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Sarcopenia and liver disease

Lara Beekman, Annalisa Berzigotti, Vanessa Banz
Liver transplantation has become a highly standardized, acceptable option for selected patients with end-stage liver disease and/or hepatocellular carcinoma in the setting of cirrhosis. Both conditions are associated with loss of skeletal muscle mass (sarcopenia) and physical deconditioning. Both conditions result in a dramatic decrease in the patients' quality of life, negatively impacting on the pre- and post-transplant prognosis. In this context, awareness of the advantages of physical activity in both the pre- and post-transplant setting is key...
October 16, 2018: Advances in Therapy
Natasha H Dolgin, Andrew J Smith, Samantha G Harrington, Babak Movahedi, Paulo N A Martins, Adel Bozorgzadeh
OBJECTIVES: A growing body of evidence shows that frailty and functional performance predict liver transplant outcomes. The Organ Procurement and Transplant Network uses the Karnofsky Performance Status scale to adjust for transplant center case mix in assessing quality measures. This study explores the strength of the relationship between Karnofsky Performance Status scores and objective measures of frailty. MATERIALS AND METHODS: This observational study includes 136 adult, first-time liver transplant recipients at UMass Memorial (2006-2015) who had 2 abdominal computed tomography scans available (at ≤ 90 days pretransplant and ≥ 7 days before that)...
October 5, 2018: Experimental and Clinical Transplantation
Anoop Misra
Prevention of diabetes poses significant challenges; especially when applied as public health intervention. While several trials, most importantly Diabetes Prevention Program, show that intensive lifestyle modification leading to weight loss is the most important intervention, many individuals and some populations may show resistance to these interventions. Roadblocks to lifestyle intervention alone or in combination include: age, some ethnic groups (e.g., south Asians), genetic make-up, and some characteristics of body phenotype...
January 2018: American Journal of Lifestyle Medicine
Ke-Vin Chang, Jin-De Chen, Wei-Ting Wu, Kuo-Chin Huang, Hong-Yi Lin, Der-Sheng Han
BACKGROUND/PURPOSE: Hepatic encephalopathy (HE), a major neuropsychiatric complication in advanced liver disease, is associated with poor prognosis. Sarcopenia, characterized by a decline in muscle mass, strength, and physical performance, is prevalent in liver cirrhosis. This study aims to explore whether sarcopenia is associated with HE in cirrhotic patients. METHODS: PubMed and EMBASE were searched for relevant cohort and case-control studies investigating the association between sarcopenia and HE up to July 2018...
September 29, 2018: Journal of the Formosan Medical Association, Taiwan Yi Zhi
Eun Kyung Choe, Hae Yeon Kang, Boram Park, Jong In Yang, Joo Sung Kim
A relationship between nonalcoholic fatty liver disease (NAFLD) and sarcopenia has been suggested. The aim of this study was to evaluate the association between NAFLD and skeletal muscle mass measured by computed tomography (CT). The clinical records of individuals visiting our center for a routine health check-up who underwent abdominal ultrasonography and abdominal CT scanning were retrospectively reviewed. Sarcopenia was diagnosed according to body mass index (BMI)-adjusted skeletal muscle mass, which was measured by CT (CT-measured skeletal muscle index (SMICT ))...
September 28, 2018: Journal of Clinical Medicine
Maryam Ebadi, Connie W Wang, Jennifer C Lai, Srinivasan Dasarathy, Matthew R Kappus, Michael A Dunn, Elizabeth J Carey, Aldo J Montano-Loza
BACKGROUND: Sarcopenia, characterized by low muscle mass, associates with mortality in patients with cirrhosis. Skeletal muscle area in a single computed tomography image at the level of the third lumbar vertebrate (L3) is a valid representative of whole body muscle mass. Controversy remains regarding applicability of psoas muscle to identify patients at greater risk of mortality. We aimed to determine psoas muscle index (PMI) association with skeletal muscle index (SMI) and to evaluate the capacity of PMI to predict liver transplant waitlist mortality...
September 29, 2018: Journal of Cachexia, Sarcopenia and Muscle
Guido Stirnimann, Maryam Ebadi, Puneeta Tandon, Aldo J Montano-Loza
PURPOSE OF REVIEW: The purpose of this review is to discuss the current evidence regarding the impact of sarcopenia on patients with cirrhosis awaiting liver transplantation and to determine if its presence should be considered a criterion for expedited transplantation or a contraindication for transplantation. RECENT FINDINGS: Sarcopenia is a negative predictor of survival in patients on a waiting list and after liver transplant. The gut-liver axis and the liver-muscle axis have been explored to understand the complex pathophysiology of sarcopenia...
