文章：

肝细胞癌患者中肌脂肪变性的患病率及其对预后的影响：一项系统综述与荟萃分析

Prevalence of and Impact on the Outcome of Myosteatosis in Patients with Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis

原文发布日期：27 February 2024

DOI: 10.3390/cancers16050952

类型: Article

开放获取: 是

英文摘要：

Background: Limited data exist on the prevalence of myosteatosis (i.e., excess accumulation of fat in skeletal muscles) in hepatocellular carcinoma (HCC) patients, and no systematic review or meta-analysis has been conducted in this context. Methods: We searched for articles published from inception until November 2023 to assess the prevalence of myosteatosis in patients with HCC. Results: Ten studies with 3316 patients focusing on myosteatosis and HCC were included. The overall prevalence of myosteatosis in HCC patients was 50% [95% Confidence Interval (CI): 35–65%]. Using the body mass index-based criteria (two studies), the prevalence was 34%, while gender-based criteria (eight studies) yielded 54% (p= 0.31). In Asian studies (n = 8), the prevalence was 45%, compared to 69% in non-Asian countries (two studies) (p= 0.02). For viral-associated HCC (eight studies), the prevalence was 49%, rising to 65% in non-alcoholic fatty liver disease-associated cases (three studies) and 86% in alcoholic liver disease-associated cases (three studies) (p< 0.01). The prevalence of myosteatosis was higher in Child–Pugh class C (3 studies, 91%) than in A (7 studies, 73%) or B (6 studies, 50%) (p= 0.02), but with no difference between Barcelona Clinic Liver Cancer stage A (3 studies, 66%), B (4 studies, 44%) and C (3 studies, 62%) (p= 0.80). Patients with myosteatosis had a significantly higher mortality (six studies) (Relative Risk: 1.35 (95%CI: 1.13–1.62,p< 0.01). Conclusion: The prevalence of myosteatosis is high in HCC patients and is associated with more severe liver disease and higher mortality rates.

摘要翻译： 

背景：目前关于肝细胞癌（HCC）患者中肌脂肪变性（即骨骼肌中脂肪过度积累）患病率的数据有限，且尚未有系统综述或荟萃分析对此进行探讨。方法：我们检索了自数据库建立至2023年11月发表的相关文献，以评估HCC患者中肌脂肪变性的患病率。结果：共纳入10项研究，涉及3316名关注肌脂肪变性与HCC的患者。HCC患者中肌脂肪变性的总体患病率为50%[95%置信区间（CI）：35–65%]。基于体重指数的标准（两项研究）显示患病率为34%，而基于性别的标准（八项研究）显示为54%（p=0.31）。在亚洲研究中（n=8），患病率为45%，而非亚洲国家（两项研究）为69%（p=0.02）。对于病毒相关HCC（八项研究），患病率为49%，在非酒精性脂肪性肝病相关病例（三项研究）中升至65%，在酒精性肝病相关病例（三项研究）中为86%（p<0.01）。Child–Pugh C级患者（三项研究，91%）的肌脂肪变性患病率高于A级（七项研究，73%）或B级（六项研究，50%）（p=0.02），但巴塞罗那临床肝癌分期A期（三项研究，66%）、B期（四项研究，44%）和C期（三项研究，62%）之间无差异（p=0.80）。患有肌脂肪变性的患者死亡率显著更高（六项研究）（相对风险：1.35（95%CI：1.13–1.62，p<0.01）。结论：肌脂肪变性在HCC患者中患病率较高，且与更严重的肝脏疾病和更高的死亡率相关。

原文链接：

Prevalence of and Impact on the Outcome of Myosteatosis in Patients with Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis