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

Ichikawa, Tatsuki; Miyaaki, Hisamitsu; Miuma, Satoshi; Motoyoshi, Yasuhide; Yamashima, Mio; Yamamichi, Shinobu; Koike, Makiko; Nakano, Yusuke; Honda, Tetsurou; Yajima, Hiroyuki; Uehara, Ryouhei; Miyazaki, Osamu; Kuribayashi, Yasutaka; Kira, Keiji; Taura, Naota; Nakao, Kazuwa

doi:10.3892/br.2021.1410

Cited by 6 publications

(4 citation statements)

References 30 publications

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“…Our findings also show that the SARC-F item “Strength” independently predicts sarcopenia, and that a SARC-F ≥ 4 is clearly associated with muscle strength rather than muscle mass. These results are consistent with those of previous studies showing that the SARC-F score has a higher correlation with muscle strength but a lower correlation with muscle mass [ 28 , 31 , 32 ]. Muscle strength has many advantages over muscle mass assessed by expensive machines in CLD patients.…”

Section: Discussionsupporting

confidence: 93%

“…SARC-F has been reported to show low sensitivity (14–21%) and high specificity (90–94%) for identifying sarcopenia in community-dwelling older adults [ 26 ]. To our knowledge, three studies involving patients with CLD have also shown that the SARC-F has low sensitivity (15–45%) and high specificity (91–98%) in this population [ 17 , 27 , 28 ]. However, the findings of these studies were limited by the small sample size, single center-study design, and the fact that the diagnosis of sarcopenia was not based on the criteria for patients with CLD.…”

Section: Discussionmentioning

confidence: 99%

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Utility of the SARC-F Questionnaire for Sarcopenia Screening in Patients with Chronic Liver Disease: A Multicenter Cross-Sectional Study in Japan

Hanai

Hiraoka

Shiraki

et al. 2021

JCM

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Diagnosing sarcopenia is challenging. This multicenter cross-sectional study aimed to evaluate the utility of the SARC-F score system for identifying sarcopenia in patients with chronic liver disease (CLD). We enrolled 717 patients from five participating centers who completed the SARC-F between November 2019 and March 2021. Sarcopenia was diagnosed based on the Japan Society of Hepatology Working Group on Sarcopenia in Liver Disease Consensus. Muscle strength was estimated using a grip dynamometer, and muscle mass was assessed using computed tomography or bioelectrical impedance analysis. The association between SARC-F and sarcopenia was analyzed using a logistic regression model. The optimal SARC-F cutoff value for identifying sarcopenia was determined using receiver operating characteristic (ROC) curve analysis. Of the 676 eligible patients, 15% were diagnosed with sarcopenia. The SARC-F distribution was 0 points in 63% of patients, 1 point in 17%, 2 points in 7%, 3 points in 4%, and ≥4 points in 8%. The SARC-F items of “Strength” (odds ratio (OR), 1.98; 95% confidence interval (CI), 1.03–3.80) and “Falls” (OR, 2.44; 95% CI, 1.48–4.03) were significantly associated with sarcopenia. The SARC-F value of 1 point showed a higher discriminative ability for identifying sarcopenia than the 4 points that are conventionally used (p < 0.001), with an area under the ROC curve of 0.68, sensitivity of 0.65, specificity of 0.68, positive predictive value of 0.27, and negative predictive value of 0.92. SARC-F is useful for identifying patients with CLD who are at risk of sarcopenia.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Utility of the SARC-F Questionnaire for Sarcopenia Screening in Patients with Chronic Liver Disease: A Multicenter Cross-Sectional Study in Japan

Hanai

Hiraoka

Shiraki

et al. 2021

JCM

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“…We also utilized HGS for our analyses that is also, however, influenced by the skeletal dimensions of the hand rather than only muscle mass and/or function. 41 Strength measurements of other large muscle groups may be more closely related to functional impairment such as walking or stair climbing 42 and need to be evaluated in future. Our study does not establish the role of FTO expression in vivo in the skeletal muscle of COPD subjects.…”

Section: Discussionmentioning

confidence: 99%

Gene polymorphisms associated with heterogeneity and senescence characteristics of sarcopenia in chronic obstructive pulmonary disease

