Development of a simple predictive model for decreased skeletal muscle mass in patients with compensated chronic liver disease

Nishikawa, Hiroki; Enomoto, Hirayuki; Ishii, Akio; Iwata, Yoshinori; Miyamoto, Yoshikazu; Ishii, Noriko; Yuri, Yukihisa; Takata, Ryo; Hasegawa, Kunihiro; Nakano, Chikage; Nishimura, Takashi; Aizawa, Nobuhiro; Sakai, Yoshiyuki; Ikeda, Naoto; Takashima, Tomoyuki; Iijima, Hiroko; Nishiguchi, Shuhei

doi:10.1111/hepr.12857

Cited by 17 publications

(18 citation statements)

References 31 publications

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“…Therefore, the serum BTR is considered to more strongly reflect the state of increased energy consumption within skeletal muscles, especially in athletes. In contrast to the correlations found in the present study, circulating BCAA levels have been reported to decrease with the decreases in skeletal muscle mass in patients with chronic liver diseases [8] and chronic heart failure [7]. In those studies, the diseases may have led to increased BCAA catabolism or insufficient BCAA intake, resulting in decreased concentrations of circulating BCAAs, which in turn may lead to a reduction in skeletal muscle mass.…”

Section: Discussioncontrasting

confidence: 99%

“…Sarcopenia (i.e., a decrease in skeletal muscle mass) is a serious clinical problem associated with poorer prognosis in various diseases [5,6]. Studies have reported a relationship between skeletal muscle mass and the concentration of circulating BCAAs in several diseases [7,8]. Patients with chronic heart failure showed lower serum BCAA concentrations and Fisher's ratios than controls, with positive correlations between the values of their skeletal muscle index (SMI), defined as skeletal muscle mass divided by the squared height, and their BCAA concentrations and Fisher's ratios [7].…”

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confidence: 99%

“…Patients with chronic heart failure showed lower serum BCAA concentrations and Fisher's ratios than controls, with positive correlations between the values of their skeletal muscle index (SMI), defined as skeletal muscle mass divided by the squared height, and their BCAA concentrations and Fisher's ratios [7]. In patients with chronic liver diseases, it was observed that lower BCAA to tyrosine ratios (BTRs) were associated with decreased skeletal muscle mass [8].…”

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confidence: 99%

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Circulating Branched-Chain Amino Acid Concentrations are Associated with Skeletal Muscle Mass and Thyroid Function in Young Japanese Men

Tsunekawa

Matsumoto

Ushiki

et al. 2020

Preprint

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Background Few nutritional markers reflect the hypermetabolic state of athletes with high levels of skeletal muscle. Although branched-chain amino acids (BCAA) play crucial roles in protein metabolism in skeletal muscle, the relation between circulating BCAA concentration and skeletal muscle mass has not been fully understood. The aim of this study is to evaluate the association between skeletal muscle mass and serum BCAA to tyrosine ratio (BTR), a convenient indicator of circulating BCAA, in young Japanese men including wrestling athletes with high skeletal muscle mass. Methods The study enrolled 111 young Japanese men: 70 wrestling athletes and 41 controls. None were taking medications or undergoing extreme dietary restriction or an intense exercise regimen. Each participant’s body composition, serum concentrations of albumin and rapid turnover proteins, BTR, and thyroid function were assessed. Results Compared to the controls, the athletes had significantly higher weight-adjusted skeletal muscle mass (SMM) ( p < 0.001) and skeletal muscle index (SMI) ( p < 0.001), and lower serum albumin concentration ( p < 0.001) and BTR ( p < 0.001). Kruskal–Wallis tests with Bonferroni multiple comparison tests showed that serum albumin concentration and BTR were significantly lower in the participants with higher SMM and SMI. Spearman's correlation analyses showed that SMM and SMI were inversely correlated with serum albumin concentration (SMM, ρ = −0.315, p = 0.001; SMI, ρ = −0.511, p < 0.001) and BTR (SMM, ρ = −0.424, p < 0.001; SMI, ρ = −0.511, p < 0.001). Serum albumin concentration was positively correlated with BTR (ρ = 0.438, p < 0.001), transthyretin (ρ = 0.281, p = 0.003) and transferrin (ρ = 0.299, p = 0.001), but BTR was not correlated with other nutritional indicators. Serum concentration of free 3,5,3′-triiodothyronine was inversely correlated with BTR (ρ = −0.308, p = 0.001), but not with serum albumin or skeletal muscle mass. Conclusions These results suggest that the consumption of circulating BCAAs increases with increased skeletal muscle mass and is facilitated by thyroid hormones independent of skeletal muscle mass. Serum BTR may be a useful biomarker to assess the hypermetabolic state of athletes.

