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Comprehensive treatment strategy for chronic liver disease patients based on body composition analysis

Research Project

Project/Area Number 19K08465
Research Category

Grant-in-Aid for Scientific Research (C)

Allocation TypeMulti-year Fund
Section一般
Review Section Basic Section 53010:Gastroenterology-related
Research InstitutionGifu University

Principal Investigator

SHIMIZU MASAHITO  岐阜大学, 大学院医学系研究科, 教授 (90402198)

Co-Investigator(Kenkyū-buntansha) 白上 洋平  岐阜大学, 医学部附属病院, 講師 (50632816)
白木 亮  岐阜大学, 大学院医学系研究科, 招へい教員 (60402195)
Project Period (FY) 2019-04-01 – 2022-03-31
Project Status Completed (Fiscal Year 2021)
Budget Amount *help
¥4,160,000 (Direct Cost: ¥3,200,000、Indirect Cost: ¥960,000)
Fiscal Year 2021: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000)
Fiscal Year 2020: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000)
Fiscal Year 2019: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000)
Keywordsサルコペニア / 慢性肝疾患 / 肥満 / 肝発癌 / 骨格筋 / サルコぺニア
Outline of Research at the Start

サルコペニア(骨格筋量と筋力の低下)は、慢性肝疾患患者の予後やQOLを悪化させる。また肥満や内臓脂肪の増加は、肝発癌のリスク因子である。本研究は、体組成の違いによって惹起される様々な分子異常が肝臓の病態に及ぼす影響を明らかにすることで、体組成解析を基盤とする全く新しい慢性肝疾患に対する包括的治療法を開発することを目標とする。肥満やサルコペニアが健康のkey wordになっている昨今、これらの病態に対する国民の関心は高まっている。また肥満や過栄養による肝障害は開発国でも大きな健康問題となっており、本研究の推進は本邦のみならず、世界に対する有益なデータの発信に繋がることが期待される。

Outline of Final Research Achievements

1. Carnitine supplementation improves prognosis in patients with cirrhosis. 2. Evaluation of trabecular bone score is useful in assessing the risk of vertebral fractures in patients with cirrhosis. 3. Reduced handgrip strength is a predictor of covert and overt hepatic encephalopathy in patients with cirrhosis. 4. Increased visceral fat mass and hyperinsulinemia raise the risk for recurrence of non-B non-C hepatocellular carcinoma after curative treatment. 5. Stroop test is useful in diagnosing covert hepatic encephalopathy and predicting the development of overt encephalopathy. 6. Zinc deficiency predicts the development and prognosis of overt hepatic encephalopathy in patients with cirrhosis. 7. Sarcopenia and hypoalbuminemia are appropriate criteria for initiation of cirrhosis nutritional therapy (The results were cited in the Annual Review edition of the Evidence-based clinical practice guidelines for Liver Cirrhosis 2020).

Academic Significance and Societal Importance of the Research Achievements

サルコペニアと低アルブミン血症が肝硬変栄養療法の開始基準として適切であることを示し、「肝硬変診療ガイドライン2020」の栄養療法フローチャートの妥当性を証明した。本研究結果は、同ガイドラインのAnnual Review版に引用された。また不顕性肝性脳症は肝硬変の最大の合併症であるが、握力測定や亜鉛欠乏症の評価、さらにはStroop testを施行することで、同病態の診断や予後予測が可能であることを明らかにした。さらに内蔵脂肪の増加や骨病変(海綿骨の脆弱化)が、慢性肝疾患の病態に及ぼす影響を検討し、sarcopenia obesityやosteosarcopeniaの臨床的重要性を報告した。

Report

(4 results)
  • 2021 Annual Research Report   Final Research Report ( PDF )
  • 2020 Research-status Report
  • 2019 Research-status Report
  • Research Products

    (34 results)

All 2021 2020 2019

All Journal Article (20 results) (of which Peer Reviewed: 20 results,  Open Access: 11 results) Presentation (14 results)

