Sarcopenic obesity increases the risk of mortality in patients with liver disease awaiting liver transplantation and in the post-transplant period.Nutrition recommendations for individuals with sarcopenia differ from ...Sarcopenic obesity increases the risk of mortality in patients with liver disease awaiting liver transplantation and in the post-transplant period.Nutrition recommendations for individuals with sarcopenia differ from recommendations for patients with obesity or sarcopenic obesity.While these nutrition guidelines have been established in non-cirrhotic patients,established guidelines for liver transplant candidates with sarcopenic obesity are lacking.In this paper,we review existing literature on sarcopenic obesity in patients with chronic liver disease and address opportunities to improve nutritional counseling in patients awaiting liver transplantation.展开更多
Obesity and sarcopenia combination, appropriately defined as sarcopenic obesity (SO), due to disproportionally reduced/low lean body mass compared to excess fat mass, may lead to disability. Aims: The aim of our study...Obesity and sarcopenia combination, appropriately defined as sarcopenic obesity (SO), due to disproportionally reduced/low lean body mass compared to excess fat mass, may lead to disability. Aims: The aim of our study was to investigate the relationship among sarcopenic obesity, physical performance, disability, and quality of life in a rehabilitation setting. Methods: Participants were recruited among obese patients (BMI > 30 kg/m2) admitted to the rehabilitation facility at the Department of Experimental Medicine, Medical Physiopatology, Food Science and Endocrinology Section during a 1-year period. A multidimensional evaluation was performed through bioelectrical impedance analysis and anthropometry, handgrip strength test, Short Physical Performance Battery (SPPB), 6-minute walk test (6MWT) and blood chemistry parameters. Psychological status (SCL-90 questionnaire), quality of life, and comorbidity (Charlson comorbidity index score) were also evaluated. Obesity was diagnosed as increased fat mass by 35% in women and by 25% in men. Sarcopenia was defined if lean body mass (LBM) was <90% of the subject’s ideal LBM. Results: 79 patients (48 women and 31 men;mean age: 60.1 ± 11.5 years, and 58.6 ± 10.8 years, respectively) were enrolled. Results showed a high prevalence of SO (54.4%) in our samples of obese subjects. Sarcopenia was present not only among older obese adults but also among younger obese subjects, and was related to reduced functional performance, to inflammatory status and to worse psychological status and quality of life.展开更多
There has been an increasing number of studies regarding the influence of body composition on the oncological outcomes of patients.Recent research demonstrated that sarcopenic obesity is associated with the occurrence...There has been an increasing number of studies regarding the influence of body composition on the oncological outcomes of patients.Recent research demonstrated that sarcopenic obesity is associated with the occurrence,development and prognosis of carcinoma.An early diagnosis and effective therapy can improve cancer patients’clinical outcomes.As a consequence,understanding the effects of sarcopenic obesity is critical to better direct patient care.This review describes the relationship between sarcopenic obesity and adverse clinical outcomes in cancer patients.Higher dose-limited toxicity and surgical complications has been found among cancer patients with sarcopenia obesity,compared with normal population.More attention should be paid to sarcopenic obesity in these patients.展开更多
Sarcopenia is a well-known complication of chronic liver disease(CLD),and it is almost always observed in patients with cirrhosis,at least in those with decompensated disease.Since nonalcoholic fatty liver disease(NAF...Sarcopenia is a well-known complication of chronic liver disease(CLD),and it is almost always observed in patients with cirrhosis,at least in those with decompensated disease.Since nonalcoholic fatty liver disease(NAFLD),recently renamed metabolic dysfunction-associated steatotic liver disease(MASLD),is becoming the leading cause of end-stage liver disease,a new scenario characterized by the frequent coexistence of NAFLD,obesity,and sarcopenia is emerging.Although it is not yet resolved whether