慢性乙型肝炎抗病毒治疗期间肝纤维化与阑尾骨骼肌质量的

StephenW

Association between liver fibrosis and appendicular skeletal muscle mass during antiviral therapy in chronic hepatitis B
Kyung Hyun Kim  1 , Dong Jin Joo  2 , Yong-Ho Lee  3 , Beom Kyung Kim  4 , Jun Yong Park  4 , Do Young Kim  4 , Sang Hoon Ahn  4 , Kwang-Hyub Han  4 , Seung Up Kim  5
Affiliations
Affiliations

    1
    Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
    2
    Department of Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea.
    3
    Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; Institute of Endocrine Research, Yonsei University College of Medicine, Seoul, Republic of Korea.
    4
    Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Republic of Korea; Yonsei Liver Center, Severance Hospital, Seoul, Republic of Korea.
    5
    Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Republic of Korea; Yonsei Liver Center, Severance Hospital, Seoul, Republic of Korea. Electronic address: [email protected].

    PMID: 32771386 DOI: 10.1016/j.dld.2020.07.004

Abstract

Background and aims: Sarcopenia is associated with fibrotic burden in patients with chronic hepatitis B. We investigated the dynamic association between fibrosis changes and appendicular skeletal muscle mass during antiviral therapy in patients with chronic hepatitis B.

Methods: Between 2015 and 2018, chronic hepatitis B patients who received paired transient elastography to assess fibrotic burden in the liver and bioelectrical impedance analysis to assess appendicular skeletal muscle mass were recruited retrospectively. The sarcopenia index was calculated as total appendicular skeletal muscle mass/body mass index. Significant liver fibrosis was defined as a liver stiffness value≥8 kPa.

Results: In total, 223 (53.7%) received antiviral therapy, whereas 192 (46.3%) did not. Appendicular skeletal muscle mass decreased significantly in the antiviral therapy group (mean 21.16→21.00 kg, P = 0.01), but not in the non-antiviral therapy group (mean 20.77→20.64 kg, P = 0.134). In a subgroup with significant liver fibrosis, similar findings were observed (mean 20.73→20.54 kg in antiviral therapy group, P = 0.037; mean 21.39→21.07 kg in the non-antiviral therapy group, P = 0.097). Older age, male gender, higher body mass index, and higher aspartate aminotransferase were significantly associated with the increased risk of appendicular skeletal muscle mass reduction (≥5% from the baseline).

Conclusions: Appendicular skeletal muscle mass significantly decreased during antiviral therapy in patients with chronic hepatitis B patients.

Keywords: Antiviral therapy; Appendicular skeletal muscle mass; Chronic hepatitis B; Liver fibrosis.

Copyright © 2020 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

StephenW

慢性乙型肝炎抗病毒治疗期间肝纤维化与阑尾骨骼肌质量的关系
金y贤1，董进Jo 2，李泳镐3，范京Kim 4，俊勇公园4，杜英金4，桑勋安4，光-韩4，成胜金5
隶属关系
隶属关系

    1个
    延世大学医学院内科，韩国首尔。
    2
    延世大学医学院外科，韩国首尔。
    3
    延世大学医学院内科，韩国首尔；延世大学医学院内分泌研究所，韩国首尔。
    4
    延世大学医学院内科，韩国首尔；延世大学医学院胃肠病研究所，韩国首尔；大韩民国首尔遣散医院延世肝脏中心。
    5
    延世大学医学院内科，韩国首尔；延世大学医学院胃肠病研究所，韩国首尔；大韩民国首尔遣散医院延世肝脏中心。电子地址：[email protected]。

    PMID：32771386 DOI：10.1016 / j.dld.2020.07.004

抽象

背景与目的：肌肉减少症与慢性乙型肝炎患者的纤维化负担有关。我们研究了慢性乙型肝炎患者在抗病毒治疗期间纤维化变化与阑尾骨骼肌质量之间的动态联系。

方法：回顾性研究2015年至2018年期间接受配对瞬时弹性成像评估肝脏纤维化负荷和生物电阻抗分析评估阑尾骨骼肌质量的慢性乙型肝炎患者。肌肉减少症指数计算为总的阑尾骨骼肌质量/体重指数。严重肝纤维化定义为肝硬度值≥8kPa。

结果：总共有223（53.7％）人接受了抗病毒治疗，而有192（46.3％）人未接受抗病毒治疗。抗病毒治疗组的阑尾骨骼肌质量显着降低（平均21.16→21.00 kg，P = 0.01），但非抗病毒治疗组未明显减少（平均20.77→20.64 kg，P = 0.134）。在具有明显肝纤维化的亚组中，观察到了相似的发现（抗病毒治疗组的平均值为20.73→20.54 kg，P = 0.037；非抗病毒治疗组的平均值为21.39→21.07 kg，P = 0.097）。老年人，男性，更高的体重指数和更高的天冬氨酸转氨酶与阑尾骨骼肌质量降低的风险增加相关（与基线相比≥5％）。

结论：慢性乙型肝炎患者在抗病毒治疗期间阑尾骨骼肌质量明显下降。

关键字：抗病毒治疗；附睾骨骼肌肿块；慢性乙型肝炎；肝纤维化。

版权所有©2020 Editrice Gastroenterologica Italiana S.r.l.由Elsevier Ltd.出版。保留所有权利。