  • [Journal Article] Increased visceral adipose tissue and hyperinsulinemia raise the risk for recurrence of Non-B Non-C hepatocellular carcinoma after curative treatment.2021

    • Author(s)
      Imai K, Takai K, Miwa T, Maeda T, Hanai T, Shiraki M, Suetsugu A, Shimizu M.
    • Journal Title

      Cancers

      Volume: 13 Issue: 7 Pages: 1542-1542

    • DOI

      10.3390/cancers13071542

    • Related Report
      2021 Annual Research Report
    • Peer Reviewed
  • [Journal Article] Usefulness of the stroop test in diagnosing minimal hepatic encephalopathy and predicting overt hepatic encephalopathy.2021

    • Author(s)
      Hanai T, Shiraki M, Nishimura K, Miwa T, Maeda T, Ogiso Y, Imai K, Suetsugu A, Takai K, Shimizu M.
    • Journal Title

      Hepatol Commun

      Volume: 5 Issue: 9 Pages: 1518-1526

    • DOI

      10.1002/hep4.1738

    • Related Report
      2021 Annual Research Report
    • Peer Reviewed
  • [Journal Article] Utility of the SARC-F questionnaire for sarcopenia screening in patients with chronic liver disease: A multicenter cross-sectional study in Japan.2021

    • Author(s)
      Hanai T, Hiraoka A, Shiraki M, Sugimoto R, Taniki N, Hiramatsu A, Nakamoto N, Iwasa M, Chayama, Shimizu M.
    • Journal Title

      J Clin Med

      Volume: 10 Issue: 15 Pages: 3448-3448

    • DOI

      10.3390/jcm10153448

    • Related Report
      2021 Annual Research Report
    • Peer Reviewed
  • [Journal Article] Usefulness of nutritional therapy recommended in the Japanese Society of Gastroenterology/Japan Society of Hepatology evidence-based clinical practice guidelines for liver cirrhosis 2020.2021

    • Author(s)
      Hanai T, Nishimura K, Miwa T, Maeda T, Ogiso Y, Imai K, Suetsugu A, Takai K, Shimizu M.
    • Journal Title

      J Gastroenterol

      Volume: 56 Issue: 10 Pages: 928-937

    • DOI

      10.1007/s00535-021-01821-z

    • Related Report
      2021 Annual Research Report
    • Peer Reviewed
  • [Journal Article] Nutritional assessment tool for predicting sarcopenia in chronic liver disease.2021

    • Author(s)
      Hanai T, Shiraki M, Nishimura K, Ogiso Y, Imai K, Suetsugu A, Takai K, Shimizu M.
    • Journal Title

      JCSM Rapid Communications

      Volume: 4 Pages: 150-158

    • Related Report
      2021 Annual Research Report
    • Peer Reviewed
  • [Journal Article] Zinc deficiency predicts overt hepatic encephalopathy and mortality in liver cirrhosis patients with minimal hepatic encephalopathy.2021

    • Author(s)
      Miwa T, Hanai T, Toshihide M, Ogiso Y, Imai K, Suetsugu A, Takai K, Shiraki M, Katsumura N, Shimizu M.
    • Journal Title

      Hepatol Res

      Volume: 51 Issue: 6 Pages: 662-673

    • DOI

      10.1111/hepr.13601

    • Related Report
      2021 Annual Research Report
    • Peer Reviewed
  • [Journal Article] Evidence-based clinical practice guidelines for Liver Cirrhosis 20202021

    • Author(s)
      Yoshiji H, Nagoshi S, Akahane T, Asaoka Y, Ueno Y, Ogawa K, Kawaguchi T, Kurosaki M, Sakaida I, Shimizu M, Taniai M, Terai S, Nishikawa H, Hiasa Y, Hidaka H, Miwa H, Chayama K, Enomoto N, Shimosegawa T, Takehara T, Koike K.
    • Journal Title

      J Gastroenterol.