the bidirectional relationship between sarcopenia and NAFLD subtends causal determinants,it is clear that the interaction of these two conditions is associated with an increased risk of poor outcomes.Notably,during the course of CLD,deregulation of the liver-muscle-adipose tissue axis has been described.Unfortunately,owing to the lack of properly designed studies,specific therapeutic guidelines for patients with sarcopenia in the context of NAFLD-related CLD have not yet been defined.Strategies aimed to induce the loss of fat mass together with the maintenance of lean body mass seem most appropriate.This can be achieved by properly designed diets integrated with specific nutritional supplementations and accompanied by adequate physical exercise.Future studies aiming to add to the knowledge of the correct assessment and approach to sarcopenia in the context of NAFLD-related CLD are eagerly awaited.展开更多
Skeletal muscle and fat tissue show distinct pathophysiological roles and pivotal functions.The culmination of muscle wasting and fat accumulation represents an opposite terminal of each state.Specifically,this situa...Skeletal muscle and fat tissue show distinct pathophysiological roles and pivotal functions.The culmination of muscle wasting and fat accumulation represents an opposite terminal of each state.Specifically,this situation has been designated as sarcopenic obesity.However,sarcopenic obesity still lacks a unanimous definition,diagnostic criteria,and generalized modalities for assessment in the context of versatile liver diseases.Moreover,the underpinning mechanisms by which a combination of abnormal skeletal muscle and fat tissue leads to the progression of liver disease and impairs health‐related consequences are still elusive.Additionally,the interplay between skeletal muscle and fat,and the driving factors that shift different body compositions are not well understood.Therefore,in this review,we discuss skeletal muscle and fat components,with the purpose of conceptualization,as well as interpret their roles in liver diseases.We focus on the definitions,diagnostic criteria,and currently available measurements for sarcopenic obesity in the literature.We comprehensively discuss recent data and evidence regarding the potential role of sarcopenic obesity in the development and progression of numerous liver diseases and associated conditions,including nonalcoholic fatty liver disease,chronic viral hepatitis,cirrhosis,and liver transplantation.Furthermore,explicit information related to the pathogenesis of sarcopenic obesity from basic research is also provided in this narrative review.Finally,we discuss,from the clinical perspective of view,how to manage sarcopenic obesity using nutritional,physical,and pharmacological methods.展开更多
Sarcopenia and obesity are two major public health concerns,particularly in the elderly population.These conditions have a significant impact on both the individual’s health and quality of life.Sarcopenia is defined ...Sarcopenia and obesity are two major public health concerns,particularly in the elderly population.These conditions have a significant impact on both the individual’s health and quality of life.Sarcopenia is defined as a loss of muscle mass,strength,and function physiologically present with aging,while obesity is an excessive accumulation of body fat.While these conditions are often considered separately,there is growing recognition that they frequently coexist,may synergistically enhance one another,leading to an increased risk of various chronic diseases and mortality.Sarcopenic obesity(SO)is the term utilized to define the simultaneous occurrence of sarcopenia and obesity(1).Since recently,the lack of common diagnostic criteria for SO has made it difficult to diagnose and manage this condition effectively.展开更多