September 26, 2018: Current Gastroenterology Reports
Rahima A Bhanji, Praveena Narayanan, Michael R Moynagh, Naoki Takahashi, Mounika Angirekula, Cassie C Kennedy, Kristin C Mara, Ross A Dierkhising, Kymberly D Watt
BACKGROUND/AIMS: Sarcopenia and frailty are commonly encountered in patients with end stage liver disease and are associated with adverse clinical outcomes including decompensation and waitlist mortality. The impact of these entities in patients with differing disease etiologies has not been elucidated. We aim to ascertain the change in their prevalence over time on the waitlist and determine their impact on hospitalization, delisting, and waitlist survival specifically for patients with non-alcoholic steatohepatitis (NASH) and alcoholic liver disease (ALD)...
September 26, 2018: Liver Transplantation
Elizabeth S Aby, Edward Lee, Satvir S Saggi, Matthew R Viramontes, Jonathan F Grotts, Vatche G Agopian, Ronald W Busuttil, Sammy Saab
BACKGROUND: Malnutrition and muscle wasting are common in patients with end-stage liver disease (ESLD), yet go underdiagnosed. Frequently used indices of nutritional status, such as body mass index, are inflated in patients with ESLD due to a fluid overloaded state. Previous work has demonstrated a strong association between psoas muscle area, a surrogate for sarcopenia, and worse survival following liver transplantation; however, the impact of sarcopenia on post liver transplant outcomes in patients with nonalcoholic steatohepatitis (NASH) cirrhosis has not been evaluated...
September 1, 2018: Journal of Clinical Gastroenterology
Kazuto Tajiri, Yukihiro Shimizu
Branched chain amino acids (BCAAs) are involved in various bioprocess such as protein metabolism, gene expression, insulin resistance and proliferation of hepatocytes. BCAAs have also been reported to suppress the growth of hepatocellular carcinoma (HCC) cells in vitro and to be required for immune cells to perform the function. In advanced cirrhotic patients, it has been clarified that serum concentrations of BCAA are decreased, whereas those of aromatic amino acids (AAAs) are increased. These alterations are thought to be the causes of hepatic encephalopathy (HE), sarcopenia and hepatocarcinogenesis and may be associated with the poor prognosis of patients with these conditions...
2018: Translational Gastroenterology and Hepatology
Satoshi Ida, Yuji Kojima, Shima Hamaoka, Naohito Urawa, Jun Araki, Ryutaro Kaneko, Kazuya Murata
BACKGROUND AND AIM: We aimed to examine the validity of the Japanese version of the SARC-F questionnaire (SARC-F-J) that employs the diagnostic criteria for sarcopenia established by the Japan Society of Hepatology in patients with chronic liver disease. METHODS: Subjects were outpatients at the Department of Hepatology at the Japanese Red Cross Ise Hospital, Japan. Evaluations were performed using the following self-administered questionnaires: SARC-F-J, Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC), the Japanese version of the Falls efficacy scale (FES), and Kaigo-Yobo checklist (CL)...
August 25, 2018: Journal of Gastroenterology and Hepatology
Luigi Schiavo, Luca Busetto, Manuela Cesaretti, Shira Zelber-Sagi, Liat Deutsch, Antonio Iannelli
Obesity and metabolic syndrome are considered as responsible for a condition known as the non-alcoholic fatty liver disease that goes from simple accumulation of triglycerides to hepatic inflammation and may progress to cirrhosis. Patients with obesity also have an increased risk of primary liver malignancies and increased body mass index is a predictor of decompensation of liver cirrhosis. Sarcopenic obesity confers a risk of physical impairment and disability that is significantly higher than the risk induced by each of the two conditions alone as it has been shown to be an independent risk factor for chronic liver disease in patients with obesity and a prognostic negative marker for the evolution of liver cirrhosis and the results of liver transplantation...
August 14, 2018: World Journal of Gastroenterology: WJG
Andreas Kroh, Diane Uschner, Toine Lodewick, Roman M Eickhoff, Wenzel Schöning, Florian T Ulmer, Ulf P Neumann, Marcel Binnebösel
BACKGROUND: Hepatocellular carcinoma is the most common innate liver tumor. Due to improved surgical techniques, even extended resections are feasible, and more patients can be treated with curative intent. As the liver is the central metabolic organ, preoperative metabolic assessment is crucial for risk stratification. Sarcopenia, obesity and sarcopenic obesity characterize body composition and metabolic status. Here we present the impact of body composition on survival after liver resection in patients with hepatocellular carcinoma...
July 26, 2018: Hepatobiliary & Pancreatic Diseases International: HBPD INT
Xiaoyan Pan, Yijing Han, Tiantian Zou, Guiqi Zhu, Ke Xu, Jina Zheng, Minghua Zheng, Xingbo Cheng
BACKGROUNDS AND AIMS: Previous studies have investigated that sarcopenia is associated with nonalcoholic fatty liver disease (NAFLD), nonalcoholic steatohepatitis, and fibrosis in NAFLD. The study aims to investigate the risk for NAFLD, especially NAFLD-related significant fibrosis among subjects with sarcopenia. METHODS: We searched electronic databases until 30, September 2017 and reviewed literature extensively. Effect estimates were pooled using random effect models regarding the risk for NAFLD and fixed effect models concerning the risk for significant fibrosis among sarcopenia patients...
