医学
内科学
慢性肝病
胃肠病学
丙型肝炎病毒
队列
肝病
慢性肝炎
病毒
免疫学
肝硬化
作者
Atsushi Hiraoka,Kojiro Michitaka,Hirofumi Izumoto,Hidetaro Ueki,Shogo Kitahata,Toshihiko Aibiki,Tomonari Okudaira,Hiroka Yamago,Yuji Miyamoto,Ryuichiro Iwasaki,Hideomi Tomida,Kenichiro Mori,Hideki Miyata,Eiji Tsubouchi,Masato Kishida,Masashi Hirooka,Masanori Abe,Bunzo Matsuura,Tomoyuki Ninomiya,Yoichi Hiasa
摘要
Aim There are few reports regarding relative changes in muscle function of patients with chronic liver disease (CLD). We examined CLD patients to evaluate relative changes in handgrip strength and muscle volume. Methods We enrolled 413 CLD outpatients who underwent handgrip strength measurements in both 2015 and 2017 (age 67.9 ± 10.0 years; male / female = 242/171; hepatitis C virus [HCV] / hepatitis B virus [HBV] / HBV and HCV / alcohol / others = 239/92/4/22/56; Child–Pugh score [CPS] in 2015 [5/6/7/8/9/ ≥ 10 = 335/51/12/11/3/1]). Relative change in muscle volume (ΔPI) from 2015 to 2017 was evaluated using computed tomography findings in 230 of the patients, using a previously reported method. Clinical characteristics, as well as relative changes of handgrip strength (ΔHGS) and ΔPI were analyzed. Results For the patient cohort as a whole, CPS became significantly worse in 2017 (5/6/7/8/9/ ≥ 10 = 319/56/13/11/5/9; P = 0.002). In individual patients with CPS decline, serum albumin level was significantly decreased (3.78 ± 0.50 to 3.33 ± 0.61 g/dL; P < 0.001), whereas no decrease was seen in those without such a decline (4.16 ± 0.48 to 4.20 ± 0.44 g/dL; P = 0.028). Furthermore, ΔHGS (−1.4 ± 4.8 [ n = 59] vs. 0.7 ± 4.8 kg [ n = 354]; P = 0.002) and ΔPI (−0.44 ± 0.88 [ n = 38] vs. 0.03 ± 0.64 cm 2 /m 2 [ n = 192]; P = 0.003) were worse in patients with, compared to those without, a decline in CPS. Age was not significantly different between patients with and without handgrip strength decline (66.5 ± 10.3 vs. 65.3 ± 9.9 years; P = 0.256). There was a significant relationship between ΔHGS, ΔPI and relative change in serum albumin (r = 0.161, P = 0.001 and r = 0.225, P < 0.001, respectively). Conclusion Decline in CPS, especially decreasing serum albumin level, showed a significant relationship with muscle function reduction and muscle volume loss.
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