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confidence: 99%

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Circulating Branched-Chain Amino Acid Concentrations are Associated with Skeletal Muscle Mass and Thyroid Function in Young Japanese Men

Tsunekawa

Matsumoto

Ushiki

et al. 2020

Preprint

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“…The mean age ( P < 0.001) was significantly higher in patients with sarcopenia than in those without sarcopenia. In contrast, the mean body mass index (BMI), which is reported to be associated with loss of skeletal muscle mass, and serum BCAA levels were markedly lower in patients with sarcopenia than in those without sarcopenia ( P < 0.01).…”

Section: Resultsmentioning

confidence: 96%

Sarcopenia predicts minimal hepatic encephalopathy in patients with liver cirrhosis

Hanai

Shiraki

Watanabe

et al. 2017

Hepatology Research

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“…Mac-2 binding protein glycosylation isomer (M2BPGi) as a liver fibrosis marker was tested, as reported elsewhere [26]. Skeletal muscle index (SMI, kg/m 2 ) was tested using BIA, as reported elsewhere [27]. SMI decline was defined as <7.0 kg/m 2 in males and < 5.7 kg/m 2 in females, referring to the Japanese guidelines [10].…”

Section: Patientsmentioning

confidence: 99%

Walking Speed: Japanese Data in Chronic Liver Diseases

Nishikawa

Enomoto

Iwata

et al. 2020

JCM

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We aim to clarify the impact of walking speed (WS) and analyze factors linked to WS decline in patients with chronic liver diseases (CLDs, 165 males and 191 females, 137 liver cirrhosis patients). The WS decline is defined as <0.8 m/second (m/s), referring to the guidelines. The median (range) WS was 1.3 m/s (0.2–2.02 m/s). There were 17 patients with WS < 0.8 m/s (4.8%). The WS value was significantly correlated with the handgrip strength value both in males (r2 = 0.252, p < 0.0001) and females (r2 = 0.256, p < 0.0001). In the multivariate analysis of factors associated with WS decline, only the extracellular water (ECW) to total body water (TBW) ratio using bioimpedance analysis was an independent predictor (p = 0.0398). Extracellular fluid excess was categorized as follows: normal condition (ECW to TBW ratio < 0.390), mild overhydrated condition (ECW to TBW ratio 0.390–0.399), and moderate to severe overhydrated condition (ECW to TBW ratio ≥ 0.400). The WS value was well stratified according to the ECW to TBW ratio (normal vs. mild, p = 0.0001; mild vs. moderate to severe, p < 0.0001; normal vs. moderate to severe, p < 0.0001; overall p-value < 0.0001). In conclusion, the ECW to TBW ratio can be closely linked to WS decline in CLD patients.

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Development of a simple predictive model for decreased skeletal muscle mass in patients with compensated chronic liver disease

Abstract: The BALB scoring system based on routinely used clinical parameters offers a convenient and non-invasive method for predicting DSMM in compensated CLD patients with high accuracy.

Cited by 17 publications

References 31 publications

Circulating Branched-Chain Amino Acid Concentrations are Associated with Skeletal Muscle Mass and Thyroid Function in Young Japanese Men

Circulating Branched-Chain Amino Acid Concentrations are Associated with Skeletal Muscle Mass and Thyroid Function in Young Japanese Men

Sarcopenia predicts minimal hepatic encephalopathy in patients with liver cirrhosis

Walking Speed: Japanese Data in Chronic Liver Diseases

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