      Volume: 56 Issue: 7 Pages: 593

    • DOI

      10.1007/s00535-021-01788-x

    • URL

      https://localhost/en/publications/49eccb58-db33-4836-a33a-4b8c5941248b

    • Related Report
      2021 Annual Research Report
    • Peer Reviewed
  • [Journal Article] Evidence-based clinical practice guidelines for liver cirrhosis 20202021

    • Author(s)
      Yoshiji H, Nagoshi S, Akahane T, Asaoka Y, Ueno Y, Ogawa K, Kawaguchi T, Kurosaki M, Sakaida I, Shimizu M, Taniai M, Terai S, Nishikawa H, Hiasa Y, Hidaka H, Miwa H, Chayama K, Enomoto N, Shimosegawa T, Takehara T, Koike K.
    • Journal Title

      Hepatol Res

      Volume: 51 Issue: 7 Pages: 725

    • DOI

      10.1111/hepr.13678

    • Related Report
      2021 Annual Research Report
    • Peer Reviewed
  • [Journal Article] Rapid depletion of subcutaneous adipose tissue during sorafenib treatment predicts poor survival in patients with hepatocellular carcinoma.2020

    • Author(s)
      Imai K, Takai K, Miwa T, Taguchi D, Hanai T, Suetsugu A, Shiraki M, Shimizu M.
    • Journal Title

      Cancers (Basel)

      Volume: 12 Issue: 7 Pages: 1795-1795

    • DOI

      10.3390/cancers12071795

    • Related Report
      2020 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] Low Levels of Serum Tryptophan Underlie Skeletal Muscle Atrophy.2020

    • Author(s)
      Ninomiya S, Nakamura N, Nakamura H, Mizutani T, Kaneda Y, Yamaguchi K, Matsumoto T, Kitagawa J, Kanemura N, Shiraki M, Hara T, Shimizu M, Tsurumi H.
    • Journal Title

      Nutrients

      Volume: 12 Issue: 4 Pages: 978-978

    • DOI

      10.3390/nu12040978

    • Related Report
      2020 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] The impact of sarcopenia and decrease in skeletal muscle mass in patients with advanced pancreatic cancer during FOLFIRINOX therapy.2020

    • Author(s)
      Uemura S, Iwashita T, Ichikawa H, Iwasa Y, Mita N, Shiraki M, Shimizu M.
    • Journal Title

      Br J Nutr

      Volume: 4 Issue: 10 Pages: 1-29

    • DOI

      10.1017/s0007114520003463

    • Related Report
      2020 Research-status Report
    • Peer Reviewed
  • [Journal Article] Late evening snack with branched-chain amino acids supplementation improves survival in patients with cirrhosis.2020

    • Author(s)
      Hanai T, Shiraki M, Imai K, Suetsugu A, Takai K, Shimizu M.
    • Journal Title

      J Clin Med

      Volume: 9 Issue: 4 Pages: 1013-1013

    • DOI

      10.3390/jcm9041013

    • Related Report
      2020 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] Usefulness of carnitine supplementation for the complications of liver cirrhosis.2020

    • Author(s)
      Hanai T, Shiraki M, Imai K, Suetugu A, Takai K, Shimizu M.
    • Journal Title

      Nutrients

      Volume: 12 Issue: 7 Pages: 1915-1915

    • DOI

      10.3390/nu12071915

    • Related Report
      2020 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] Prognostic impact of sarcopenic obesity after neoadjuvant chemotherapy followed by surgery in elderly patients with esophageal squamous cell carcinoma.2020

    • Author(s)
      Onishi S, Tajika M, Tanaka T, Yamada K, Abe T, Higaki E, Hosoi T, Inaba Y, Muro K, Shimizu M, Niwa Y.
    • Journal Title

      J Clin Med

      Volume: 9 Issue: 9 Pages: 2974-2974

    • DOI

      10.3390/jcm9092974

    • Related Report
      2020 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] Sustained virological response by direct?acting antivirals reduces the recurrence risk of hepatitis C?related hepatocellular carcinoma after curative treatment2019

    • Author(s)
      Imai Kenji、Takai Koji、Hanai Tatsunori、Suetsugu Atsushi、Shiraki Makoto、Shimizu Masahito
    • Journal Title