In the last decade,many investigators including us have reported the negative impact of preoperative sarcopenia or low skeletal muscle mass on outcomes after surgery including hepato-biliary-pancreatic(HBP)surgery suc...In the last decade,many investigators including us have reported the negative impact of preoperative sarcopenia or low skeletal muscle mass on outcomes after surgery including hepato-biliary-pancreatic(HBP)surgery such as liver transplantation,liver surgery,biliary surgery,and pancreatic surgery(1-5).In addition to low skeletal muscle mass,the abnormality of body compositions,decreased muscle quality and visceral obesity,has been clarified to be also negatively associated with poor outcomes after HBP surgery(2-5).Consequently,it was easily supposed that co-existence of sarcopenia and obesity,called sarcopenic obesity(SO),had more strong negative impact on outcomes.Actually,not a few studies have demonstrated negative clinical impact of SO on outcomes after HBP surgery using various definitions for SO(6-10).We reported that patients with SO,defined by low skeletal muscle mass with high visceral fat to subcutaneous fat ratio evaluated by preoperative computed tomography(CT)image,had significant worse survival than non-sarcopenia patients and patients with sarcopenia only after liver transplantation,hepatic resection,and pancreatic resection(6-9).展开更多
Background and Objectives:This study investigated the relationship between socioeconomic factors,dietary intake,and sarcopenic obesity among older adults in Korea.Methods and Study Design:Data from the seventh Korean ...Background and Objectives:This study investigated the relationship between socioeconomic factors,dietary intake,and sarcopenic obesity among older adults in Korea.Methods and Study Design:Data from the seventh Korean National Health and Nutrition Examination Survey(2016-2018)were analyzed.The study included 3,690 participants(1,645 men and 2,045 women)aged 65 years and older.Sarcopenic obesity was defined as the coexistence of low muscle strength(handgrip strength<28 kg in men and<18 kg in women)and abdominal obesity(waist circumference>90 cm in men and>85 cm in women).Socioeconomic factors assessed included age,living status,residential area,employment,education,and family income level.Dietary intake was evaluated using the nutrient adequacy ratio and mean adequacy ratio derived from 24-h dietary recall data.Multiple logistic regression was used to identify factors associated with sarcopenic obesity.Results:The prevalence rates of sarcopenic obesity were 6.5%in men and 17.4%in women.Low education levels were significantly associated with a higher prevalence of sarcopenic obesity in women,whereas lower family income levels were associated with an increased risk of sarcopenic obesity in men.In women,a lower mean adequacy ratio was significantly associated with a higher risk of sarcopenic obesity.Conclusions:Lower family income and education level are associated with a higher prevalence of sarcopenic obesity.Additionally,overall nutritional adequacy is inversely related to the prevalence of sarcopenic obesity,particularly in women.展开更多
The prevalence of metabolic-associated fatty liver disease(MAFLD)has increased substantially in recent years because of the global obesity pandemic.MAFLD,now recognized as the number one cause of chronic liver disease...The prevalence of metabolic-associated fatty liver disease(MAFLD)has increased substantially in recent years because of the global obesity pandemic.MAFLD,now recognized as the number one cause of chronic liver disease in the world,not only increases liver-related morbidity and mortality among sufferers but also worsens the complications associated with other comorbid conditions such as cardiovascular disease,type 2 diabetes mellitus,obstructive sleep apnoea,lipid disorders and sarcopenia.Understanding the interplay between MAFLD and these comorbidities is important to design optimal therapeutic strategies.Sarcopenia can be either part of the disease process that results in MAFLD(e.g.,obesity or adiposity)or a consequence of MAFLD,especially in the advanced stages such as fibrosis and cirrhosis.Sarcopenia can also worsen MAFLD by reducing exercise capacity and by the production of various muscle-related chemical factors.Therefore,it is crucial to thoroughly understand how we deal with these diseases,especially when they coexist.We explore the pathobiological interlinks between MAFLD and sarcopenia in this comprehensive clinical update review article and propose evidence-based therapeutic strategies to enhance patient care.展开更多
