肝移植受者肌肉质量下降与糖尿病发展的关系

IF 6.8 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM
Diabetes & Metabolism Journal Pub Date : 2024-01-01 Epub Date: 2024-01-03 DOI:10.4093/dmj.2022.0100
Sejeong Lee, Minyoung Lee, Young-Eun Kim, Hae Kyung Kim, Sook Jung Lee, Jiwon Kim, Yurim Yang, Chul Hoon Kim, Hyangkyu Lee, Dong Jin Joo, Myoung Soo Kim, Eun Seok Kang
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引用次数: 0

摘要

背景:移植后糖尿病(PTDM)是移植后最重要的并发症之一。需要接受移植手术的终末期肝病患者容易出现肌肉疏松症,但肌肉疏松症与 PTDM 之间的关系仍有待阐明。我们旨在研究术后肌肉质量下降对 PTDM 发生的影响:方法:纳入 2005 年至 2020 年期间在一家三甲医院接受肝移植手术的 500 名患者。方法:共纳入了 500 名 2005 年至 2020 年期间在三级甲等医院接受肝移植手术的患者,在移植前和移植后 1 年使用计算机断层扫描测量了 L3-L5 椎骨水平的骨骼肌面积。采用 Cox 比例危险模型研究了移植后肌肉面积的变化与 PTDM 发病率之间的关系:结果:在随访期间(中位数为 4.9 年),165 名患者(33%)发生了 PTDM。与未发生 PTDM 的患者相比,发生 PTDM 的患者肌肉质量损失更大。在对其他干扰因素进行调整后,肌肉损耗会明显增加患 PTDM 的风险(危险比为 1.50;95% 置信区间为 1.23 至 1.84;P=0.001)。在357名肌肉质量下降的受试者中,有124人(34.7%)患上了PTDM,而在肌肉质量维持组的143名患者中,有41人(28.7%)患上了PTDM。有肌肉损失的患者的PTDM累积发病率明显高于无肌肉损失的患者(P=0.034):结论:肝移植后肌肉消耗与 PTDM 发生风险增加有关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Association of Muscle Mass Loss with Diabetes Development in Liver Transplantation Recipients.

Backgruound: Post-transplant diabetes mellitus (PTDM) is one of the most significant complications after transplantation. Patients with end-stage liver diseases requiring transplantation are prone to sarcopenia, but the association between sarcopenia and PTDM remains to be elucidated. We aimed to investigate the effect of postoperative muscle mass loss on PTDM development.

Methods: A total of 500 patients who underwent liver transplantation at a tertiary care hospital between 2005 and 2020 were included. Skeletal muscle area at the level of the L3-L5 vertebrae was measured using computed tomography scans performed before and 1 year after the transplantation. The associations between the change in the muscle area after the transplantation and the incidence of PTDM was investigated using a Cox proportional hazard model.

Results: During the follow-up period (median, 4.9 years), PTDM occurred in 165 patients (33%). The muscle mass loss was greater in patients who developed PTDM than in those without PTDM. Muscle depletion significantly increased risk of developing PTDM after adjustment for other confounding factors (hazard ratio, 1.50; 95% confidence interval, 1.23 to 1.84; P=0.001). Of the 357 subjects who had muscle mass loss, 124 (34.7%) developed PTDM, whereas of the 143 patients in the muscle mass maintenance group, 41 (28.7%) developed PTDM. The cumulative incidence of PTDM was significantly higher in patients with muscle loss than in patients without muscle loss (P=0.034).

Conclusion: Muscle depletion after liver transplantation is associated with increased risk of PTDM development.

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来源期刊
Diabetes & Metabolism Journal
Diabetes & Metabolism Journal Medicine-Endocrinology, Diabetes and Metabolism
CiteScore
10.40
自引率
6.80%
发文量
92
审稿时长
52 weeks
期刊介绍: The aims of the Diabetes & Metabolism Journal are to contribute to the cure of and education about diabetes mellitus, and the advancement of diabetology through the sharing of scientific information on the latest developments in diabetology among members of the Korean Diabetes Association and other international societies. The Journal publishes articles on basic and clinical studies, focusing on areas such as metabolism, epidemiology, pathogenesis, complications, and treatments relevant to diabetes mellitus. It also publishes articles covering obesity and cardiovascular disease. Articles on translational research and timely issues including ubiquitous care or new technology in the management of diabetes and metabolic disorders are welcome. In addition, genome research, meta-analysis, and randomized controlled studies are welcome for publication. The editorial board invites articles from international research or clinical study groups. Publication is determined by the editors and peer reviewers, who are experts in their specific fields of diabetology.
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