      Molecular and Clinical Oncology

      Volume: - Pages: 111-116

    • DOI

      10.3892/mco.2019.1956

    • Related Report
      2020 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] Rapid Depletions of Subcutaneous Fat Mass and Skeletal Muscle Mass Predict Worse Survival in Patients with Hepatocellular Carcinoma Treated with Sorafenib2019

    • Author(s)
      Imai Kenji、Takai Koji、Miwa Takao、Taguchi Daisuke、Hanai Tatsunori、Suetsugu Atsushi、Shiraki Makoto、Shimizu Masahito
    • Journal Title

      Cancers

      Volume: 11 Issue: 8 Pages: 1206-1206

    • DOI

      10.3390/cancers11081206

    • Related Report
      2019 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] Homeostatic Model Assessment of Insulin Resistance for Predicting the Recurrence of Hepatocellular Carcinoma after Curative Treatment.2019

    • Author(s)
      Imai K, Takai K, Hanai T, Suetsugu A, Shiraki M, Shimizu M.
    • Journal Title

      Int J Mol Sci.

      Volume: 20 Issue: 3 Pages: 605-605

    • DOI

      10.3390/ijms20030605

    • Related Report
      2019 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] Effect of loop diuretics on skeletal muscle depletion in patients with liver cirrhosis.2019

    • Author(s)
      Hanai T, Shiraki M, Miwa T, Watanabe S, Imai K, Suetsugu A, Takai K, Moriwaki H, Shimizu M.
    • Journal Title

      Hepatol Res.

      Volume: 49 Issue: 1 Pages: 82-95

    • DOI

      10.1111/hepr.13244

    • NAID

      40021909580

    • Related Report
      2019 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] Prognostic significance of minimal hepatic encephalopathy in patients with liver cirrhosis in Japan: A propensity score-matching analysis.2019

    • Author(s)
      Hanai T, Shiraki M, Watanabe S, Imai K, Suetsugu A, Takai K, Moriwaki H, Shimizu M.
    • Journal Title

      J Gastroenterol Hepatol.

      Volume: - Issue: 10 Pages: 1809-1816

    • DOI

      10.1111/jgh.14635

    • Related Report
      2019 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] A nationwide survey on non-B, non-C hepatocellular carcinoma in Japan: 2011-2015 update.2019

    • Author(s)
      Tateishi R, Uchino K, Fujiwara N, Takehara T, Okanoue T, Seike M, Yoshiji H, Yatsuhashi H, Shimizu M, Torimura T, Moriyama M, Sakaida I, Okada H, Chiba T, Chuma M, Nakao K, Isomoto H, Sasaki Y, Kaneko S, Masaki T, Chayama K, Koike K.
    • Journal Title

      J Gastroenterol.

      Volume: 54 Issue: 4 Pages: 367-376

    • DOI

      10.1007/s00535-018-1532-5

    • Related Report
      2019 Research-status Report
    • Peer Reviewed / Open Access
  • [Presentation] ワークショップ 16「肝癌のハイリスク患者 地域,職域,院内での拾い上げ」 肥満関連因子からみた根治治療後肝癌再発高リスク群の拾い上げ2021

    • Author(s)
      今井健二  高井光治  清水雅仁
    • Organizer
      第107回日本消化器病学会総会
    • Related Report
      2021 Annual Research Report
  • [Presentation] シンポジウム11「肝硬変:新ガイドラインの評価と集学的治療の最前線」 肝硬変診療ガイドライン2020栄養療法フローチャートの有用性に関する検討2021

    • Author(s)
      華井竜徳  三輪貴生  清水雅仁
    • Organizer
      第107回日本消化器病学会総会
    • Related Report
      2021 Annual Research Report
  • [Presentation] パネルディスカッション1「肝疾患におけるサルコペニアの診断と治療」 肝硬変患者におけるサルコペニア合併は顕性肝性脳症を予測する―競合リスクモデルおよび傾向スコアマッチング法を用いた検討2021

