Background and aim: Sarcopenia, a condition of progressive and generalized loss of muscle mass, strength and physical perfor- mance, is an important burden in patients with liver cirrhosis due to its correlation with negative out-comes. The gold standard for its evaluation is Skeletal Muscle Index (SMI), calculated with computed tomography (CT) and specific software. However, this method can be time-consuming, expensive and needs trained operators. For these reasons, researchers have proposed different techniques, faster and easier, like the Trasversal Psoas Muscle Thickness (TPMT). The aim of this study is to evaluate the performance of SMI and TPMT in detect- ing sarcopenia in cirrhotic patients. Materials and methods: The abdominal CT performed in 181 cir- rhotic patients was used to calculate both SMI and TPMT. SMI was taken at L3 level and images were analyzed with SliceOmatic V4.2 software, to find the total muscle area. Cut-offs were: SMI ≤38.5 cm 2 /m 2 for women and SMI ≤52.4 cm2/m2 for men. TPMT was taken at the level of the umbilicus and cut-offs were: TMPT≤14 mm/m for women and TMPT≤17.8 mm/m for men. Results: SMI and TPMT were correlated either considering all patients (r=0,63 con p<0,001), only males (r=0,62, p<0,001) or females (r=0,58, p<0,001). Sarcopenia was diagnosed by SMI in 81 patients TPMT in 65. TPMT underestimated sarcopenia in 22 cases, and overestimated 6 patients, showing a sensibility of 73% and spec- ificity of 94%. Both sarcopenia by SMI and sarcopenia by TPMT were significantly associated with mortality. Conclusions: Since TPMT has a lower sensibility this method should not be recommended to replace the SMI analysis. The total muscle area is likely to be more representative while psoas muscle is only 13% of this area.
Pigliacelli, A., Merli, M., Lattanzi, B., Trebicka, J., Bruni, A., Fabrini, N. (2020). Transversal psoas muscle thickness and skeletal muscle index: a comparison of two tools for the diagnosis of sarcopenia in cirrhosis. DIGESTIVE AND LIVER DISEASE, 52, 1-3 [10.1016/s1590-8658(20)30852-5].
Transversal psoas muscle thickness and skeletal muscle index: a comparison of two tools for the diagnosis of sarcopenia in cirrhosis
A. Bruni;
2020
Abstract
Background and aim: Sarcopenia, a condition of progressive and generalized loss of muscle mass, strength and physical perfor- mance, is an important burden in patients with liver cirrhosis due to its correlation with negative out-comes. The gold standard for its evaluation is Skeletal Muscle Index (SMI), calculated with computed tomography (CT) and specific software. However, this method can be time-consuming, expensive and needs trained operators. For these reasons, researchers have proposed different techniques, faster and easier, like the Trasversal Psoas Muscle Thickness (TPMT). The aim of this study is to evaluate the performance of SMI and TPMT in detect- ing sarcopenia in cirrhotic patients. Materials and methods: The abdominal CT performed in 181 cir- rhotic patients was used to calculate both SMI and TPMT. SMI was taken at L3 level and images were analyzed with SliceOmatic V4.2 software, to find the total muscle area. Cut-offs were: SMI ≤38.5 cm 2 /m 2 for women and SMI ≤52.4 cm2/m2 for men. TPMT was taken at the level of the umbilicus and cut-offs were: TMPT≤14 mm/m for women and TMPT≤17.8 mm/m for men. Results: SMI and TPMT were correlated either considering all patients (r=0,63 con p<0,001), only males (r=0,62, p<0,001) or females (r=0,58, p<0,001). Sarcopenia was diagnosed by SMI in 81 patients TPMT in 65. TPMT underestimated sarcopenia in 22 cases, and overestimated 6 patients, showing a sensibility of 73% and spec- ificity of 94%. Both sarcopenia by SMI and sarcopenia by TPMT were significantly associated with mortality. Conclusions: Since TPMT has a lower sensibility this method should not be recommended to replace the SMI analysis. The total muscle area is likely to be more representative while psoas muscle is only 13% of this area.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
