Psoas muscle index in sarcopenia following transjugular intrahepatic portosystemic shunt: A multicenter, retrospective study
Abstract Aims Although the skeletal muscle index at the third lumbar vertebra (L3‐SMI) is commonly utilized for the diagnosis of sarcopenia, the psoas muscle index at L3 (L3‐PMI) may serve as a reliable alternative indicator. This study aims to investigate the application of the PMI in patients who...
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| Format: | Article |
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Wiley
2024-12-01
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| Series: | Portal Hypertension & Cirrhosis |
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| Online Access: | https://doi.org/10.1002/poh2.94 |
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| author | Tongqiang Li Ze Wang Yang Liu Liguo Dai Xiaoli Zhu Jiacheng Liu Qikun Guo Weijie Luo Yaowei Bai Wei Luo Menglan Chu Duiping Feng Bin Xiong |
| author_facet | Tongqiang Li Ze Wang Yang Liu Liguo Dai Xiaoli Zhu Jiacheng Liu Qikun Guo Weijie Luo Yaowei Bai Wei Luo Menglan Chu Duiping Feng Bin Xiong |
| author_sort | Tongqiang Li |
| collection | DOAJ |
| description | Abstract Aims Although the skeletal muscle index at the third lumbar vertebra (L3‐SMI) is commonly utilized for the diagnosis of sarcopenia, the psoas muscle index at L3 (L3‐PMI) may serve as a reliable alternative indicator. This study aims to investigate the application of the PMI in patients who have undergone transjugular intrahepatic portosystemic shunt (TIPS). Methods This study included a cohort of 406 patients with cirrhosis who underwent TIPS between February 2016 and July 2022 across three medical centers in China. Clinical and imaging data, specifically L3‐SMI and L3‐PMI, were collected for these patients. The prognosis of the patients was assessed through re‐examinations and telephone follow‐ups, which extended up to 5 years. The diagnostic thresholds for sarcopenia, as defined by L3‐PMI and L3‐SMI, were established at 6.36 or 42.00 cm²/m² for males and 3.92 or 38.00 cm²/m² for females, respectively. Cox proportional hazards and Kaplan–Meier (K‐M) analyses were employed to evaluate patient survival. Results The findings indicated that both L3‐PMI and L3‐SMI before TIPS were independent risk factors for mortality. The results of the paired t‐test demonstrated a significant increase in L3‐PMI 1 month post‐TIPS (5.11 ± 1.81 vs. 5.71 ± 1.90 cm²/m², p < 0.001), whereas L3‐SMI did not exhibit a significant increase until 6 months post‐TIPS (45.45 ± 9.41 vs. 48.59 ± 10.38 cm²/m², p < 0.001). Among these patients, 191 (47.0%) and 159 (39.2%) were diagnosed with sarcopenia according to the L3‐PMI and L3‐SMI models, respectively. Patients identified as sarcopenic by both indicators demonstrated a significantly lower survival rate (L3‐SMI model: hazard ratio [HR], 1.913; 95% confidence interval [CI], 1.094–3.410; log‐rank p = 0.020; L3‐PMI model: HR, 1.867; 95% CI, 1.059–3.290; log‐rank p = 0.030). In sarcopenic patients, the reversal of sarcopenia associated with improved survival occurred 1 month after TIPS in the L3‐PMI model (HR, 2.675; 95% CI, 1.245–5.735; log‐rank p = 0.012), while a similar effect was not observed until 6 months post‐TIPS in the L3‐SMI model (HR, 3.342; 95% CI, 1.477–7.560; log‐rank p = 0.004). Conclusions L3‐PMI and L3‐SMI demonstrate comparable efficacy in diagnosing cirrhosis‐related sarcopenia. Furthermore, L3‐PMI has the capacity to identify improvements in sarcopenia as early as 1 month following TIPS, thereby providing earlier insights into patient survival outcomes. |
| format | Article |
| id | doaj-art-9def1ea87b62477aa4ecddcadb709fbf |
| institution | OA Journals |
| issn | 2770-5838 2770-5846 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Wiley |
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| series | Portal Hypertension & Cirrhosis |
| spelling | doaj-art-9def1ea87b62477aa4ecddcadb709fbf2025-08-20T01:58:08ZengWileyPortal Hypertension & Cirrhosis2770-58382770-58462024-12-013417318310.1002/poh2.94Psoas muscle index in sarcopenia following transjugular intrahepatic portosystemic shunt: A multicenter, retrospective studyTongqiang Li0Ze Wang1Yang Liu2Liguo Dai3Xiaoli Zhu4Jiacheng Liu5Qikun Guo6Weijie Luo7Yaowei Bai8Wei Luo9Menglan Chu10Duiping Feng11Bin Xiong12Department of Interventional Radiology The First Affiliated Hospital of Guangzhou Medical University Guangzhou Guangdong ChinaDepartment of Interventional Radiology The First Affiliated Hospital of Soochow University Suzhou Jiangsu ChinaDepartment of Oncological and Vascular Intervention First Hospital of Shanxi Medical University Taiyuan Shanxi ChinaDepartment of Interventional Radiology The First Affiliated Hospital of Guangzhou Medical University Guangzhou Guangdong ChinaDepartment of Interventional Radiology The First Affiliated Hospital of Soochow University Suzhou Jiangsu ChinaDepartment of Radiology, Union Hospital, Tongji Medical College Huazhong University of Science and Technology Wuhan Hubei