Calculated body muscle mass as a useful screening marker for low skeletal muscle mass and sarcopenia in chronic liver disease

Abstract

Aim Sarcopenia is a harmful condition in patients with chronic liver disease. However, the evaluation of body muscle mass requires expensive instrumentation. The sarcopenia index (SI): (creatinine / cystatin C × 100) has been reported to correlate with muscle volume. A calculated body muscle mass (CBMM) using creatinine, cystatin C, and bodyweight also correlates with muscle mass. We evaluated the applicability of using SIs and CBMMs as screening methods for sarcopenia. Methods Patients (n = 303) with liver damage were evaluated for creatinine, cystatin C, and grip strength (GS). All patients were evaluated using cross‐sectional computed tomography images of the third lumbar vertebrae to determine their skeletal muscle (SM) mass. CBMMs and SIs were compared with SMs, GSs, and sarcopenia. Results Correlation coefficients (R) between SMI (SM / height2 [m2]) and CBMM, and between GS and CBMM were 0.643 and 0.723, respectively. Factors contributing to low GSs; low SM indices; and sarcopenia were age and SM; sex, age, GS, SI, and CBMM indices; and sex, bodyweight, and CBMM, respectively, in the multivariate logistic analyses. Receiver operating characteristic curve analysis between sarcopenia and CBMM showed an area under the receiver operating characteristic curve of 0.78504 in women and 0.86067 in men. Cut‐off CBMM values for sarcopenia were 27.903 (sensitivity 0.73958) in women and 39.731 (sensitivity 0.7941) in men. Conclusions CBMMs and SIs are simple and minimally invasive screening methods in which low levels are indicative of sarcopenia in patients with liver disease.

Comparison of calculated body muscle mass and SARC‑F as methods of screening for sarcopenia in patients with chronic liver disease

“…Separately, CBMM appeared to be a suitable screening method for sarcopenia based on the results of the present study. In our previous study, it was shown that the AUC for CBMM against sarcopenia was 0.78504 in females and 0.85067 in males (9), in agreement with the results of the present study. Since the study population was different between the previous and present study, the efficacy of CBMM for sarcopenia screening has been validated by both.…”

“…In the present study, sex and age also affected the rate of sarcopenia, and a difference between the sexes was also found in our previous study as well (9). Age is a well-established factor for sarcopenia (29).…”

“…Chronic kidney disease (CKD) was staged based on the levels of Cr-based eGFRs in ml/min/1.73 m 2 (18). The difference in GFR was calculated as follows (19) (9). The cutoff SARC-F score for sarcopenia was ≥4 points (6).…”

“…Several reports have previously described the potential of SARC-F for screening of sarcopenia in patients with chronic liver disease (8). In our previous study, it was reported that the calculated body muscle mass (CBMM) is a useful screening marker for discerning low SM mass and sarcopenia in chronic liver disease (9). CBMM was calculated using body weight in kg, serum creatinine (Cr) and serum cystatin C (CysC), and the approximated body muscle mass was measured using…”

Direct-acting Antivirals Improved the Quality of Life, Ameliorated Disease-related Symptoms, and Augmented Muscle Volume Three Years Later in Patients with Hepatitis C Virus

“…The presence of RLS was defined by the RLS criteria. We previously reported that the receiver operating characteristic (ROC) curve analysis between sarcopenia and CBMM revealed an area under the ROC curve of 0.78504 in women and 0.86067 in men, and the cut-off CBMM values for sarcopenia were 27.903 in women and 39.731 in men with chronic liver disease ( 28 ). The sex, HCV genotype, DAAs, age (<65 years old), minimal hepatic encephalopathy (MHE; 22 cases), poor sleeper according to the ESS (4 cases), RLS (13 cases), psychological distress (PD) in K-6 (2 cases), and sarcopenia in CBMM (women, <28; men, <40; 70 cases) were not significantly associated with the dGHN.…”