Analysis Of The Incidence And Related Factors Of Cirrhosis-associated Sarcopenia

Objective: To explore the characteristics of cirrhosis-associated sarcopenia,sarcopenic obesity;subgroup analysis of related factors affecting cirrhosis-associated sarcopenia;and analysis the relationship between sarcopenia and body composition and clinical outcomes.Methods: A retrospective analysis was conducted from June 1,2015 to September 30,2017 on patients admitted to the organ transplant center and gastrointestinal surgery at the Affiliated Hospital of Qingdao University,and patients admitted to the physical examination center.The subjects were collected and screened according to the inclusion criteria and divided into cirrhosis group(L group),gastric cancer group(G group)and healthy control group(H group).The skeletal muscle area of the cross section of the third lumbar vertebra was measured by CT,and the skeletal muscle index was further calculated by the BMI or measuring the visceral fat area at the level of the umbilicus to diagnose sarcopenia and sarcopenic obesity.We collected related data.Descriptive and correlational analyses were conducted.Results: A total of 253 samples were included in this study,101 in the cirrhosis group,101 in the gastric cancer group,and 51 in the healthy control group.The incidence of sarcopenia in the cirrhotic population(79.21%)was significantly greater than that of gastric cancer(56.44%)and healthy population(39.22%).In the cirrhotic group,there were 65 cases of male sarcopenia with an incidence of 83.27% and 15 cases of female sarcopenia,and the incidence rate was 68.18%.There was no significant difference between the two groups(P > 0.05).The incidence of sarcopenia in patients with cirrhosis complicated with liver cancer was similar to that cirrhosis without liver cancer,with no significant difference(75.93 vs.82.99%,P = 0.38);the rate of sarcopenic obesity in patients with cirrhosis complicated with liver cancer was 29.63%,which was significantly higher than that of cirrhosis without liver cancer(10.64%).About 27.5% of the patients with sarcopenic obesity in cirrhosis patients have diabetes mellitus,which is higher than people without sarcopenic obesity(9.52%);among the 24 patients with diabetes mellitus,22 patients have sarcopenia(91.67%).Eight patients had sarcopenic obesity(33.33%).Muscle mass is related to area(r = 0.46,P < 0.01),whereas fat area is negatively correlated with fat density(r =-0.69,P < 0.01);serum albumin content is related to muscle density(r = 0.20,P = 0.05).The higher the muscle density,the less postoperative albumin use(r =-0.26,P = 0.01).Triglyceride levels are positively correlated with body fat area(r = 0.36,P < 0.01).The skeletal muscle area was negatively correlated with the MELD score that suggested the prognosis of liver transplantation(r =-0.24,P = 0.02).Conclusion: The incidence of cirrhosis-associated sarcopenia is greater than that of gastric cancer patie nts and healthy people.The incidence of sarcopenic obesity in patients with cirrhosis complicated with liver cancer was higher than that in patients without liver cancer.The occurrence of cirrhosis-associated sarcopenia is closely related to diabetes.