L3 Skeletal Muscle Index Dynamics in Patients with HCV-Related Compensated Cirrhosis Following Sustained Virological Response after Direct Acting Antiviral Treatment
<i>Background and Objectives</i>: Sarcopenia is commonly associated with liver cirrhosis and predicts clinical outcome. Our aim was to identify the changes in skeletal muscle index (SMI) on computed tomography (CT) examination, as a quantitative marker of sarcopenia, in patients with HCV...
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MDPI AG
2021-11-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/57/11/1226 |
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| author | Florin Mihai Anca Trifan Carol Stanciu Laura Huiban Cristina Muzîca Corina Lupașcu-Ursulescu Dragoș Negru Marius Lucian Savin Irina Gîrleanu Tudor Cuciureanu Ana Maria Sîngeap |
| author_facet | Florin Mihai Anca Trifan Carol Stanciu Laura Huiban Cristina Muzîca Corina Lupașcu-Ursulescu Dragoș Negru Marius Lucian Savin Irina Gîrleanu Tudor Cuciureanu Ana Maria Sîngeap |
| author_sort | Florin Mihai |
| collection | DOAJ |
| description | <i>Background and Objectives</i>: Sarcopenia is commonly associated with liver cirrhosis and predicts clinical outcome. Our aim was to identify the changes in skeletal muscle index (SMI) on computed tomography (CT) examination, as a quantitative marker of sarcopenia, in patients with HCV-related cirrhosis after direct acting antivirals (DAAs) treatment and to assess predictive factors for the evolution of SMI. <i>Materials and Methods:</i> This is a single center retrospective study in patients with HCV-related compensated cirrhosis who obtained sustained virological response (SVR) after DAAs. CT examinations were performed in 52 patients before and within 5–24 months after treatment. The total muscle area (<i>TMA</i>) of abdominal muscle at the level of third lumbar vertebra (L3) was measured at baseline and after SVR. The L3-SMI was calculated from <i>TMA</i> divided by body height squared (cm<sup>2</sup>/m<sup>2</sup>). We assessed changes in L3-SMI after SVR according to baseline body mass index (BMI) and laboratory data. Predictive factors were assessed by linear regression model. <i>Results:</i> Patients with L3-SMI above the gender-specific cut-off value at baseline had higher values of serum creatinine (median 0.73) compared to patients with low L3-SMI (median 0.68, <i>p</i> = 0.031). After SVR, 14 patients showed increase of L3-SMI, and 38 patients had a decrease of L3-SMI. BMI in the decreased L3-SMI group was significantly lower (median 26.17) than those without decreased L3-SMI (median 28.84, <i>p</i> = 0.021). ALT values in the decreased L3-SMI group (median 66.5) were significantly lower than those without a decrease in L3-SMI (median 88, <i>p</i> = 0.045). <i>Conclusions:</i> Low creatinine serum level correlates with sarcopenia. SMI was partially influenced by the viral clearance. Lower BMI and ALT serum levels at baseline were predictive for no benefit in terms of muscle mass dynamics. Understanding all the mechanisms involved in sarcopenia and identifying the most vulnerable patients could ensure optimal adapted care strategies. |
| first_indexed | 2024-03-10T05:17:22Z |
| format | Article |
| id | doaj.art-023feb1e72984b7ca1c3bc294f6b8274 |
| institution | Directory Open Access Journal |
| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-10T05:17:22Z |
| publishDate | 2021-11-01 |
| publisher | MDPI AG |
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| series | Medicina |
| spelling | doaj.art-023feb1e72984b7ca1c3bc294f6b82742023-11-23T00:17:37ZengMDPI AGMedicina1010-660X1648-91442021-11-015711122610.3390/medicina57111226L3 Skeletal Muscle Index Dynamics in Patients with HCV-Related Compensated Cirrhosis Following Sustained Virological Response after Direct Acting Antiviral TreatmentFlorin Mihai0Anca Trifan1Carol Stanciu2Laura Huiban3Cristina Muzîca4Corina Lupașcu-Ursulescu5Dragoș Negru6Marius Lucian Savin7Irina Gîrleanu8Tudor Cuciureanu9Ana Maria