预测肝细胞癌 (HCC) 肝移植 (LT) 患者术后生存率的具体 CT 相关骨骼肌参数仍不清楚。越来越多的证据支持脂肪酸及其脂质中间体在调节骨骼肌质量和功能中的作用，脂蛋白亚组分与身体成分之间的关​​系仍不清楚。 对2015年1月至2022年9月期间接受LT的成年HCC患者进行回顾性分析。 CT 参数，包括骨骼肌指数 (SMI)、腰肌指数 (PMI)、骨骼肌密度 (SMD)、内脏和皮下脂肪组织（VAT 和 SAT）、L3 水平的 VAT/SAT 比率以及血脂谱，在 LT 之前进行评估。在 284 名患有 HCC 的 LT 患者中，224 名在 LT 后 3 个月内接受了 CT（L3 级）治疗，82 名 (37%) 被诊断患有肌脂肪变性。肌脂肪变性患者的 1 年和 3 年生存率显着较低（p = 0.002，p = 0.01），这一趋势甚至超出了米兰标准（p = 0.004，p = 0.04）。调整协变量后，SMD 与移植后存活率呈显着负相关（HR：0.90，[95% 置信区间 (CI)：0.83-0.98]，C 统计量：0.78，p = 0.009）。 Pearson 的相关分析显示，高密度脂蛋白胆固醇 (HDL-C) 和载脂蛋白 A1 (ApoA1) 水平与 SMD 呈正相关。多元逐步回归分析表明，SMD 每减少 10 个 Hounsfield 单位，HDL-C 就会减少 0.16 mmol/L，ApoA1 就会减少 0.18 g/L。LT 前评估骨骼肌密度的常规腹部 CT 扫描显着相关与移植后死亡率。此外，LT 前异常的 HDL-C 和 ApoA1 水平与肌脂肪变性相关。© 2024。亚太肝脏研究协会。

The specific CT-related skeletal muscle parameters predictive of postoperative survival in liver transplant (LT) patients with hepatocellular carcinoma (HCC) remain unclear. There is increasing evidence supporting the role of fatty acids and their lipid intermediates in regulating skeletal muscle mass and function, the relationship between lipoprotein subfractions and body composition remains unclear.Adult patients with HCC who underwent LT between January 2015 and September 2022 were retrospectively analyzed. CT parameters, including skeletal muscle index (SMI), psoas muscle index (PMI), skeletal muscle density (SMD), visceral and subcutaneous adipose tissue (VAT and SAT), and the VAT/SAT ratio at the L3 level, and lipid profiles, were assessed prior to LT.Of the 284 LT patients with HCC, 224 underwent CT (L3 level) within 3 months of LT, and 82 (37%) were diagnosed with myosteatosis. Patients with myosteatosis exhibited significantly lower 1- and 3-year survival rates (p = 0.002, p = 0.01), a trend persisting even beyond the Milan criteria (p = 0.004, p = 0.04). After adjusting for covariates, SMD demonstrated a significant negative correlation with post-transplant survival (HR: 0.90, [95% Confidence Interval(CI): 0.83-0.98], C-statistic: 0.78, p = 0.009). Pearson's correlation analysis revealed a positive correlation between high-density lipoprotein cholesterol (HDL-C) and apolipoprotein A1(ApoA1) levels and SMD. Multivariate stepwise regression analysis demonstrated that every 10 Hounsfield unit decrease in SMD was associated with a 0.16 mmol/L decrease in HDL-C and a 0.18 g/L decrease in ApoA1.Routine abdominal CT scans for assessing skeletal muscle density before LT were significantly associated with post-transplant mortality. Furthermore, abnormal HDL-C and ApoA1 levels before LT were associated with myosteatosis.© 2024. Asian Pacific Association for the Study of the Liver.