    • Author(s)
      三輪貴生  華井竜徳  清水雅仁
    • Organizer
      第57回日本肝臓学会総会
    • Related Report
      2021 Annual Research Report
  • [Presentation] シンポジウム4「肝硬変のトータルマネジメント―QOL 改善と予後延長を目指して」 Late evening snackは肝硬変患者の予後を改善するか? -傾向スコアマッチングおよび傾向スコア逆確率による重み付け解析による検討2021

    • Author(s)
      華井竜徳  清水雅仁
    • Organizer
      第57回日本肝臓学会総会
    • Related Report
      2021 Annual Research Report
  • [Presentation] パネルディスカッション7「門脈圧亢進症の診断と治療の進歩」 不顕性肝性脳症患者における亜鉛欠乏症は顕性脳症発症および予後予測因子である―競合リスクモデルを用いた検討2021

    • Author(s)
      三輪貴生  華井竜徳  清水雅仁
    • Organizer
      第57回日本肝臓学会総会
    • Related Report
      2021 Annual Research Report
  • [Presentation] パネルディスカッション7「重要臓器機能低下を踏まえた栄養管理の工夫:肝・腎・心・肺機能障害に着目して」 肝硬変におけるサルコペニアは骨粗鬆症と関連する2021

    • Author(s)
      華井竜徳  白木 亮  清水雅仁
    • Organizer
      第36回日本臨床栄養代謝学会学術集会
    • Related Report
      2021 Annual Research Report
  • [Presentation] パネルディスカッション 肝硬変における握力と予後との関連について:性層別解析2020

    • Author(s)
      華井竜徳  白木 亮  清水雅仁
    • Organizer
      第56回日本肝臓学会総会
    • Related Report
      2020 Research-status Report
  • [Presentation] ワークショップ「門脈圧亢進症におけるサルコペニアの実際と対策」肝硬変患者のサルコペニアと予後についての検討2020

    • Author(s)
      白木 亮  華井竜徳  清水雅仁
    • Organizer
      第27回日本門脈圧亢進症学会総会
    • Related Report
      2020 Research-status Report
  • [Presentation] シンポジウム3「消化器疾患におけるサルコペニア」 消化器疾患におけるサルコペニアの検討2019

    • Author(s)
      白木 亮  大西祥代  清水雅仁
    • Organizer
      第105回日本消化器病学会総会
    • Related Report
      2019 Research-status Report
  • [Presentation] ワークショップ9「肝疾患とサルコペニア・栄養異常-現状と展望-」  肝疾患サルコペニア判定における歩行速度の有用性について2019

    • Author(s)
      華井竜徳  白木 亮  清水雅仁
    • Organizer
      第55回日本肝臓学会総会
    • Related Report
      2019 Research-status Report
  • [Presentation] スポンサードセミナー2(シンポジウム)「肝硬変 (高齢化時代の肝硬変の合併症対策)」 合併症対策 ③筋痙攣2019

    • Author(s)
      白木 亮  清水雅仁
    • Organizer
      第22回日本高齢消化器病学会総会
    • Related Report
      2019 Research-status Report
  • [Presentation] シンポジウム Stroop-testによるミニマル肝性脳症のスクリーニングについての検討2019

    • Author(s)
      華井竜徳  白木 亮  清水雅仁
    • Organizer
      第26回日本門脈圧亢進症学会総会
    • Related Report
      2019 Research-status Report
  • [Presentation] 皮下脂肪量が肝細胞癌症例の臨床経過に与える影響-男女間の体組成の違いに着目した検討-2019

    • Author(s)
      今井健二  高井光治  華井竜徳  末次 淳  白木 亮 清水雅仁
    • Organizer
      第55回肝臓学会総会
    • Related Report
      2019 Research-status Report
  • [Presentation] 慢性肝疾患患者において蛋白低栄養はエネルギー低栄養と比して生存率低下と関連する2019

    • Author(s)
      華井竜徳  白木 亮  清水雅仁
    • Organizer
      第42回日本栄養アセスメント研究会
    • Related Report
      2019 Research-status Report

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Published: 2019-04-18   Modified: 2023-01-30  

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