AIM To perform a systematic review to evaluate the incidence and prevalence of non-alcoholic fatty liver disease(NAFLD) in adult patients with sarcopenia.METHODS Randomized clinical trials,cross-sectional or cohort st...AIM To perform a systematic review to evaluate the incidence and prevalence of non-alcoholic fatty liver disease(NAFLD) in adult patients with sarcopenia.METHODS Randomized clinical trials,cross-sectional or cohort studies including adult patients(over 18 years) with sarcopenia were selected.The primary outcomes of interest were the prevalence or incidence of NAFLD in sarcopenic patients.In the screening process,44 fulltext articles were included in the review and 41 studies were excluded.RESULTS Three cross-sectional studies were included.The authors attempted to perform a systematic review,but due to the differences between the studies,a qualitative synthesis was provided.The diagnosis of NAFLD was made by non-invasive methods(image methods or any surrogate markers) in all three evaluated studies.All the studies suggested that there was an independent association between sarcopenia and NAFLD.CONCLUSION Sarcopenia is independently associated with NAFLD and possibly to an advanced fibrosis.展开更多
Background: Hepatocellular carcinoma is the most common innate liver tumor. Due to improved surgical techniques, even extended resections are feasible, and more patients can be treated with curative intent. As the liv...Background: Hepatocellular carcinoma is the most common innate liver tumor. Due to improved surgical techniques, even extended resections are feasible, and more patients can be treated with curative intent. As the liver is the central metabolic organ, preoperative metabolic assessment is crucial for risk stratification. Sarcopenia, obesity and sarcopenic obesity characterize body composition and metabolic status. Here we present the impact of body composition on survival after liver resection in patients with hepatocellular carcinoma. Methods: A retrospective database analysis of 70 patients who were assigned for liver resection due to hepatocellular carcinoma was conducted. For assessment of sarcopenia and obesity, skeletal muscle surface area was measured at lumbar vertebra 3 level(L3) in preoperative four-phase contrast enhanced abdominal CT scans, and L3 muscle index and body fat percentage were calculated. Results: Univariate analysis comparing the survival curves using the score test demonstrated superior postoperative overall survival for sarcopenic( P = 0.035) and sarcopenic obese( P = 0.048) patients as well as a trend favoring obese( P = 0.130) subjects. Whereas multivariate analysis could not identify significant difference in postoperative survival regarding sarcopenia, obesity or sarcopenic obesity. Only large tumor size, multifocal disease and male gender were risk factors for long-term survival. Conclusions: Sarcopenia, obesity and sarcopenic obesity are indeed no risk factors for poor postoperative survival in this study. Our data do not support the evaluation of sarcopenia, obesity and sarcopenic obesity before liver resection in hepatocellular carcinoma patients.展开更多
Alectinib is a first-line treatment for patients withadvanced non-small cell lung cancer(NSCLC)harbor-ing anaplastic lymphoma kinase-positive(ALK+)driveraberrations with a median progression-free survival of 35months ...Alectinib is a first-line treatment for patients withadvanced non-small cell lung cancer(NSCLC)harbor-ing anaplastic lymphoma kinase-positive(ALK+)driveraberrations with a median progression-free survival of 35months and a 5-year overall survival of 63%[1].Currently,alectinib also shows improvement as an adjuvant treat-ment in resected stage IA-IIIB ALK+NSCLC[2].Alectinibhas a mild safety profile,but a notable underreported side-effect is weight gain[3].Studies show sarcopenic obesityrates doubling from 24%to 47%in the first year of treatment[3],with persisting weight gain appearing early[4].Givenpatients’extended survival,this poses risks for metabolic,cardiovascular,and psychological health.展开更多
文摘Sarcopenic obesity increases the risk of mortality in patients with liver disease awaiting liver transplantation and in the post-transplant period.Nutrition recommendations for individuals with sarcopenia differ from recommendations for patients with obesity or sarcopenic obesity.While these nutrition guidelines have been established in non-cirrhotic patients,established guidelines for liver transplant candidates with sarcopenic obesity are lacking.In this paper,we review existing literature on sarcopenic obesity in patients with chronic liver disease and address opportunities to improve nutritional counseling in patients awaiting liver transplantation.
