Objective To investigate the relationship between the expression levels of serum growth differentiation factor-8(GDF-8),vascular endothelial growth factor(VEGF),and fibroblast growth factor 21(FGF21)and the occurrence of sarcopenia in patients with liver cirrhosis.Methods From January 2022 to March 2024,63 patients with liver cirrhosis com-plicated with sarcopenia treated in our hospital were included as the sarcopenia group,and 60 patients with liver cirrhosis were included as the control group.The serum levels of GDF-8,VEGF,and FGF21 were compared.Spearman correlation was applied to analyze the relationship between serum GDF-8,VEGF,FGF21 levels and sarcopenia staging.Logistic regression was applied to analyze the factors affecting the occurrence of sarcopenia in patients with cirrhosis.Receiver operating char-acteristic(ROC)curves were applied to analyze the predictive value of serum GDF-8,VEGF,and FGF21 levels for the devel-opment of sarcopenia in patients with cirrhosis.Results The levels of GDF-8 and FGF21 in the serum of patients with liver cirrhosis complicated with sarcopenia were greatly higher,while the level of VEGF was greatly lower(t=7.719,10.011,11.837,all P＜0.001).The levels of GDF-8 and FGF21 in serum gradually increased with the progression of sarcopenia,while the level of VEGF gradually decreased with the progression of sarcopenia(F=16.605,15.527,19.995,all P＜0.001).The levels of serum GDF-8 and FGF21 in patients were positively correlated with the stage of sarcopenia(r=0.760,0 525,P＜0.05),while the level ofVEGF was negatively correlated with the stage of sarcopenia(r=-0.546,P＜0.05).There were great differences between the control group and the sarcopenia group in BMI,the proportion of diabetes history,grip strength,walking speed,RASM,and high-density lipoprotein levels(P＜0.05).The history of diabetes(OR=2.496,95％CI 1 315-4.738),the increase of serum GDF-8(OR=2.115,95％CI 1377-3249)and FGF21(OR=2.894,95％CI 1.598-5 241)levels were risk fac-tors for sarcopenia in patients with cirrhosis(P＜0.05),and high BMI(OR=0.618,95％CI 0.461-0.828),RASM(OR=0.573,95％CI0.370-0.887)and VEGF(OR=0.469,95％CI0.307-0.718)levels were protective factors(P＜0.05).The area under the curve(AUC)of serum GDF-8,VEGF,and FGF21 levels in predicting sarcopenia in patients with cirrhosis was 0.836,0.912,and 0.921,respectively.The AUC of the combined detection of the three was 0.980,which was better than that of the individual detection(Z/P=3.878/＜0.001、2.954/0.003、2.678/0.007).Conclusion The levels of serum GDF-8,VEGF,and FGF21 are closely related to the occurrence of sarcopenia in patients with cirrhosis.Detecting the levels of the three in serum may have certain clinical value for predicting the occurrence of sarcopenia in patients with cirrhosis.
万方数据
维普
