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sarcopenia in liver cirrhosis

Michael Ney, Leah Gramlich, Vanessa Mathiesen, Robert J Bailey, Mark Haykowsky, Mang Ma, Juan G Abraldes, Puneeta Tandon
BACKGROUND/AIMS: Sarcopenia, muscle weakness, and physical frailty are independent predictors of mortality in cirrhosis. These adverse prognostic factors are potentially modifiable with lifestyle interventions, including adequate nutritional intake and physical activity. Our aim was to identify patient-perceived barriers and enablers to these interventions. PATIENTS AND METHODS: Adult patients with cirrhosis were prospectively recruited from two tertiary care liver clinics...
March 2017: Saudi Journal of Gastroenterology: Official Journal of the Saudi Gastroenterology Association
Tatsunori Hanai, Makoto Shiraki, Satoshi Watanabe, Takahiro Kochi, Kenji Imai, Atsushi Suetsugu, Koji Takai, Hisataka Moriwaki, Masahito Shimizu
AIM: Minimal hepatic encephalopathy (MHE) and sarcopenia impair the health-related quality of life and prognosis in patients with liver cirrhosis; however, the relationship between MHE and sarcopenia remains unclear. The aim of this study was to investigate their relationship and to identify the predictors of MHE in cirrhotic patients. METHODS: This retrospective study evaluated 120 cirrhotic patients who were tested for MHE and sarcopenia. MHE was diagnosed by using the computer-aided neuropsychiatric test...
February 15, 2017: Hepatology Research: the Official Journal of the Japan Society of Hepatology
Nicolas Golse, Petru Octav Bucur, Oriana Ciacio, Gabriella Pittau, Antonio Sa Cunha, René Adam, Denis Castaing, Teresa Antonini, Audrey Coilly, Didier Samuel, Daniel Cherqui, Eric Vibert
Although sarcopenia is a common complication of cirrhosis, its diagnosis remains nonconsensual: computed tomography (CT) scan determinations vary and no cutoff values have been established in cirrhotic populations undergoing liver transplantation (LT). Our aim was to compare the accuracy of the most widely used measurement techniques and to establish useful cutoffs in the setting of LT. From the 440 patients transplanted between January 2008 and May 2011 in our tertiary center, we selected 256 patients with cirrhosis for whom a recent CT scan was available during the 4 months prior to LT...
February 2017: Liver Transplantation
Paola Begini, Elia Gigante, Giulio Antonelli, Francesco Carbonetti, Elsa Iannicelli, Giulia Anania, Barbara Imperatrice, Adriano Maria Pellicelli, Gianfranco Delle Fave, Massimo Marignani
 Background. Sarcopenia is a complication and independent risk factor for mortality in patients with liver cirrhosis. AIM: To assess the prevalence and influence of sarcopenia on overall survival in a cohort of cirrhotic patients with hepatocellular carcinoma managed in a tertiary center. MATERIAL AND METHODS: Abdominal computed tomography of 92 consecutive hepatocellular carcinoma cirrhotic patients, enrolled and followed from 2004 to 2014, were retrospectively studied with a software analyzing the cross-sectional areas of muscles at third lumbar vertebra level...
January 2017: Annals of Hepatology
Mariya L Samoylova, Kenneth E Covinsky, Marta Haftek, Selena Kuo, John P Roberts, Jennifer C Lai
Cirrhosis leads to sarcopenia and functional decline that can severely impact one's ability to function at home and in society. Self-reported disability scales to quantify disability-Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL)-are validated to predict mortality in older adults. To evaluate disability in liver transplantation (LT) candidates and quantify its impact on outcomes, consecutive outpatients ≥18 years listed for LT with laboratory Model for End-Stage Liver Disease scores of ≥12 at a single high-volume US LT center were assessed for ADLs and IADLs during clinic visits...
March 2017: Liver Transplantation
Silvia Nardelli, Barbara Lattanzi, Sabrina Torrisi, Francesca Greco, Alessio Farcomeni, Stefania Gioia, Manuela Merli, Oliviero Riggio
BACKGROUND & AIMS: Hepatic encephalopathy (HE) is an important complication in patients with cirrhosis who received transjugular intrahepatic portosystemic shunts (TIPS). We investigated whether a decrease in muscle mass was associated independently with the occurrence of HE after TIPS. METHODS: We performed a prospective study of 46 consecutive patients with cirrhosis (mean age, 58.6 ± 9.1 y; mean model for end-stage liver disease score, 11.3 ± 3.3; mean Child-Pugh score, 7...
November 2, 2016: Clinical Gastroenterology and Hepatology
Srinivasan Dasarathy, Manuela Merli
Sarcopenia or loss of skeletal muscle mass is the major component of malnutrition and is a frequent complication in cirrhosis that adversely affects clinical outcomes. These include survival, quality of life, development of other complications and post liver transplantation survival. Radiological image analysis is currently utilized to diagnose sarcopenia in cirrhosis. Nutrient supplementation and physical activity are used to counter sarcopenia but have not been consistently effective because the underlying molecular and metabolic abnormalities persist or are not influenced by these treatments...