文摘Obesity and sarcopenia combination, appropriately defined as sarcopenic obesity (SO), due to disproportionally reduced/low lean body mass compared to excess fat mass, may lead to disability. Aims: The aim of our study was to investigate the relationship among sarcopenic obesity, physical performance, disability, and quality of life in a rehabilitation setting. Methods: Participants were recruited among obese patients (BMI > 30 kg/m2) admitted to the rehabilitation facility at the Department of Experimental Medicine, Medical Physiopatology, Food Science and Endocrinology Section during a 1-year period. A multidimensional evaluation was performed through bioelectrical impedance analysis and anthropometry, handgrip strength test, Short Physical Performance Battery (SPPB), 6-minute walk test (6MWT) and blood chemistry parameters. Psychological status (SCL-90 questionnaire), quality of life, and comorbidity (Charlson comorbidity index score) were also evaluated. Obesity was diagnosed as increased fat mass by 35% in women and by 25% in men. Sarcopenia was defined if lean body mass (LBM) was <90% of the subject’s ideal LBM. Results: 79 patients (48 women and 31 men;mean age: 60.1 ± 11.5 years, and 58.6 ± 10.8 years, respectively) were enrolled. Results showed a high prevalence of SO (54.4%) in our samples of obese subjects. Sarcopenia was present not only among older obese adults but also among younger obese subjects, and was related to reduced functional performance, to inflammatory status and to worse psychological status and quality of life.
基金the National Natural Science Foundation of China[No.81773238]Zhongnan Hospital Foster Foundation[cxpy20160042].
文摘There has been an increasing number of studies regarding the influence of body composition on the oncological outcomes of patients.Recent research demonstrated that sarcopenic obesity is associated with the occurrence,development and prognosis of carcinoma.An early diagnosis and effective therapy can improve cancer patients’clinical outcomes.As a consequence,understanding the effects of sarcopenic obesity is critical to better direct patient care.This review describes the relationship between sarcopenic obesity and adverse clinical outcomes in cancer patients.Higher dose-limited toxicity and surgical complications has been found among cancer patients with sarcopenia obesity,compared with normal population.More attention should be paid to sarcopenic obesity in these patients.
文摘Sarcopenia is a well-known complication of chronic liver disease(CLD),and it is almost always observed in patients with cirrhosis,at least in those with decompensated disease.Since nonalcoholic fatty liver disease(NAFLD),recently renamed metabolic dysfunction-associated steatotic liver disease(MASLD),is becoming the leading cause of end-stage liver disease,a new scenario characterized by the frequent coexistence of NAFLD,obesity,and sarcopenia is emerging.Although it is not yet resolved whether the bidirectional relationship between sarcopenia and NAFLD subtends causal determinants,it is clear that the interaction of these two conditions is associated with an increased risk of poor outcomes.Notably,during the course of CLD,deregulation of the liver-muscle-adipose tissue axis has been described.Unfortunately,owing to the lack of properly designed studies,specific therapeutic guidelines for patients with sarcopenia in the context of NAFLD-related CLD have not yet been defined.Strategies aimed to induce the loss of fat mass together with the maintenance of lean body mass seem most appropriate.This can be achieved by properly designed diets integrated with specific nutritional supplementations and accompanied by adequate physical exercise.Future studies aiming to add to the knowledge of the correct assessment and approach to sarcopenia in the context of NAFLD-related CLD are eagerly awaited.
文摘Skeletal muscle and fat tissue show distinct pathophysiological roles and pivotal functions.The culmination of muscle wasting and fat accumulation represents an opposite terminal of each state.Specifically,this situation has been designated as sarcopenic obesity.However,sarcopenic obesity still lacks a unanimous definition,diagnostic criteria,and generalized modalities for assessment in the context of versatile liver diseases.Moreover,the underpinning mechanisms by which a combination of abnormal skeletal muscle and fat tissue leads to the progression of liver disease and impairs health‐related consequences are still elusive.Additionally,the interplay between skeletal muscle and fat,and the driving factors that shift different body compositions are not well understood.Therefore,in this review,we discuss skeletal muscle and fat components,with the purpose of conceptualization,as well as interpret their roles in liver diseases.We focus on the definitions,diagnostic criteria,and currently available measurements for sarcopenic obesity in the literature.We comprehensively discuss recent data and evidence regarding the potential role of sarcopenic obesity in the development and progression of numerous liver diseases and associated conditions,including nonalcoholic fatty liver disease,chronic viral hepatitis,cirrhosis,and liver transplantation.Furthermore,explicit information related to the pathogenesis of sarcopenic obesity from basic research is also provided in this narrative review.Finally,we discuss,from the clinical perspective of view,how to manage sarcopenic obesity using nutritional,physical,and pharmacological methods.