2018: Digestive Diseases
Min Jung Lee, Eun-Hee Kim, Sung-Jin Bae, Gi-Ae Kim, Sung Won Park, JaeWon Choe, Chang Hee Jung, Woo Je Lee, Hong-Kyu Kim
Background/Aims: Sarcopenia has emerged as an important risk factor for non-alcoholic fatty liver disease (NAFLD). Although aging is the main cause of sarcopenia, the longitudinal association between age-related body composition changes and NAFLD development has not been fully investigated. Thus, we evaluated whether age-related increased fat mass or decreased muscle mass is an independent risk factor for incident NAFLD. Methods: We conducted a retrospective cohort study involving 4,398 initially NAFLD-free subjects who underwent routine health examinations during 2004 to 2005 and returned for a follow-up during 2014 to 2015...
July 20, 2018: Gut and Liver
Stergios A Polyzos, Andrew N Margioris
Sarcopenic obesity, a chronic condition, is today a major public health problem with increasing prevalence worldwide, which is due to progressively aging populations, the increasing prevalence of obesity, and the changes in lifestyle during the last several decades. Patients usually present to healthcare facilities for obesity and related comorbidities (type 2 diabetes mellitus, non-alcoholic fatty liver disease, dyslipidemia, hypertension, and cardiovascular disease) or for non-specific symptoms related to sarcopenia per se (e...
September 2018: Hormones: International Journal of Endocrinology and Metabolism
Yasuyuki Tamai, Motoh Iwasa, Yuya Kawasaki, Naohiko Yoshizawa, Suguru Ogura, Ryosuke Sugimoto, Akiko Eguchi, Norihiko Yamamoto, Kazushi Sugimoto, Hiroshi Hasegawa, Yoshiyuki Takei
AIM: Hepatocellular carcinoma (HCC) patients with sarcopenia have a poor survival, but there are no predictive markers for survival relating to muscle mass and liver function. Therefore, we investigated whether the ratio between estimated glomerular filtration rates of serum creatinine (Scre) and serum cystatin C (Scys) (eGFRcre/eGFRcys) can be used as a predictive marker of survival in HCC patients. METHODS: First, the correlation between Scre/Scys ratio and muscle mass was examined in 50 patients with chronic liver disease...
July 13, 2018: Hepatology Research: the Official Journal of the Japan Society of Hepatology
Maria Kalafateli, Andreas Karatzas, Georgios Tsiaoussis, Efstratios Koutroumpakis, Paraskevi Tselekouni, Nikolaos Koukias, Christos Konstantakis, Stelios Assimakopoulos, Charalambos Gogos, Konstantinos Thomopoulos, Christina Kalogeropoulou, Christos Triantos
Background: Ongoing evidence suggests that sarcopenia adversely affects outcomes in cirrhosis. The aim of this study was to evaluate muscle fat infiltration as a component of sarcopenia and its prognostic value in this setting. Methods: In 98 consecutive patients with cirrhosis, muscle density was measured during a computed tomography scan at the level of the fourth to fifth lumbar (L4) vertebrae. Univariate and multivariate Cox regression analysis was used to determine predictors of survival...
July 2018: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
Puneeta Tandon, Kathleen Patricia Ismond, Kenneth Riess, Andres Duarte-Rojo, Bandar Al-Judaibi, Michael Andrew Dunn, Jennifer Holman, Nancy Howes, Mark Joseph Franklin Haykowsky, Deborah Ann Josbeno, Margaret McNeely
Physical inactivity, sarcopenia, and frailty are highly prevalent, independent predictors of morbidity and mortality in patients with cirrhosis. Across a range of chronic diseases, exercise training is a key recommendation supported by guidelines and, for some conditions, even by governmental funding of exercise programmes. Consistent with the broader chronic disease literature, the evidence for a benefit of exercise in cirrhosis is promising. Several small trials have reported significant improvements in muscle health (mass, strength, functional capacity), quality of life, fatigue, and reductions in the hepatic venous pressure gradient, without adverse events...
June 30, 2018: Journal of Hepatology
Lucilene Rezende Anastácio, Samanta Catherine Ferreira
PURPOSE OF REVIEW: Nutritional status of patients after liver transplantation is affected by dietary intake and this, in turn, is affected by eating behavior. The present review will highlight recent studies on these topics after liver transplantation. RECENT FINDINGS: Malnutrition drops significantly after liver transplantation. Recovery of weight lost during liver disease occurs within 1 year. Liver transplantation recipients gain weight up to the second or third year, often becoming overweight and obese...
September 2018: Current Opinion in Clinical Nutrition and Metabolic Care
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