Type II fibre atrophy and nuclear disruption in decompensated cirrhosis
Bibliographic record
Abstract
Background & Aims: Loss of skeletal muscle mass is a common complication in cirrhosis that is associated with higher morbidity and mortality. Since the specific pathophysiology of cirrhosis-related muscle loss is unclear, we performed histological evaluation of muscle tissue from patients with cirrhosis undergoing liver transplantation (LT). Methods: muscle was collected at LT from 57 patients. Specimens were analyzed for immunohistochemical determination of fibre size and type, nuclear position and total tissue triglyceride. Computed tomography was used to determine the skeletal muscle index and sarcopenia was defined using previously published cut-offs. The D'Amico cirrhosis classification was used to categorize patients as having decompensated cirrhosis. Results: <0.001) than in patients with compensated cirrhosis. In the multivariate logistic regression analysis, size of type IIA fibres and percentage of centralized nuclei were independently associated with decompensated cirrhosis. Conclusions: Patients with decompensated cirrhosis have myopathy characterized by fibre type II atrophy and disruption of nuclear positioning. Further work is warranted to evaluate the factors related to the development of muscle pathology in cirrhosis and to develop regimens of muscle rehabilitation for this patient population pre- and post-LT. Impact and implications: Our study illustrates the presence of myopathy at the histological level in patients with cirrhosis undergoing liver transplantation. Patients with decompensated cirrhosis, compared with compensated cirrhosis, exhibit type II (glycolytic) muscle fibre atrophy and disruption of nuclear positioning. Patients with decompensated cirrhosis gain an extended survival benefit from liver transplantation but are likely to begin this extension of life enfeebled by loss of muscle mass and function. The involvement of glycolytic muscle fibres may have implications for strength and fatiguability; thus, post-transplant resistance exercise may help with rehabilitation.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".