文摘Sarcopenia and obesity are two major public health concerns,particularly in the elderly population.These conditions have a significant impact on both the individual’s health and quality of life.Sarcopenia is defined as a loss of muscle mass,strength,and function physiologically present with aging,while obesity is an excessive accumulation of body fat.While these conditions are often considered separately,there is growing recognition that they frequently coexist,may synergistically enhance one another,leading to an increased risk of various chronic diseases and mortality.Sarcopenic obesity(SO)is the term utilized to define the simultaneous occurrence of sarcopenia and obesity(1).Since recently,the lack of common diagnostic criteria for SO has made it difficult to diagnose and manage this condition effectively.
文摘In the last decade,many investigators including us have reported the negative impact of preoperative sarcopenia or low skeletal muscle mass on outcomes after surgery including hepato-biliary-pancreatic(HBP)surgery such as liver transplantation,liver surgery,biliary surgery,and pancreatic surgery(1-5).In addition to low skeletal muscle mass,the abnormality of body compositions,decreased muscle quality and visceral obesity,has been clarified to be also negatively associated with poor outcomes after HBP surgery(2-5).Consequently,it was easily supposed that co-existence of sarcopenia and obesity,called sarcopenic obesity(SO),had more strong negative impact on outcomes.Actually,not a few studies have demonstrated negative clinical impact of SO on outcomes after HBP surgery using various definitions for SO(6-10).We reported that patients with SO,defined by low skeletal muscle mass with high visceral fat to subcutaneous fat ratio evaluated by preoperative computed tomography(CT)image,had significant worse survival than non-sarcopenia patients and patients with sarcopenia only after liver transplantation,hepatic resection,and pancreatic resection(6-9).
基金supported by the Korean Society of Community Nutrition,funded by a grant from the Korea Disease Control and Prevention Agency(No.ISSN 2733-5488).
文摘Background and Objectives:This study investigated the relationship between socioeconomic factors,dietary intake,and sarcopenic obesity among older adults in Korea.Methods and Study Design:Data from the seventh Korean National Health and Nutrition Examination Survey(2016-2018)were analyzed.The study included 3,690 participants(1,645 men and 2,045 women)aged 65 years and older.Sarcopenic obesity was defined as the coexistence of low muscle strength(handgrip strength<28 kg in men and<18 kg in women)and abdominal obesity(waist circumference>90 cm in men and>85 cm in women).Socioeconomic factors assessed included age,living status,residential area,employment,education,and family income level.Dietary intake was evaluated using the nutrient adequacy ratio and mean adequacy ratio derived from 24-h dietary recall data.Multiple logistic regression was used to identify factors associated with sarcopenic obesity.Results:The prevalence rates of sarcopenic obesity were 6.5%in men and 17.4%in women.Low education levels were significantly associated with a higher prevalence of sarcopenic obesity in women,whereas lower family income levels were associated with an increased risk of sarcopenic obesity in men.In women,a lower mean adequacy ratio was significantly associated with a higher risk of sarcopenic obesity.Conclusions:Lower family income and education level are associated with a higher prevalence of sarcopenic obesity.Additionally,overall nutritional adequacy is inversely related to the prevalence of sarcopenic obesity,particularly in women.
