Sarcopenia—A Valuable Imaging Biomarker for Disease Progression in Patients With Primary Sclerosing Cholangitis (PSC)?

IF 5.2 2区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Liver International Pub Date : 2025-09-09 DOI:10.1111/liv.70328

Alena Levers, Judith Pantke, Filip Klimeš, Henrike Lenzen, Daniel Düx, Richard Taubert, Heiner Wedemeyer, Frank Wacker, Kristina I. Ringe

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Abstract

Background and Aims

We aimed to ascertain the prevalence of sarcopenia in patients with primary sclerosing cholangitis (PSC) and to assess the prognostic value as a biomarker for disease outcome.

Methods

We collected data from 224 patients (148 male, 76 female; mean age 41 years) from January 2002 to December 2021, with a confirmed diagnosis of PSC who underwent magnetic resonance imaging (MRI). Muscle mass was quantified at the level of the third lumbar vertebra by measurement of psoas muscle thickness (PMT) and total psoas muscle area (PMA). Sarcopenia was defined according to previously published cut-off values. Muscle mass and the prevalence of sarcopenia were correlated with patient and disease characteristics, prognostic scoring systems (model for end-stage liver disease (MELD) score; Mayo Risk Score; Amsterdam-Oxford PSC Score) and clinical endpoints (liver transplantation, cirrhosis decompensation, liver-related death).

Results

Seventy-eight patients reached a total of 104 clinical endpoints (liver transplantation n = 57, cirrhosis decompensation n = 28, liver-related death n = 19). Sarcopenia was prevalent in 27.7% and 51.3%, respectively (according to the definition of PMT and PMA). Sarcopenia was significantly more prevalent in female patients and in patients without IBD (p < 0.05). A slight but significant negative correlation of muscle mass was noticed with the MELD (r = −0.244, p = 0.001) and Mayo Risk Score (r = −0.13, p = 0.046). At follow-up, sarcopenia was associated with an inferior liver-related event-free survival (p < 0.05).

Conclusions

Sarcopenia is highly prevalent in a large PSC cohort from a tertiary care centre, even more frequent in female patients and in patients without concomitant IBD. Furthermore, the presence of sarcopenia in PSC patients is associated with an inferior liver-related event-free survival.

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骨骼肌减少-原发性硬化性胆管炎（PSC）患者疾病进展的有价值的成像生物标志物？

背景和目的我们旨在确定原发性硬化性胆管炎（PSC）患者肌肉减少症的患病率，并评估其作为疾病预后的生物标志物的预后价值。方法收集2002年1月至2021年12月确诊PSC的224例患者的资料，其中男性148例，女性76例，平均年龄41岁，行磁共振成像（MRI）检查。通过测量腰肌厚度（PMT）和总腰肌面积（PMA）在第三腰椎水平量化肌肉质量。肌少症是根据先前公布的临界值来定义的。肌肉质量和肌肉减少症患病率与患者和疾病特征、预后评分系统(终末期肝病模型（MELD）评分；梅奥风险评分；阿姆斯特丹-牛津PSC评分)和临床终点（肝移植、肝硬化失代偿、肝脏相关死亡）。结果78例患者共达到104个临床终点（肝移植57例，肝硬化失代偿28例，肝脏相关死亡19例）。骨骼肌减少症患病率分别为27.7%和51.3%（根据PMT和PMA的定义）。肌肉减少症在女性患者和非IBD患者中更为普遍（p < 0.05）。肌肉质量与MELD （r = - 0.244, p = 0.001）和Mayo风险评分（r = - 0.13, p = 0.046）呈轻微但显著的负相关。在随访中，肌肉减少症与低肝相关无事件生存率相关（p < 0.05）。结论：骨骼肌减少症在三级保健中心的PSC队列中非常普遍，在女性患者和无IBD的患者中更为常见。此外，PSC患者中肌肉减少症的存在与较差的肝脏相关无事件生存率相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Liver International 医学-胃肠肝病学

CiteScore

13.90

自引率

4.50%

发文量

348

审稿时长

2 months

期刊介绍： Liver International promotes all aspects of the science of hepatology from basic research to applied clinical studies. Providing an international forum for the publication of high-quality original research in hepatology, it is an essential resource for everyone working on normal and abnormal structure and function in the liver and its constituent cells, including clinicians and basic scientists involved in the multi-disciplinary field of hepatology. The journal welcomes articles from all fields of hepatology, which may be published as original articles, brief definitive reports, reviews, mini-reviews, images in hepatology and letters to the Editor.