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The association of the serum levels of myostatin, follistatin, and interleukin-6 with sarcopenia, and their impacts on survival in patients with hepatocellular carcinoma

Clinical and Molecular Hepatology 2020년 26권 4호 p.492 ~ 505
Choi Kang-Hyug, 장희윤, 안중모, 황성호, 정정화, 최윤숙, 김진욱, 장은선, 최광현, 정숙향,
소속 상세정보
 ( Choi Kang-Hyug ) - Seoul National University College of Medicine Seoul National University Bundang Hospital Department of Internal Medicine
장희윤 ( Jang Hee-Yoon ) - Seoul National University College of Medicine Seoul National University Bundang Hospital Department of Internal Medicine
안중모 ( Ahn Joong-Mo ) - Seoul National University College of Medicine Seoul National University Bundang Hospital Department of Radiology
황성호 ( Hwang Sung-Ho ) - Daewon Univeristy College Department of Nursing
정정화 ( Chung Jung-Wha ) - Wonkwang University Sanbon Hospital Department of Internal Medicine
최윤숙 ( Choi Yun-Suk ) - Seoul National University College of Medicine Seoul National University Bundang Hospital Department of Internal Medicine
김진욱 ( Kim Jin-Wook ) - Seoul National University College of Medicine Seoul National University Bundang Hospital Department of Internal Medicine
장은선 ( Jang Eun-Sun ) - Seoul National University College of Medicine Seoul National University Bundang Hospital Department of Internal Medicine
최광현 ( Choi Gwang-Hyeon ) - Seoul National University College of Medicine Seoul National University Bundang Hospital Department of Internal Medicine
정숙향 ( Jeong Sook-Hyang ) - Seoul National University College of Medicine Seoul National University Bundang Hospital Department of Internal Medicine

Abstract


Background/Aims: The role of serum myokine levels in sarcopenia and the outcome of hepatocellular carcinoma (HCC) patients are not clear. This study investigated the serum levels of myostatin, follistatin, and interleukin-6 (IL-6) in HCC patients and their association with sarcopenia and survival.

Methods: Using prospectively collected pretreatment samples from 238 HCC patients in a hospital from 2012 to 2015, the serum levels of 3 myokines were determined and compared to 50 samples from age and sex-matched healthy controls. Sarcopenia was evaluated using the psoas muscle index (PMI) measured at the third lumbar level in the computed tomography, and clinical data were collected until 2017.

Results: The median levels of the 3 myokines for the male and female HCC patients were as follow: myostatin (3,979.3 and 2,976.3 pg/mL), follistatin (2,118.5 and 2,174.6 pg/mL), and IL-6 (2.5 and 2.7 pg/mL), respectively. Those in the HCC patients were all significantly higher than in the healthy controls. In the HCC patient, the median PMI was 4.43 (males) and 2.17 cm2/m2 (females) with a sarcopenic prevalence of 56.4%. The serum levels of myostatin, IL-6 and follistatin in the HCC patients showed a positive, negative, and no correlation with PMI, respectively. The serum follistatin level was an independent factor for poor survival in HCC patients.

Conclusions: The serum levels of myostatin, follistatin, and IL-6 and their correlation with sarcopenia and survival were presented in HCC patients for the first time. The role of the serum follistatin level as a poor prognostic biomarker warrants further study.

키워드

Hepatocellular carcinoma; Myostatin; Follistatin; Interleukin 6; Sarcopenia

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