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Clinical usefulness of psoas muscle thickness for the diagnosis of sarcopenia in patients with liver cirrhosis.
Clin Mol Hepatol 2018; 24(3):319-330CM

Abstract

BACKGROUND/AIMS

The most widely used method for diagnosing sarcopenia is the skeletal muscle index (SMI). Several studies have suggested that psoas muscle thickness per height (PMTH) is also effective for detecting sarcopenia and predicting prognosis in patients with cirrhosis. The aim of this study was to evaluate the optimal cutoff values of PMTH for detecting sarcopenia in cirrhotic patients.

METHODS

All cirrhotic patients who underwent abdominal computed tomography (CT) scan including L3 and umbilical levels for measuring SMI and transverse psoas muscle thickness, respectively, were included. Two definitions of sarcopenia were used: (1) sex-specific cutoffs of SMI (≤52.4 cm2 /m2 in men and ≤38.5 cm2 /m2 in women) for SMI-sarcopenia and (2) cutoff of PMTH (<16.8 mm/m) for PMTH-sarcopenia.

RESULTS

Six hundred fifty-three patients were included. The average age was 53.6 ± 10.2 years, and 499 patients (76.4%) were men. PMTH correlated well with SMI in both men and women (P<0.001). Two hundred forty-one (36.9%) patients met the criteria for SMI-sarcopenia. The best PMTH cutoff values for predicting SMI-sarcopenia were 17.3 mm/m in men and 10.4 mm/m in women, and these were defined as sex-specific cutoffs of PMTH (SsPMTH). The previously published cutoff of PMTH was defined as sex-nonspecific cutoff of PMTH (SnPMTH). Two hundred thirty (35.2%) patients were diagnosed with SsPMTH-sarcopenia, and 280 (44.4%) patients were diagnosed with SnPMTH-sarcopenia. On a multivariate Cox regression analysis, SsPMTH-sarcopenia (hazard ratio [HR], 1.944; 95% confidence interval [CI], 1.144-3.304; P=0.014) was significantly associated with mortality, while SnPMTH-sarcopenia was not (HR, 1.446; 95% CI, 0.861-2.431; P=0.164).

CONCLUSION

PMTH was well correlated with SMI in cirrhotic patients. SsPMTH-sarcopenia was an independent predictor of mortality in these patients and more accurately predicted mortality compared to SnPMTH-sarcopenia.

Authors+Show Affiliations

Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea.Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.Department of Gastroenterology, Adnan Menderes University Medical School, Aydin, Turkey.Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.Department of Biostatistics, Korea University College of Medicine, Seoul, Korea.Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29706058

Citation

Gu, Dae Hoe, et al. "Clinical Usefulness of Psoas Muscle Thickness for the Diagnosis of Sarcopenia in Patients With Liver Cirrhosis." Clinical and Molecular Hepatology, vol. 24, no. 3, 2018, pp. 319-330.
Gu DH, Kim MY, Seo YS, et al. Clinical usefulness of psoas muscle thickness for the diagnosis of sarcopenia in patients with liver cirrhosis. Clin Mol Hepatol. 2018;24(3):319-330.
Gu, D. H., Kim, M. Y., Seo, Y. S., Kim, S. G., Lee, H. A., Kim, T. H., ... Um, S. H. (2018). Clinical usefulness of psoas muscle thickness for the diagnosis of sarcopenia in patients with liver cirrhosis. Clinical and Molecular Hepatology, 24(3), pp. 319-330. doi:10.3350/cmh.2017.0077.
Gu DH, et al. Clinical Usefulness of Psoas Muscle Thickness for the Diagnosis of Sarcopenia in Patients With Liver Cirrhosis. Clin Mol Hepatol. 2018;24(3):319-330. PubMed PMID: 29706058.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical usefulness of psoas muscle thickness for the diagnosis of sarcopenia in patients with liver cirrhosis. AU - Gu,Dae Hoe, AU - Kim,Moon Young, AU - Seo,Yeon Seok, AU - Kim,Sang Gyune, AU - Lee,Han Ah, AU - Kim,Tae Hyung, AU - Jung,Young Kul, AU - Kandemir,Altay, AU - Kim,Ji Hoon, AU - An,Hyunggin, AU - Yim,Hyung Joon, AU - Yeon,Jong Eun, AU - Byun,Kwan Soo, AU - Um,Soon Ho, Y1 - 2018/04/30/ PY - 2017/12/04/received PY - 2018/02/05/accepted PY - 2018/5/1/pubmed PY - 2019/6/14/medline PY - 2018/5/1/entrez KW - Cirrhosis KW - Prognosis KW - Psoas muscle KW - Sarcopenia SP - 319 EP - 330 JF - Clinical and molecular hepatology JO - Clin Mol Hepatol VL - 24 IS - 3 N2 - BACKGROUND/AIMS: The most widely used method for diagnosing sarcopenia is the skeletal muscle index (SMI). Several studies have suggested that psoas muscle thickness per height (PMTH) is also effective for detecting sarcopenia and predicting prognosis in patients with cirrhosis. The aim of this study was to evaluate the optimal cutoff values of PMTH for detecting sarcopenia in cirrhotic patients. METHODS: All cirrhotic patients who underwent abdominal computed tomography (CT) scan including L3 and umbilical levels for measuring SMI and transverse psoas muscle thickness, respectively, were included. Two definitions of sarcopenia were used: (1) sex-specific cutoffs of SMI (≤52.4 cm2 /m2 in men and ≤38.5 cm2 /m2 in women) for SMI-sarcopenia and (2) cutoff of PMTH (<16.8 mm/m) for PMTH-sarcopenia. RESULTS: Six hundred fifty-three patients were included. The average age was 53.6 ± 10.2 years, and 499 patients (76.4%) were men. PMTH correlated well with SMI in both men and women (P<0.001). Two hundred forty-one (36.9%) patients met the criteria for SMI-sarcopenia. The best PMTH cutoff values for predicting SMI-sarcopenia were 17.3 mm/m in men and 10.4 mm/m in women, and these were defined as sex-specific cutoffs of PMTH (SsPMTH). The previously published cutoff of PMTH was defined as sex-nonspecific cutoff of PMTH (SnPMTH). Two hundred thirty (35.2%) patients were diagnosed with SsPMTH-sarcopenia, and 280 (44.4%) patients were diagnosed with SnPMTH-sarcopenia. On a multivariate Cox regression analysis, SsPMTH-sarcopenia (hazard ratio [HR], 1.944; 95% confidence interval [CI], 1.144-3.304; P=0.014) was significantly associated with mortality, while SnPMTH-sarcopenia was not (HR, 1.446; 95% CI, 0.861-2.431; P=0.164). CONCLUSION: PMTH was well correlated with SMI in cirrhotic patients. SsPMTH-sarcopenia was an independent predictor of mortality in these patients and more accurately predicted mortality compared to SnPMTH-sarcopenia. SN - 2287-285X UR - https://www.unboundmedicine.com/medline/citation/29706058/Clinical_usefulness_of_psoas_muscle_thickness_for_the_diagnosis_of_sarcopenia_in_patients_with_liver_cirrhosis_ L2 - http://e-cmh.org/journal/view.php?doi=10.3350/cmh.2017.0077 DB - PRIME DP - Unbound Medicine ER -