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Article

Combined Albumin-Bilirubin Grade and Skeletal Muscle Mass as a Predictor in Liver Cirrhosis

by
Hiroki Nishikawa
1,2,*,
Hirayuki Enomoto
1,
Kazunori Yoh
1,
Yoshinori Iwata
1,
Yoshiyuki Sakai
1,
Kyohei Kishino
1,
Naoto Ikeda
1,
Tomoyuki Takashima
1,
Nobuhiro Aizawa
1,
Ryo Takata
1,
Kunihiro Hasegawa
1,
Noriko Ishii
1,
Yukihisa Yuri
1,
Takashi Nishimura
1,
Hiroko Iijima
1 and
Shuhei Nishiguchi
1
1
Division of Hepatobiliary and Pancreatic Disease, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan
2
Center for clinical research and education, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2019, 8(6), 782; https://doi.org/10.3390/jcm8060782
Submission received: 6 May 2019 / Revised: 30 May 2019 / Accepted: 31 May 2019 / Published: 1 June 2019
(This article belongs to the Section Gastroenterology & Hepatopancreatobiliary Medicine)
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Abstract

We aimed to compare the prognostic impact among albumin-bilirubin (ALBI) grade, the Child-Pugh classification and our proposed combined ALBI grade and skeletal muscle mass (SMM) grading system in patients with liver cirrhosis (LC) (n = 468, 254 males and 214 females) using the Akaike information criterion (AIC) and time-dependent receiver operating characteristics (ROC) curve analysis. SMM was tested using bioimpedance analysis. Male subjects with skeletal muscle mass index (SMI) <7.0 cm2/m2 and female subjects with SMI <5.7 cm2/m2 were defined as having low SMM. Patients with ALBI grade 1, 2 and 3 were given 1, 2 and 3 points. Patients with and without low SMM were given 1 and 0 point, respectively. The sum of the point of ALBI (1, 2, or 3) and SMM (0 or 1) was defined as the ALBI-SMM grade. The value obtained with the AIC for survival by the ALBI-SMM grade was the lowest among three assessment methods (AIC: 513.418 in ALBI grade, 533.584 in Child-Pugh classification and 493.72 in ALBI-SMM grade). In time-dependent ROC analysis, all area under the ROCs of the ALBI-SMM grade in each time point were the highest among three assessment methods. In conclusion, the ALBI-SMM grading system can be helpful for LC patients.
Keywords: albumin-bilirubin grade; Child-Pugh classification; skeletal muscle mass; liver cirrhosis; predictability albumin-bilirubin grade; Child-Pugh classification; skeletal muscle mass; liver cirrhosis; predictability

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MDPI and ACS Style

Nishikawa, H.; Enomoto, H.; Yoh, K.; Iwata, Y.; Sakai, Y.; Kishino, K.; Ikeda, N.; Takashima, T.; Aizawa, N.; Takata, R.; et al. Combined Albumin-Bilirubin Grade and Skeletal Muscle Mass as a Predictor in Liver Cirrhosis. J. Clin. Med. 2019, 8, 782. https://doi.org/10.3390/jcm8060782

AMA Style

Nishikawa H, Enomoto H, Yoh K, Iwata Y, Sakai Y, Kishino K, Ikeda N, Takashima T, Aizawa N, Takata R, et al. Combined Albumin-Bilirubin Grade and Skeletal Muscle Mass as a Predictor in Liver Cirrhosis. Journal of Clinical Medicine. 2019; 8(6):782. https://doi.org/10.3390/jcm8060782

Chicago/Turabian Style

Nishikawa, Hiroki, Hirayuki Enomoto, Kazunori Yoh, Yoshinori Iwata, Yoshiyuki Sakai, Kyohei Kishino, Naoto Ikeda, Tomoyuki Takashima, Nobuhiro Aizawa, Ryo Takata, and et al. 2019. "Combined Albumin-Bilirubin Grade and Skeletal Muscle Mass as a Predictor in Liver Cirrhosis" Journal of Clinical Medicine 8, no. 6: 782. https://doi.org/10.3390/jcm8060782

APA Style

Nishikawa, H., Enomoto, H., Yoh, K., Iwata, Y., Sakai, Y., Kishino, K., Ikeda, N., Takashima, T., Aizawa, N., Takata, R., Hasegawa, K., Ishii, N., Yuri, Y., Nishimura, T., Iijima, H., & Nishiguchi, S. (2019). Combined Albumin-Bilirubin Grade and Skeletal Muscle Mass as a Predictor in Liver Cirrhosis. Journal of Clinical Medicine, 8(6), 782. https://doi.org/10.3390/jcm8060782

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