J Hepatol:较低的皮下脂肪组织指数与女性肝硬化患者死亡率较高相关

2018-08-31 MedSci MedSci原创

较低的SAT与肝硬化女性患者的死亡率较高相关。皮下脂肪组织具有良好的代谢特征—较低的SATI可能反映了主要能量库的耗竭,导致了不良的临床结果。

研究背景和目的:骨骼肌和脂肪组织有不同的功能。本研究的目的是在肝硬化患者中,探讨骨骼肌、内脏和皮下脂肪组织的预后意义。

研究方法:来自677例患者第三腰椎的CT图像被量化为3个身体成分指数(cm2)/m2),内脏脂肪组织指数,皮下脂肪组织指数(SATI)和骨骼肌指数(SMI)。采用Cox比例和竞争分析危险模型进行了评估,评估死亡率与身体成分间的关系。

研究结果:大多数患者为男性(67%),平均年龄为57±7岁,晚末期肝病(MELD)评分为14±8,平均身体质量指数为27±6 kg/m2。尽管两性之间的身体质量指数相似,男性患者SMI(53±12比45±9 cm2/m2)更大,而女性(67±52比48±37 cm2/m2)SATI则更高(p<0.001)。在对MELD评分和其他混杂变量进行调整后,在性别分层的多元分析中,女性的SATI(危险比HR 0.99;95%可信区间0.98 - 1.00;p=0.01)和男性的SMI(HR 0.98;95%可信区间0.96 - -1.00;p=0。02)是重要的预测因子。女性患者的SATI (<60cm2/m2)越低,死亡风险越高 (HR 2.06; 95% CI 1.08-3.91; p=0.03)。在等待肝移植的女性患者中,调整MELD和其他混杂因素,采用竞争风险分析,研究表明较低的SATI也是一独立的死亡率预测因子(95%可信区间1.28 - -6.12; p=0.01)。

研究结论:较低的SAT与肝硬化女性患者的死亡率较高相关。皮下脂肪组织具有良好的代谢特征—较低的SATI可能反映了主要能量库的耗竭,导致了不良的临床结果。

原始出处

Ebadi M, Tandon P, Moctezuma-Velazquez C, et al. Low subcutaneous adiposity associates with higher mortality in female patients with cirrhosis. J Hepatol, 2018, 69(3), 608-616.

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    2018-09-02 gwc384
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    2018-08-31 guging

    谢谢!最新的信息读起来就是收获大

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