藏族肝硬化患者合并肌肉减少症的发病及相关因素

The prevalence and risk factors of sarcopenia in Tibetan patients with liver cirrhosis

目的探讨藏族肝硬化患者合并肌肉减少症的发病情况及危险因素。方法纳入2017年7月~2018年9月西藏自治区人民政府驻成都办事处医院住院的209名藏族肝硬化患者,收集相关临床资料。通过CT测量L3层面的肌肉横截面积,计算L3骨骼肌质量指数,确定肌肉减少症,并分析相关危险因素。结果41例未合并肌肉减少症组骨骼肌指数为(48.93±6.86)cm2/m2,168例合并肌肉减少症组骨骼肌指数为(37.50±7.20)cm2/m2,两组骨骼肌指数比较差异有统计学意义(P<0.01)。209例肝硬化患者中,肌肉减少症发生率为80.38%。男性肝硬化患者肌肉减少症明显高于女性(P<0.01)。以骨骼肌质量指数判断是否发生肌肉减少症为因变量,将年龄、性别、体重指数、白蛋白、胆固醇、甘油三酯、Child-Pugh分级作为自变量建立Logistic回归方程,最终体重指数、白蛋白、性别为发生肌肉减少症的危险因素。结论藏族肝硬化患者合并肌肉减少症较为普遍,且男性发生率高于女性,体重指数、白蛋白、性别是其主要危险因素。

Objective To explore the prevalence and risk factors of sarcopenia in Tibetan patients with liver cirrhosis.Methods 209 cirrhotic Tibetan patients were recruited prospectively between July,2017 and Sep,2018 in our hospital and the related clinical data were recorded.Their cross-sectional skeletal muscle areas at the level of the L3 vertebra were measured by computed tomography and sarcopenia was determined by L3 skeletal muscle index.Its risk factors were analyzed.Results The skeletal muscle index in 41 patients without sarcopenia was(48.93±6.86)cm2/m2,and the index in 168 patients with sarcopenia was(37.50±7.20)cm2/m2(P<0.01).Among the 209 cirrhotic Tibetan patients,the prevalence of sarcopenia was 80.38%.The prevalence of sarcopenia in male cirrhotic patients was significantly higher in than that in female(95.67%vs 27.65%,P<0.01).Logistic regression model was performed after setting sarcopenia according to the value of skeletal muscle index as the dependent variable,and age,gender,body mass index,albumin,cholesterol,triglyceride,Child-Pugh score were deemed as independent variables.We found that lower body mass index,decreased albumin and male gender,were found to be independently associated with increased risk of sarcopenia.Conclusion This study suggests that sarcopenia might be prevalent in Tibetan patients with liver cirrhosis.Sarcopenia might affect male patients more than female.Lower body mass index,decreased albumin and male gender are risk factors for sarcopenia.