The rate of muscle wasting in liver transplant recipients on waiting list:post-transplant outcomes and associated serum metabolite patterns  

作　　者：Zachary P.Rokop Thomas M.O’Connell Taylor Munsch Lauren Nephew Eric Orman Plamen Mihaylov Richard S.Mangus Chandrashekhar Kubal 

机构地区：[1]Division of Transplant Surgery,Department of Surgery,Indiana University School of Medicine,Indianapolis,IN,USA [2]Department of Otolaryngology,Head&Neck Surgery,Indiana University School of Medicine,Indianapolis,IN,USA [3]Indiana Center for Musculoskeletal Health,Indiana University School of Medicine,Indianapolis,IN,USA [4]Division of Gastroenterology and Hepatology,Department of Medicine,Indiana University School of Medicine,Indianapolis,IN,USA

出　　处：《Hepatobiliary Surgery and Nutrition》2024年第6期962-973,I0003-I0006,共16页肝胆外科与营养(英文)

摘　　要：Background:Sarcopenia at the time of liver transplantation(LT)is an established risk factor for mortality following LT.However,most studies in this context have defined sarcopenia by one-time,static measurements.The aims of this study were(I)to determine the impact of the rate of muscle loss in waitlisted LT recipients on post-LT outcomes and(II)to identify patterns of serum metabolites associated with patients with more progressive sarcopenia.Methods:Patients undergoing liver transplant from 2008 to 2018 who received more than one computed tomography(CT)scans within 12 months prior to liver transplant were included(n=61).The psoas muscle index(PMI)was calculated using Slice-O-Matic software and corrected for patient height(m2).Patients were classified into two groups based the rate of reduction in PMI-high wasting[HW;change in PMI(ΔPMI)≤−1%/month]and low wasting(LW;ΔPMI>−1%/month).Pre-transplant serum metabolic profiles were collected using nuclear magnetic resonance(NMR)spectroscopy.Living kidney donor sera was used as healthy controls.Results:MedianΔPMI was−2.0%/month in HW and−0.15%/month in LW patients(P<0.001).Post-transplant 1-year mortality was significantly higher in HW patients.There were no significant differences in metabolite concentrations between HW and LW patients.However,perturbations in taurine,sarcosine,betaine and the aromatic amino acids(AAAs),were observed in patients with liver disease as compared to healthy controls.Liver disease was also associated with a decrease in lipoprotein profiles,especially high-density lipoprotein(HDL)particles.Conclusions:In patients undergoing LT,the rate of progression of sarcopenia is a strong prognostic indicator of post-LT death.Serum metabolite profiles were not characteristically unique to HW patients,and most closely resemble derangements associated with chronic liver disease.

关 键 词：Liver transplantation(LT) SARCOPENIA psoas muscle index(PMI) METABOLOME 

分 类 号：R73[医药卫生—肿瘤]