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Association of Muscle Mass Loss with Diabetes Development in Liver Transplantation Recipients

 Sejeong Lee  ;  Minyoung Lee  ;  Young-Eun Kim  ;  Hae Kyung Kim  ;  Sook Jung Lee  ;  Jiwon Kim  ;  Yurim Yang  ;  Chul Hoon Kim  ;  Hyangkyu Lee  ;  Dong Jin Joo  ;  Myoung Soo Kim  ;  Eun Seok Kang 
 DIABETES & METABOLISM JOURNAL, Vol.48(1) : 146-156, 2024-01 
Journal Title
Issue Date
Diabetes Mellitus* / epidemiology ; Diabetes Mellitus* / etiology ; Humans ; Liver Transplantation* / adverse effects ; Muscles ; Retrospective Studies ; Risk Factors ; Sarcopenia* / complications ; Sarcopenia* / diagnostic imaging ; Sarcopenia* / epidemiology
Diabetes mellitus ; Liver transplantation ; Muscle, skeletal ; Sarcopenia
Background: Post-transplant diabetes mellitus (PTDM) is one of the most significant complications after transplantation. Patients with end-stage liver diseases requiring transplantation are prone to sarcopenia, but the association between sarcopenia and PTDM remains to be elucidated. We aimed to investigate the effect of postoperative muscle mass loss on PTDM development.

Methods: A total of 500 patients who underwent liver transplantation at a tertiary care hospital between 2005 and 2020 were included. Skeletal muscle area at the level of the L3-L5 vertebrae was measured using computed tomography scans performed before and 1 year after the transplantation. The associations between the change in the muscle area after the transplantation and the incidence of PTDM was investigated using a Cox proportional hazard model.

Results: During the follow-up period (median, 4.9 years), PTDM occurred in 165 patients (33%). The muscle mass loss was greater in patients who developed PTDM than in those without PTDM. Muscle depletion significantly increased risk of developing PTDM after adjustment for other confounding factors (hazard ratio, 1.50; 95% confidence interval, 1.23 to 1.84; P=0.001). Of the 357 subjects who had muscle mass loss, 124 (34.7%) developed PTDM, whereas of the 143 patients in the muscle mass maintenance group, 41 (28.7%) developed PTDM. The cumulative incidence of PTDM was significantly higher in patients with muscle loss than in patients without muscle loss (P=0.034).

Conclusion: Muscle depletion after liver transplantation is associated with increased risk of PTDM development.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pharmacology (약리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
3. College of Nursing (간호대학) > Dept. of Nursing (간호학과) > 1. Journal Papers
Yonsei Authors
Kang, Eun Seok(강은석) ORCID logo https://orcid.org/0000-0002-0364-4675
Kim, Myoung Soo(김명수) ORCID logo https://orcid.org/0000-0002-8975-8381
Kim, Young-Eun(김영은)
Kim, Jiwon(김지원)
Kim, Chul Hoon(김철훈) ORCID logo https://orcid.org/0000-0002-7360-429X
Kim, Hae-Kyung(김혜경)
Lee, Minyoung(이민영) ORCID logo https://orcid.org/0000-0002-9333-7512
Lee, Hyang Kyu(이향규) ORCID logo https://orcid.org/0000-0002-0821-6020
Joo, Dong Jin(주동진) ORCID logo https://orcid.org/0000-0001-8405-1531
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