Chinese Hepatolgy ›› 2025, Vol. 30 ›› Issue (1): 65-73.

• Liver Fibrosis & Cirrhosis • Previous Articles     Next Articles

The diagnostic value of the psoas muscle index combined with arm circumference in patients with cirrhosis and sarcopenia

YU Hong1, JING Jin-hua2, GUZAINUR Yiliar3, SUN Wei1, DOU Jing1, NING Zhong-hui4, XU Qiang4, WANG Xiao-bo4, WANG Zhuan-guo4, WANG Xiao-zhong4, JIANG Yi5, GUO Feng4   

  1. 1. The Fourth Clinical Medical College of Xinjiang Medical University, Urumqi, Urumqi 830000,China;
    2. Chinese Medicine Hospital of Changji,Xinjiang 831100,China;
    3. School of Nursing,Xinjiang Medical University, Urumqi,Urumqi 830000,China;
    4. Traditional Chinese Medicine Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830000,China;
    5. South University of Science and Technology of China,Shenzhen 518000,China
  • Online:2025-01-31 Published:2025-03-10
  • Contact: GUO Feng

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Abstract: Objective To evaluate the diagnostic value of the psoas muscle index combined with nutritional assessment in patients with cirrhosis and sarcopenia. Methods The clinical data of 215 patients diagnosed with cirrhosis in Traditional Chinese Medicine Hospital of Xinjiang Uygur Autonomous Region were collected. Using skeletal muscle index (SMI) of the third lumbar spine (L3) (male < 50 cm2/m2 or female < 39 cm2/m2) as the diagnostic criterion, patients were divided into sarcopenia and non-sarcopenia groups for intergroup comparisons. The receiver operating characteristic curve (ROC) was plotted, and the area under the curve (AUC) was used to determined the diagnostic value of nutritional assessment indicators, and CT imaging indicators. Methods (1) According to comparison results of serological indexes and liver function between patients in sarcopenia and non-sarcopenia groups, the differences in age, RBC count, and HGB were statistically significant (P<0.05). The nutritional scores of patients in sarcopenia group were higher than those in non-sarcopenia group. The TSF, AMC, upper arm circumference, calf circumference, SMI, PMI, and psoas muscle area of patients in sarcopenia group were lower than those of patients in non-sarcopenia group, and the differences were all statistically significant (P<0.05). (2) In patients with cirrhosis and sarcopenia, upper arm circumference had a high diagnostic value, with the AUC=0.769 (95% CI: 0.676～0.861) and a cutoff value of 28.25 cm for men, and the AUC=0.789 (95% CI: 0.688～0.889) and a cutoff value of 29.50 cm for women. (3) In the AUC of CT imaging diagnostic evaluation indicators for liver cirrhosis with muscular dystrophy, the order from high to low is: PMI, psoas muscle area, APMI and axis diameter psoas muscle, which were 0.732 (95% CI 0.629～0.835), 0.694 (95% CI 0.587～0.802), 0.640(95% CI 0.522～0.757), and 0.611 (95% CI 0.494～0.727) for male; and 0.692 (95% CI 0.574～0.810), 0.685 (95% CI 0.571～0.799), 0.530 (95% CI 0.409～0.650), and 0.544 (95% CI 0.425～0.662) for female, respectively. The cutoff values of PMI were 7.41 cm2/m2 for male and 4.64 cm2/m2 for female.(4) The AUC of the psoas muscle index combined with upper arm circumference was higher with a value of 0.824 (95% CI 0.745～0.903) for male, and 0.833 (95% CI 0.745～0.921) for female. Conclusion The psoas muscle index can be used as one of the clinical evaluation tools in patients with cirrhosis and sarcopenia. The psoas muscle index combined with arm circumference has a higher diagnostic value.

Key words: Psoas muscle index, Arm circumference, Cirrhosis, Sarcopenia