Attaway

Bellar

Welch

et al. 2023

J cachexia sarcopenia muscle

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Background Sarcopenia, or loss of skeletal muscle mass and decreased contractile strength, contributes to morbidity and mortality in patients with chronic obstructive pulmonary disease (COPD). The severity of sarcopenia in COPD is variable, and there are limited data to explain phenotype heterogeneity. Others have shown that COPD patients with sarcopenia have several hallmarks of cellular senescence, a potential mechanism of primary (age‐related) sarcopenia. We tested if genetic contributors explain the variability in sarcopenic phenotype and accelerated senescence in COPD. Methods To identify gene variants [single nucleotide polymorphisms (SNPs)] associated with sarcopenia in COPD, we performed a genome‐wide association study (GWAS) of fat free mass index (FFMI) in 32 426 non‐Hispanic White (NHW) UK Biobank participants with COPD. Several SNPs within the fat mass and obesity‐associated (FTO) gene were associated with sarcopenia that were validated in an independent COPDGene cohort (n = 3656). Leucocyte telomere length quantified in the UK Biobank cohort was used as a marker of senescence. Experimental validation was done by genetic depletion of FTO in murine skeletal myotubes exposed to prolonged intermittent hypoxia or chronic hypoxia because hypoxia contributes to sarcopenia in COPD. Molecular biomarkers for senescence were also quantified with FTO depletion in murine myotubes. Results Multiple SNPs located in the FTO gene were associated with sarcopenia in addition to novel SNPs both within and in proximity to the gene AC090771.2, which transcribes long non‐coding RNA (lncRNA). To replicate our findings, we performed a GWAS of FFMI in NHW subjects from COPDGene. The SNP most significantly associated with FFMI was on chromosome (chr) 16, rs1558902A > T in the FTO gene (β = 0.151, SE = 0.021, P = 1.40 × 10−12 for UK Biobank |β= 0.220, SE = 0.041, P = 9.99 × 10−8 for COPDGene) and chr 18 SNP rs11664369C > T nearest to the AC090771.2 gene (β = 0.129, SE = 0.024, P = 4.64 × 10−8 for UK Biobank |β = 0.203, SE = 0.045, P = 6.38 × 10−6 for COPDGene). Lower handgrip strength, a measure of muscle strength, but not FFMI was associated with reduced telomere length in the UK Biobank. Experimentally, in vitro knockdown of FTO lowered myotube diameter and induced a senescence‐associated molecular phenotype, which was worsened by prolonged intermittent hypoxia and chronic hypoxia. Conclusions Genetic polymorphisms of FTO and AC090771.2 were associated with sarcopenia in COPD in independent cohorts. Knockdown of FTO in murine myotubes caused a molecular phenotype consistent with senescence that was exacerbated by hypoxia, a common condition in COPD. Genetic variation may interact with hypoxia and contribute to variable severity of sarcopenia and skeletal muscle molecular senescence phenotype in COPD.

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“…Ideally, the cutoff point should be at a point where sensitivity and specificity are optimally balanced, but considering SARC-F's position as a screening tool, better sensitivity may be better [39]. Alternatively, a modified version of SARC-F could be used to increase detection sensitivity for sarcopenia [40].…”

Section: Discussionmentioning

confidence: 99%

Accurate SARC-F Score in Patients with Liver Disease

et al. 2023

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SARC-F is a well-accepted screening tool for sarcopenia. A SARC-F value of 1 point is reported to be more discriminating in identifying sarcopenia than 4 points (recommended cutoff point). The prognostic impact of the SARC-F score was investigated in patients with liver disease (LD, n = 269, median age = 71 years, 96 hepatocellular carcinoma (HCC) cases). Factors associated with SARC-F ≥ 4 points and SARC-F ≥ 1 point were also examined. In the multivariate analysis, age (p = 0.048), and Geriatric Nutritional Risk Index (GNRI) score (p = 0.0365) were significant factors linked to SARC-F ≥ 1 point. In our patients with LD, the SARC-F score is well correlated with the GNRI score. The 1-year cumulative overall survival ratio in patients with SARC-F ≥ 1 (n = 159) and SARC-F 0 (n = 110) was 78.3% and 90.1% (p = 0.0181). After excluding 96 HCC cases, similar tendencies were found (p = 0.0289). In the receiver operating curve (ROC) analysis based on the prognosis for the SARC-F score, the area under the ROC was 0.60. The sensitivity was 0.57, the specificity was 0.62, and the optimal cutoff point of the SARC-F score was 1. In conclusion, sarcopenia in LDs can be affected by nutritional conditions. A SARC-F score of ≥1 is more useful than a score of 4 in predicting the prognosis of patients with LD.

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

Cited by 6 publications

References 30 publications

Utility of the SARC-F Questionnaire for Sarcopenia Screening in Patients with Chronic Liver Disease: A Multicenter Cross-Sectional Study in Japan

Utility of the SARC-F Questionnaire for Sarcopenia Screening in Patients with Chronic Liver Disease: A Multicenter Cross-Sectional Study in Japan

Gene polymorphisms associated with heterogeneity and senescence characteristics of sarcopenia in chronic obstructive pulmonary disease

Accurate SARC-F Score in Patients with Liver Disease

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