor surgeries [ 20 , 21 ].…”

Section: Discussionmentioning

confidence: 99%

Correlation of Psoas Muscle Index with Fragility Vertebral Fracture: A Retrospective Cross-Sectional Study of Middle-Aged and Elderly Women

Zhang

Dilixiati

Jiang

et al. 2022

International Journal of Endocrinology

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Objective. To investigate the correlation of psoas muscle index (PMI) with fragility vertebral fracture. Methods. A total of 184 middle-aged and elderly women were included in the study. We measured the bilateral psoas muscle area on the picture archiving and communication system (PACS) from computed tomography images and calculated PMI. We observed lateral radiographs of the thoracolumbar spine and assessed vertebral fractures using the Genant semiquantitative method. The T-score, bone mineral density (BMD) of the lumbar (L)1-4, femoral neck, and trochanter were measured by dual-energyX-ray absorptiometry (DXA). The data was collected and then statistically analyzed. Results. The PMI of the nonosteoporosis group was higher than that of the osteoporosis group ( P value = 0.006). Height in the nonosteoporosis group was higher than that in the osteoporosis group ( P value = 0.013). Weight, body mass index (BMI), left psoas muscle area, BMD of the L1-4, femoral neck, femoral trochanter, and T-score in the nonosteoporosis group were higher than those in the osteoporosis group ( P value <0.001). The right psoas muscle area in the nonosteoporosis group was higher than that in the osteoporosis group ( P value = 0.008). The incidence of combined thoracolumbar fracture was significantly higher in the osteoporosis group than that in the nonosteoporosis group ( P value <0.001). For nonosteoporosis subjects, the PMI of the vertebral fracture group was lower than that of the nonvertebral fracture group ( P value = 0.034). Conclusions. A decrease in height, weight, BMI, bilateral psoas muscle area, and PMI is associated with osteoporosis. Combined thoracolumbar fractures are more common in osteoporosis. Sarcopenia may be an independent risk factor for nonosteoporotic vertebral fractures.

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“…Other studies have attempted to use the total psoas area or the psoas muscle index at L3/L4 [50]. However, there is a lack of evidence supporting a significant correlation between the psoas muscle and total body muscle and its association with the prognosis of sarcopenia in patients with cirrhosis [28,51]. Meanwhile, there is significant correlation in muscle measurements between T12/L4 and L3 [36,52,53], so it is possible that muscle mass measurement at other vertebral segments apart from L3 could also accurately diagnose sarcopenia and predict survival in patients with cirrhosis and sarcopenia, though further studies are needed before this measurement can be widely recommended.…”

Section: Muscle Mass/quantitymentioning

confidence: 99%

Sarcopenia in cirrhosis: epidemiology, diagnosis, management and prognosis

Liu

Nguyen³

2023

Current Opinion in Gastroenterology

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Purpose of review With the development of many international guidelines, research on sarcopenia has increased rapidly, showing that sarcopenia is predictive of adverse outcomes, including increased mortality and impaired mobility, in patients with cirrhosis. The purpose of this article is to review the current evidence concerning the epidemiology, diagnosis, management and predictive value of sarcopenia on the prognosis of patients with cirrhosis. Recent findings Sarcopenia is a frequent and lethal complication of cirrhosis. Currently, abdominal computed tomography imaging is the most commonly used method to diagnose sarcopenia. In clinical practice, assessing muscle strength and physical performance, such as by measuring handgrip strength and gait speed, is of increasing interest. In addition to the necessary pharmacological therapy, adequate intake of protein, energy and micronutrients, as well as regular moderate-intensity exercise, can help to minimize sarcopenia. Sarcopenia has been shown to be a strong predictor of prognosis in patients with severe liver disease. Summary A global consensus is needed on the definition and operational parameters for the diagnosis of sarcopenia. Further research should focus on developing standardized screening, management and treatment protocols for sarcopenia. Adding sarcopenia to existing models may better exploit the effect of sarcopenia on prognosis in patients with cirrhosis, which should be investigated further.

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Psoas Muscle Index Can Be Used to Predict Long-Term Mortality in Young Male Patients With Acute-on-Chronic Liver Failure

Cited by 8 publications

References 29 publications

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

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

Correlation of Psoas Muscle Index with Fragility Vertebral Fracture: A Retrospective Cross-Sectional Study of Middle-Aged and Elderly Women

Sarcopenia in cirrhosis: epidemiology, diagnosis, management and prognosis

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