Sîngeap10Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, RomaniaFaculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, RomaniaFaculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, RomaniaFaculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, RomaniaFaculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, RomaniaFaculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, RomaniaFaculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, RomaniaFaculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, RomaniaFaculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, RomaniaFaculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, RomaniaFaculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania<i>Background and Objectives</i>: Sarcopenia is commonly associated with liver cirrhosis and predicts clinical outcome. Our aim was to identify the changes in skeletal muscle index (SMI) on computed tomography (CT) examination, as a quantitative marker of sarcopenia, in patients with HCV-related cirrhosis after direct acting antivirals (DAAs) treatment and to assess predictive factors for the evolution of SMI. <i>Materials and Methods:</i> This is a single center retrospective study in patients with HCV-related compensated cirrhosis who obtained sustained virological response (SVR) after DAAs. CT examinations were performed in 52 patients before and within 5–24 months after treatment. The total muscle area (<i>TMA</i>) of abdominal muscle at the level of third lumbar vertebra (L3) was measured at baseline and after SVR. The L3-SMI was calculated from <i>TMA</i> divided by body height squared (cm<sup>2</sup>/m<sup>2</sup>). We assessed changes in L3-SMI after SVR according to baseline body mass index (BMI) and laboratory data. Predictive factors were assessed by linear regression model. <i>Results:</i> Patients with L3-SMI above the gender-specific cut-off value at baseline had higher values of serum creatinine (median 0.73) compared to patients with low L3-SMI (median 0.68, <i>p</i> = 0.031). After SVR, 14 patients showed increase of L3-SMI, and 38 patients had a decrease of L3-SMI. BMI in the decreased L3-SMI group was significantly lower (median 26.17) than those without decreased L3-SMI (median 28.84, <i>p</i> = 0.021). ALT values in the decreased L3-SMI group (median 66.5) were significantly lower than those without a decrease in L3-SMI (median 88, <i>p</i> = 0.045). <i>Conclusions:</i> Low creatinine serum level correlates with sarcopenia. SMI was partially influenced by the viral clearance. Lower BMI and ALT serum levels at baseline were predictive for no benefit in terms of muscle mass dynamics. Understanding all the mechanisms involved in sarcopenia and identifying the most vulnerable patients could ensure optimal adapted care strategies.https://www.mdpi.com/1648-9144/57/11/1226sarcopeniaskeletal muscle indexliver cirrhosissustained virological responsecomputed tomography |
| spellingShingle | Florin Mihai Anca Trifan Carol Stanciu Laura Huiban Cristina Muzîca Corina Lupașcu-Ursulescu Dragoș Negru Marius Lucian Savin Irina Gîrleanu Tudor Cuciureanu Ana Maria Sîngeap L3 Skeletal Muscle Index Dynamics in Patients with HCV-Related Compensated Cirrhosis Following Sustained Virological Response after Direct Acting Antiviral Treatment Medicina sarcopenia skeletal muscle index liver cirrhosis sustained virological response computed tomography |
| title | L3 Skeletal Muscle Index Dynamics in Patients with HCV-Related Compensated Cirrhosis Following Sustained Virological Response after Direct Acting Antiviral Treatment |
| title_full | L3 Skeletal Muscle Index Dynamics in Patients with HCV-Related Compensated Cirrhosis Following Sustained Virological Response after Direct Acting Antiviral Treatment |
| title_fullStr | L3 Skeletal Muscle Index Dynamics in Patients with HCV-Related Compensated Cirrhosis Following Sustained Virological Response after Direct Acting Antiviral Treatment |
| title_full_unstemmed | L3 Skeletal Muscle Index Dynamics in Patients with HCV-Related Compensated Cirrhosis Following Sustained Virological Response after Direct Acting Antiviral Treatment |
| title_short | L3 Skeletal Muscle Index Dynamics in Patients with HCV-Related Compensated Cirrhosis Following Sustained Virological Response after Direct Acting Antiviral Treatment |
| title_sort | l3 skeletal muscle index dynamics in patients with hcv related compensated cirrhosis following sustained virological response after direct acting antiviral treatment |
| topic | sarcopenia skeletal muscle index liver cirrhosis sustained virological response computed tomography |
| url | https://www.mdpi.com/1648-9144/57/11/1226 |
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