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Sarcopenia Defined by Psoas Muscle Thickness Predicts Mortality After Transjugular Intrahepatic Portosystemic Shunt

Digestive Diseases and Sciences Aims and scope Submit manuscript

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An Invited Commentary to this article was published on 07 March 2023

Abstract

Purpose

To assess and compare the value of psoas muscle thickness at the level of the third lumbar (L3) vertebra (TPML) or umbilicus (TPMU) and skeletal muscle index (SMI) for diagnosing sarcopenia and predicting mortality in patients undergoing transjugular intrahepatic portosystemic shunt (TIPS).

Materials and Methods

Two hundred forty-nine patients undergoing TIPS were included in this retrospective study. The cut-offs of L3-SMI for sarcopenia were 42.0 cm2/m2 in men and 38.0 cm2/m2 in women. The cut-offs for TPML/height and TPMU/height to predict mortality was established using a receiver-operating characteristic analysis. The Kaplan–Meier and Cox regression were used for survival analyses.

Results

Compared with TPMU/height, TPML/height was more consistent with L3-SM for the diagnosis of sarcopenia (Kappa coefficient: 0.63 vs. 0.36 in men; 0.61 vs. 0.45 in women). The Cox analysis showed that both TPML/height and TPMU/height were independent risk factors for mortality. The optimal cut-off values of TPML/height and TPMU/height for mortality in men and women were 11.2 mm/m, 9.4 mm/m, 18.4 mm/m, 15.1 mm/m, respectively. There were 119 (47.8%), 87 (34.9%), and 82 (32.9%) patients diagnosed with sarcopenia in the TPMU/height, TPML/height, and L3-SMI models, respectively. Kaplan–Meier analysis showed that the overall survival was significantly lower in the sarcopenia group in all three models.

Conclusion

TPMU/height and TPML/height have a similar survival prognostic value as L3-SMI. TPML/height has better consistency with L3-SMI in diagnosing sarcopenia and is a more stable alternative to L3-SMI for diagnosing sarcopenia in patients undergoing TIPS.

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Funding

This work was supported by National Natural Science Foundation of China (grant number: 81873917).

Author information

Author notes

  1. Tongqiang Li, Jiacheng Liu, Jianbo Zhao and Yaowei Bai have contributed equally to this work.

Authors and Affiliations

  1. Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue #1277, Wuhan, 430022, China

    Tongqiang Li, Jiacheng Liu, Yaowei Bai, Songjiang Huang, Chongtu Yang, Yingliang Wang, Chen Zhou, Chaoyang Wang, Shuguang Ju, Yang Chen, Wei Yao & Bin Xiong

  2. Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China

    Tongqiang Li, Jiacheng Liu, Yaowei Bai, Songjiang Huang, Chongtu Yang, Yingliang Wang, Chen Zhou, Chaoyang Wang, Shuguang Ju, Yang Chen & Wei Yao

  3. Division of Vascular and Interventional Radiology, Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, 510000, China

    Jianbo Zhao

  4. Department of Interventional Radiology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, China

    Bin Xiong

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  1. Tongqiang Li
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Contributions

BX, TL and JL conceived and designed the study. YB, YW, SH, CW, SJ and WY collected the data. TL, CY and YC analyzed all data. JL and TL drafted the manuscript. BX and JZ revised the final manuscript. All authors have read and approved the final manuscript.

Corresponding author

Correspondence to Bin Xiong.

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The authors of this manuscript declare that they have no conflicts of interest.

Research involving human participants and/or animals

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This retrospective study was approved by the institutional review board of the Union Hospital, Tongji Medical College, Huazhong University of Science and Technology.

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As a retrospective analysis, informed consent in this study was waived.

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Li, T., Liu, J., Zhao, J. et al. Sarcopenia Defined by Psoas Muscle Thickness Predicts Mortality After Transjugular Intrahepatic Portosystemic Shunt. Dig Dis Sci 68, 1641–1652 (2023). https://doi.org/10.1007/s10620-022-07806-z

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