Agreement and diagnostic differences among three definitions of sarcopenia in patients with chronic hepatitis C

Abstract

BackgroundThere is neither a gold standard definition nor a universal consensus to diagnose sarcopenia in patients with chronic hepatitis C. Thus, we aimed to compare the prevalence of sarcopenia and the agreement and discrepancies between European Working Group on Sarcopenia in Older People (EWGSOP1), EWGSOP2, and Foundation for the National Institutes of Health Biomarkers Consortium Sarcopenia Project (FNIH) definitions in chronic hepatitis C.MethodsDual‐energy x‐ray absorptiometry was used to assess muscle mass by quantifying appendicular lean mass (ALM) adjusted for squared height (ALM/ht2) or for body mass index (ALMBMI). Muscle function was evaluated by handgrip strength. Subjective Global Assessment was used to assess the nutrition status.ResultsThis cross‐sectional study included 103 outpatients (mean age, 50.6 ± 11.3 years; 33.0% with compensated cirrhosis). Sarcopenia prevalence was 8.7%, 9.7%, and 9.7%, according to EWGSOP1, EWGSOP2, and FNIH definitions, respectively. There was neither a sex‐ nor a liver disease severity–specific difference in the prevalence of sarcopenia between the criteria applied. Sixteen (15.5%) patients fulfilled at least one of these criteria, and 3 out of 16 (18.8%) simultaneously had sarcopenia by consensus of the three criteria. Sarcopenic obesity was identified in 9 out of 16 (56.3%) patients, and 6 out of 9 (66.7%) of these only met FNIH consensus.ConclusionsIn patients without cirrhosis or with compensated cirrhosis, and with chronic hepatitis C, the agreement between EWGSOP1 and EWGSOP2 classifications was substantial for sarcopenia diagnosis. Concerning EWGSOP and FNIH criteria, a fair agreement and limited overlap were found in these patients.

Editorial: Hepatitis C virus eradication improves skeletal muscle mass—Authors' reply

“…Regarding another query, despite the clinical recognition of sarcopenia in patients with cirrhosis, there is neither a gold standard definition nor a universal operational criterion for sarcopenic case finding. 8 In our study, the diagnosis of sarcopenia was performed as proposed by the European Working Group on Sarcopenia in Older People 2 (EWGSOP 2) criteria to detect sarcopenia. 9 In this context, it should be emphasised that the EWGSOP definitions are directed towards the older adult population.…”