文摘The prevalence of metabolic-associated fatty liver disease(MAFLD)has increased substantially in recent years because of the global obesity pandemic.MAFLD,now recognized as the number one cause of chronic liver disease in the world,not only increases liver-related morbidity and mortality among sufferers but also worsens the complications associated with other comorbid conditions such as cardiovascular disease,type 2 diabetes mellitus,obstructive sleep apnoea,lipid disorders and sarcopenia.Understanding the interplay between MAFLD and these comorbidities is important to design optimal therapeutic strategies.Sarcopenia can be either part of the disease process that results in MAFLD(e.g.,obesity or adiposity)or a consequence of MAFLD,especially in the advanced stages such as fibrosis and cirrhosis.Sarcopenia can also worsen MAFLD by reducing exercise capacity and by the production of various muscle-related chemical factors.Therefore,it is crucial to thoroughly understand how we deal with these diseases,especially when they coexist.We explore the pathobiological interlinks between MAFLD and sarcopenia in this comprehensive clinical update review article and propose evidence-based therapeutic strategies to enhance patient care.
文摘AIM To perform a systematic review to evaluate the incidence and prevalence of non-alcoholic fatty liver disease(NAFLD) in adult patients with sarcopenia.METHODS Randomized clinical trials,cross-sectional or cohort studies including adult patients(over 18 years) with sarcopenia were selected.The primary outcomes of interest were the prevalence or incidence of NAFLD in sarcopenic patients.In the screening process,44 fulltext articles were included in the review and 41 studies were excluded.RESULTS Three cross-sectional studies were included.The authors attempted to perform a systematic review,but due to the differences between the studies,a qualitative synthesis was provided.The diagnosis of NAFLD was made by non-invasive methods(image methods or any surrogate markers) in all three evaluated studies.All the studies suggested that there was an independent association between sarcopenia and NAFLD.CONCLUSION Sarcopenia is independently associated with NAFLD and possibly to an advanced fibrosis.
文摘Background: Hepatocellular carcinoma is the most common innate liver tumor. Due to improved surgical techniques, even extended resections are feasible, and more patients can be treated with curative intent. As the liver is the central metabolic organ, preoperative metabolic assessment is crucial for risk stratification. Sarcopenia, obesity and sarcopenic obesity characterize body composition and metabolic status. Here we present the impact of body composition on survival after liver resection in patients with hepatocellular carcinoma. Methods: A retrospective database analysis of 70 patients who were assigned for liver resection due to hepatocellular carcinoma was conducted. For assessment of sarcopenia and obesity, skeletal muscle surface area was measured at lumbar vertebra 3 level(L3) in preoperative four-phase contrast enhanced abdominal CT scans, and L3 muscle index and body fat percentage were calculated. Results: Univariate analysis comparing the survival curves using the score test demonstrated superior postoperative overall survival for sarcopenic( P = 0.035) and sarcopenic obese( P = 0.048) patients as well as a trend favoring obese( P = 0.130) subjects. Whereas multivariate analysis could not identify significant difference in postoperative survival regarding sarcopenia, obesity or sarcopenic obesity. Only large tumor size, multifocal disease and male gender were risk factors for long-term survival. Conclusions: Sarcopenia, obesity and sarcopenic obesity are indeed no risk factors for poor postoperative survival in this study. Our data do not support the evaluation of sarcopenia, obesity and sarcopenic obesity before liver resection in hepatocellular carcinoma patients.
文摘Alectinib is a first-line treatment for patients withadvanced non-small cell lung cancer(NSCLC)harbor-ing anaplastic lymphoma kinase-positive(ALK+)driveraberrations with a median progression-free survival of 35months and a 5-year overall survival of 63%[1].Currently,alectinib also shows improvement as an adjuvant treat-ment in resected stage IA-IIIB ALK+NSCLC[2].Alectinibhas a mild safety profile,but a notable underreported side-effect is weight gain[3].Studies show sarcopenic obesityrates doubling from 24%to 47%in the first year of treatment[3],with persisting weight gain appearing early[4].Givenpatients’extended survival,this poses risks for metabolic,cardiovascular,and psychological health.