December 2016: Journal of Hepatology
Aldo J Montano-Loza, Paul Angulo, Judith Meza-Junco, Carla M M Prado, Michael B Sawyer, Crystal Beaumont, Nina Esfandiari, Mang Ma, Vickie E Baracos
BACKGROUND AND AIMS: Obesity is frequently associated with cirrhosis, and cirrhotic patients may develop simultaneous loss of skeletal muscle and gain of adipose tissue, culminating in the condition of sarcopenic obesity. Additionally, muscle depletion is characterized by both a reduction in muscle size and increased proportion of muscular fat, termed myosteatosis. In this study, we aimed to establish the frequency and clinical significance of sarcopenia, sarcopenic obesity and myosteatosis in cirrhotic patients...
May 2016: Journal of Cachexia, Sarcopenia and Muscle
Michael A Dunn, Deborah A Josbeno, Amy R Schmotzer, Amit D Tevar, Andrea F DiMartini, Douglas P Landsittel, Anthony Delitto
Frailty with sarcopenia in cirrhosis causes liver transplant wait-list attrition and deaths. Regular physical activity is needed to protect patients with cirrhosis from frailty. We subjectively assess physical performance in selecting patients for transplant listing, but we do not know whether clinical assessments reflect the extent of activity patients actually perform. To investigate this question, 53 wait-listed patients self-assessed their performance of ordinary physical tasks using the Rosow-Breslau survey, and clinicians assessed their physical performance status with the Karnofsky index...
October 2016: Liver Transplantation
Connie W Wang, Sandy Feng, Kenneth E Covinsky, Hilary Hayssen, Li-Qin Zhou, Benjamin M Yeh, Jennifer C Lai
BACKGROUND: Sarcopenia and functional impairment are common and lethal extrahepatic manifestations of cirrhosis. We aimed to determine the association between computed tomography (CT)-based measures of muscle mass and quality (sarcopenia) and performance-based measures of muscle function. METHODS: Adults listed for liver transplant underwent testing of muscle function (grip strength, Short Physical Performance Battery [SPPB]) within 3 months of abdominal CT. Muscle mass (cm/m) = total cross-sectional area of psoas, paraspinal, and abdominal wall muscles at L3 on CT, normalized for height...
August 2016: Transplantation
Maria Kalafateli, Konstantinos Mantzoukis, Yan Choi Yau, Ali O Mohammad, Simran Arora, Susana Rodrigues, Marie de Vos, Kassiani Papadimitriou, Douglas Thorburn, James O'Beirne, David Patch, Massimo Pinzani, Marsha Y Morgan, Banwari Agarwal, Dominic Yu, Andrew K Burroughs, Emmanuel A Tsochatzis
BACKGROUND: Although malnutrition and sarcopenia are prevalent in cirrhosis, their impact on outcomes following liver transplantation is not well documented. METHODS: The associations of nutritional status and sarcopenia with post-transplant infections, requirement for mechanical ventilation, intensive care (ICU) and hospital stay, and 1 year mortality were assessed in 232 consecutive transplant recipients. Nutritional status and sarcopenia were assessed using the Royal Free Hospital-Global Assessment (RFH-GA) tool and the L3-psoas muscle index (L3-PMI) on CT, respectively...
February 2017: Journal of Cachexia, Sarcopenia and Muscle
Atsushi Hiraoka, Kojiro Michitaka, Hidetaro Ueki, Miho Kaneto, Toshihiko Aibiki, Tomonari Okudaira, Takamasa Kawakami, Hiroka Yamago, Yoshifumi Suga, Hideomi Tomida, Yuji Miyamoto, Nobuaki Azemoto, Kenichiro Mori, Hideki Miyata, Eiji Tsubouchi, Tomoyuki Ninomiya, Masashi Hirooka, Masanori Abe, Bunzo Matsuura, Yoichi Hiasa
BACKGROUND/AIM: The frequency of sarcopenia, defined as loss of both muscle volume and strength, was analyzed in chronic liver disease (CLD). METHODS AND MATERIALS: From April to September 2015, 807 Japanese CLD patients treated as outpatients were enrolled (67.1±10.0 years, men : women=466 : 341, hepatitis C virus : hepatitis B virus : hepatitis B and C virus : alcohol : other=511 : 134 : 3 : 45 : 114). Sarcopenia was diagnosed when the patient showed muscle volume loss and reduced handgrip strength, whereas those with only muscle volume loss were classified as 'v-presarcopenia' and those with only reduced handgrip strength were classified as 's-presarcopenia'...
August 2016: European Journal of Gastroenterology & Hepatology
Nagisa Hara, Motoh Iwasa, Ryosuke Sugimoto, Rumi Mifuji-Moroka, Kyoko Yoshikawa, Eriko Terasaka, Ayana Hattori, Masumi Ishidome, Yoshinao Kobayashi, Hiroshi Hasegawa, Kazuko Iwata, Yoshiyuki Takei
OBJECTIVE: Although the prognosis is known to be poor in cirrhosis patients associated with sarcopenia, the relationships among skeletal muscle, visceral fat, and the liver have not yet been thoroughly investigated. Therefore, the prognosis and its associations with body composition and the severity of liver disease were examined in patients with cirrhosis. METHODS: The skeletal muscle mass and visceral fat area were measured in 161 patients with cirrhosis, the effects of body composition on the prognosis were analyzed, and any factors that contribute to changes in body composition were assessed...