ChinaDepartment of Interventional Radiology The First Affiliated Hospital of Guangzhou Medical University Guangzhou Guangdong ChinaDepartment of Interventional Radiology The First Affiliated Hospital of Guangzhou Medical University Guangzhou Guangdong ChinaDepartment of Radiology, Union Hospital, Tongji Medical College Huazhong University of Science and Technology Wuhan Hubei ChinaDepartment of Interventional Radiology The First Affiliated Hospital of Guangzhou Medical University Guangzhou Guangdong ChinaDepartment of Interventional Radiology The First Affiliated Hospital of Guangzhou Medical University Guangzhou Guangdong ChinaDepartment of Oncological and Vascular Intervention First Hospital of Shanxi Medical University Taiyuan Shanxi ChinaHepatobiliary and Pancreatic Interventional Treatment Center, Division of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital Zhejiang University School of Medicine Hangzhou Zhejiang ChinaAbstract Aims Although the skeletal muscle index at the third lumbar vertebra (L3‐SMI) is commonly utilized for the diagnosis of sarcopenia, the psoas muscle index at L3 (L3‐PMI) may serve as a reliable alternative indicator. This study aims to investigate the application of the PMI in patients who have undergone transjugular intrahepatic portosystemic shunt (TIPS). Methods This study included a cohort of 406 patients with cirrhosis who underwent TIPS between February 2016 and July 2022 across three medical centers in China. Clinical and imaging data, specifically L3‐SMI and L3‐PMI, were collected for these patients. The prognosis of the patients was assessed through re‐examinations and telephone follow‐ups, which extended up to 5 years. The diagnostic thresholds for sarcopenia, as defined by L3‐PMI and L3‐SMI, were established at 6.36 or 42.00 cm²/m² for males and 3.92 or 38.00 cm²/m² for females, respectively. Cox proportional hazards and Kaplan–Meier (K‐M) analyses were employed to evaluate patient survival. Results The findings indicated that both L3‐PMI and L3‐SMI before TIPS were independent risk factors for mortality. The results of the paired t‐test demonstrated a significant increase in L3‐PMI 1 month post‐TIPS (5.11 ± 1.81 vs. 5.71 ± 1.90 cm²/m², p < 0.001), whereas L3‐SMI did not exhibit a significant increase until 6 months post‐TIPS (45.45 ± 9.41 vs. 48.59 ± 10.38 cm²/m², p < 0.001). Among these patients, 191 (47.0%) and 159 (39.2%) were diagnosed with sarcopenia according to the L3‐PMI and L3‐SMI models, respectively. Patients identified as sarcopenic by both indicators demonstrated a significantly lower survival rate (L3‐SMI model: hazard ratio [HR], 1.913; 95% confidence interval [CI], 1.094–3.410; log‐rank p = 0.020; L3‐PMI model: HR, 1.867; 95% CI, 1.059–3.290; log‐rank p = 0.030). In sarcopenic patients, the reversal of sarcopenia associated with improved survival occurred 1 month after TIPS in the L3‐PMI model (HR, 2.675; 95% CI, 1.245–5.735; log‐rank p = 0.012), while a similar effect was not observed until 6 months post‐TIPS in the L3‐SMI model (HR, 3.342; 95% CI, 1.477–7.560; log‐rank p = 0.004). Conclusions L3‐PMI and L3‐SMI demonstrate comparable efficacy in diagnosing cirrhosis‐related sarcopenia. Furthermore, L3‐PMI has the capacity to identify improvements in sarcopenia as early as 1 month following TIPS, thereby providing earlier insights into patient survival outcomes.https://doi.org/10.1002/poh2.94cirrhosisportal hypertensionpsoas muscle indexsarcopeniaskeletal muscle indextransjugular intrahepatic portosystemic shunt |
| spellingShingle | Tongqiang Li Ze Wang Yang Liu Liguo Dai Xiaoli Zhu Jiacheng Liu Qikun Guo Weijie Luo Yaowei Bai Wei Luo Menglan Chu Duiping Feng Bin Xiong Psoas muscle index in sarcopenia following transjugular intrahepatic portosystemic shunt: A multicenter, retrospective study Portal Hypertension & Cirrhosis cirrhosis portal hypertension psoas muscle index sarcopenia skeletal muscle index transjugular intrahepatic portosystemic shunt |
| title | Psoas muscle index in sarcopenia following transjugular intrahepatic portosystemic shunt: A multicenter, retrospective study |
| title_full | Psoas muscle index in sarcopenia following transjugular intrahepatic portosystemic shunt: A multicenter, retrospective study |
| title_fullStr | Psoas muscle index in sarcopenia following transjugular intrahepatic portosystemic shunt: A multicenter, retrospective study |
| title_full_unstemmed | Psoas muscle index in sarcopenia following transjugular intrahepatic portosystemic shunt: A multicenter, retrospective study |
| title_short | Psoas muscle index in sarcopenia following transjugular intrahepatic portosystemic shunt: A multicenter, retrospective study |
| title_sort | psoas muscle index in sarcopenia following transjugular intrahepatic portosystemic shunt a multicenter retrospective study |
| topic | cirrhosis portal hypertension psoas muscle index sarcopenia skeletal muscle index transjugular intrahepatic portosystemic shunt |
| url | https://doi.org/10.1002/poh2.94 |
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