2021 Fiscal Year Final Research Report
Comprehensive treatment strategy for chronic liver disease patients based on body composition analysis
| Project/Area Number |
19K08465
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Multi-year Fund |
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| Section | 一般 |
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| Review Section |
Basic Section 53010:Gastroenterology-related
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| Research Institution | Gifu University |
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Principal Investigator |
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| 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)
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| Project Period (FY) |
2019-04-01 – 2022-03-31
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| Keywords | サルコペニア / 慢性肝疾患 / 肥満 / 肝発癌 / 骨格筋 |
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| 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).
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| Free Research Field |
消化器内科学
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| 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。
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