2016: Internal Medicine
Ragesh B Thandassery, Aldo J Montano-Loza
Most widely recognized complications in cirrhotic patients include ascites, hepatic encephalopathy, variceal bleeding, kidney dysfunction, and hepatocellular carcinoma; however, malnutrition and muscle wasting (sarcopenia) constitute common complications which negatively impact survival, quality of life, and response to stressors, such as infection and surgery in patients with cirrhosis. Despite the important role that malnutrition and sarcopenia play in the prognosis of patients with cirrhosis, they are frequently overlooked, in part because nutritional assessment can be a difficult task in patients with cirrhosis due to fluid retention and/or overweight...
June 2016: Current Treatment Options in Gastroenterology
Srinivasan Dasarathy
PURPOSE OF REVIEW: Sarcopenia or loss of skeletal muscle mass is the major component of malnutrition and occurs in the majority of patients with liver disease. Lower muscle contractile function also contributes to the adverse consequences of sarcopenia. There are no effective therapies to prevent or reverse sarcopenia in liver disease. This review will discuss the advances in diagnosis, pathogenesis, and treatment options for sarcopenia in liver disease. RECENT FINDINGS: Sarcopenia increases mortality and risk of development of other complications of cirrhosis, and worsens postliver transplant outcomes while quality of life is decreased...
May 2016: Current Opinion in Gastroenterology
Norifumi Harimoto, Tomoharu Yoshizumi, Masahiro Shimokawa, Kazuhito Sakata, Kouichi Kimura, Shinji Itoh, Toru Ikegami, Tetsuo Ikeda, Ken Shirabe, Yoshihiko Maehara
AIM: The present study investigated the effect of sarcopenia on short- and long-term surgical outcomes and identified potential prognostic factors for hepatocellular carcinoma (HCC) following hepatectomy among patients 70 years of age and older. METHODS: Patient data were retrospectively collected for 296 consecutive patients who underwent hepatectomy for HCC with curative intent. Patients were assigned to two groups according to age (younger than 70 years, and 70 years and older), and the presence of sarcopenia...
November 2016: Hepatology Research: the Official Journal of the Japan Society of Hepatology
M Sinclair, P J Gow, M Grossmann, P W Angus
BACKGROUND: Sarcopenia (loss of muscle mass) is common in cirrhosis and is associated with poor outcomes. Current teaching recommends the use of protein supplementation and exercise, however, this fails to address many other factors which contribute to muscle loss in this setting. AIMS: To summarise existing knowledge regarding the aetiology of sarcopenia in cirrhosis, diagnostic modalities and the clinical significance of this condition. In addition to discuss recent research findings that may allow the development of more effective treatments...
April 2016: Alimentary Pharmacology & Therapeutics
Tatsunori Hanai, Makoto Shiraki, Sachiyo Ohnishi, Tsuneyuki Miyazaki, Takayasu Ideta, Takahiro Kochi, Kenji Imai, Atsushi Suetsugu, Koji Takai, Hisataka Moriwaki, Masahito Shimizu
AIM: Sarcopenia impairs the outcome of patients with liver cirrhosis independently of liver function reserves. The aim of this study was to investigate whether the rate of skeletal muscle wasting predicts mortality in cirrhotic patients. METHODS: This retrospective study evaluated 149 cirrhotic patients who visited our hospital between March 2004 and September 2012. The skeletal muscle cross-sectional area at the level of the third lumbar vertebra was measured by computed tomography, from which the skeletal muscle index was obtained for diagnosis of sarcopenia...
July 2016: Hepatology Research: the Official Journal of the Japan Society of Hepatology
Jennifer C Lai, Jennifer L Dodge, Saunak Sen, Kenneth Covinsky, Sandy Feng
UNLABELLED: Cirrhosis is characterized by sarcopenia and malnutrition, leading to progressive functional decline. We aimed to objectively measure functional decline in patients with cirrhosis awaiting liver transplantation and its association with waiting list mortality. Consecutive adults listed for liver transplantation with laboratory Model for End-Stage Liver Disease (MELD) ≥12 at a single center underwent functional status assessments at every outpatient visit using the Short Physical Performance Battery (0 = impaired to 12 = robust), consisting of gait, chair stands, and balance tests...
February 2016: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
Eric R Kallwitz
Loss of muscle mass and function is a common occurrence in both patients with decompensated cirrhosis and those undergoing liver transplantation. Sarcopenia is associated with morbidity and mortality before and after liver transplantation. The ability of skeletal muscle mass to recover after transplant is questionable, and long term adverse events associated with persistent sarcopenia have not been well studied. Limited data is available examining mechanisms by which decreased muscle mass might develop. It is not clear which interventions might reduce the prevalence of sarcopenia and associated health burdens...
October 21, 2015: World Journal of Gastroenterology: WJG
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