Grip Strength: A Useful Marker for Composite Hepatic Events in Patients with Chronic Liver Diseases

Nishikawa, Hiroki; Enomoto, Hirayuki; Iwata, Yoshinori; Ikeda, Naoto; Aizawa, Nobuhiro; Nishimura, Takashi; Iijima, Hiroko; Nishiguchi, Shuhei

doi:10.3390/diagnostics10040238

Cited by 16 publications

(19 citation statements)

References 56 publications

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“…Since HCC often recurs and requires repeated treatments, the loss of muscle strength may have been a stronger factor than the loss of skeletal muscle mass in the process. Indeed, recently published studies have reported that GS (muscle strength) has a greater effect on the prognosis than the skeletal muscle mass in community-dwelling elderly people, as well as patients with chronic liver disease [ 19 , 20 , 21 ]. In fact, the European Working Group on Sarcopenia in Older People (EWGSOP) guidelines state that low muscle strength is the primary parameter of sarcopenia, because muscle strength is the most reliable measure of the muscle function [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

“…These studies included a variety of tumors, including lung, colorectal, breast and prostate cancers, suggesting that the effect of GS may not be independent of the cancer type. Furthermore, it has already been shown that GS has a stronger prognostic impact than SMI in CLD, the underlying disease of HCC [ 19 , 21 ]. These results suggest that a low GS is a poor prognostic factor for systemic chemotherapy other than lenvatinib in u-HCC.…”

Section: Discussionmentioning

confidence: 99%

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Impact of Grip Strength in Patients with Unresectable Hepatocellular Carcinoma Treated with Lenvatinib

Endo

Kuroda

Kanazawa

et al. 2020

Cancers

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Although sarcopenia is characterized by a loss of muscle strength and skeletal muscle mass, few studies have evaluated the effect of muscle strength on hepatocellular carcinoma (HCC) patients. We evaluated the impact of sarcopenia-related factors (grip strength (GS) and the skeletal muscle index (SMI)) on the survival among lenvatinib-treated unresectable HCC (u-HCC) patients. This single-center cohort study was conducted at a university hospital. The study population included 63 lenvatinib-treated u-HCC patients managed between April 2018 and April 2020. A decreased GS and decreased SMI were found in 21 (33.3%) and 22 (34.9%) patients, respectively. The overall survival (OS) of the normal GS group was significantly higher than that of the decreased GS group, while that of the normal and decreased SMI groups did not differ markedly. There were no significant differences in the progression-free survival between the normal GS and decreased GS groups or the normal SMI and decreased SMI groups. A multivariate Cox proportional hazards model showed that modified albumin-bilirubin-grade (mALBI) 2b (hazard ratio (HR) 4.39) and a decreased GS (HR 3.55) were independently associated with an increased risk of poor prognosis. In addition to the hepatic functional reserve, a decreased GS was a poor prognostic factor in lenvatinib-treated u-HCC patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Impact of Grip Strength in Patients with Unresectable Hepatocellular Carcinoma Treated with Lenvatinib

Endo

Kuroda

Kanazawa

et al. 2020

Cancers

View full text Add to dashboard Cite

show abstract

“…However, those studies had individually defined cut‐off values for a low SMI and were not guideline‐based. More recent studies have reported that low grip strength (muscle strength) has a greater effect on the prognosis than a low skeletal muscle mass in patients with CLD as well as patients with HCC treated with lenvatinib 45–47 . In fact, the European Working Group on Sarcopenia in Older People (EWGSOP) guidelines state that a low muscle strength is the primary parameter of sarcopenia, as muscle strength is the most reliable measure of the muscle function 21 .…”

Section: Discussionmentioning

confidence: 99%

Calf and arm circumference as simple markers for screening sarcopenia in patients with chronic liver disease

Endo

Sato

Kakisaka

et al. 2020

Hepatology Research

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Aim To prevent the progression of sarcopenia, early identification is important. We investigated the usefulness of sarcopenia screening tests using the arm and calf circumferences in patients with chronic liver disease. Methods This was a single‐center cross‐sectional study based on data collected from a university hospital. We analyzed simple anthropometric data and sarcopenia‐related chemical data or imaging data between April and December 2019. Sarcopenia was defined according to the Japan Society of Hepatology guidelines. Results In total, 661 patients participated. Low muscle mass and low muscle strength were found in 245 (37.1%) and 153 (23.1%) patients, respectively. Ultimately, 90 (13.6%) patients were diagnosed with sarcopenia. The sarcopenia group was significantly older and had a higher cirrhosis ratio and poorer liver function than the non‐sarcopenia group. The sarcopenia group had a significantly lower body mass index, arm circumferences and calf circumferences than the non‐sarcopenia group. A receiver operating characteristics analysis for diagnosing sarcopenia by arm and calf circumferences showed respective areas under the curve of 0.89 and 0.91 for men and 0.84 and 0.89 for women. The optimal cut‐off values of arm and calf circumferences were respectively determined to be 25.0 and 32.6 cm for men (sensitivity 88.4% and 83.7%; specificity 74.0% and 84.7%) and 22.7 and 32.1 cm for women (sensitivity 66.0% and 85.1%; specificity 90.0% and 81.3%). Conclusions The arm and calf circumferences seem useful as simple surrogate markers for screening sarcopenia in patients with chronic liver disease.

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“…Indeed, recently published studies have reported that GS (muscle strength) has a greater effect on the prognosis than the skeletal muscle mass in community-dwelling elderly people, as well as patients with chronic liver disease [17][18][19] hospital stays, increased functional limitations, poor health-related quality of life and death). In addition, the measurement of GS is usually easier than the measurement of skeletal muscle mass because the measurement of skeletal muscle mass requires special equipment, such as a bioelectrical impedance analysis (BIA), dual-energy X-ray absorptiometry (DEXA) and CT.…”

Section: Discussionmentioning

confidence: 99%

Impact of Grip Strength in Patients with Unresectable Hepatocellular Carcinoma Treated with Lenvatinib

Endo¹,

Kuroda²,

Kanazawa³

et al. 2020

Preprint

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Although sarcopenia is characterized by a loss of muscle strength and skeletal muscle mass, few studies have evaluated the effect of muscle strength on hepatocellular carcinoma (HCC) patients. We separately evaluated the impact of sarcopenia-related factors (grip strength [GS] and the skeletal muscle index [SMI]) on the survival among lenvatinib-treated unresectable HCC (u-HCC) patients. This single-center cohort study was conducted at a university hospital. The study population included 63 lenvatinib-treated u-HCC patients managed between April 2018 and April 2020. A decreased GS and decreased SMI were found in 21 (33.3%) and 22 (34.9%) patients, respectively. The overall survival (OS) of the normal GS group was significantly higher than that of the decreased GS group, while that of the normal and decreased SMI groups did not differ markedly. There were no significant differences in the progression-free survival between the normal GS and decreased GS groups or the normal SMI and decreased SMI groups. A multivariate Cox proportional hazards model showed that ALBI2b (hazard ratio [HR] 4.39) and a decreased GS (HR 3.55) were independently associated with an increased risk of poor prognosis. In addition to the hepatic functional reserve, a decreased GS was a poor prognostic factor in lenvatinib-treated u-HCC patients.

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Grip Strength: A Useful Marker for Composite Hepatic Events in Patients with Chronic Liver Diseases

Cited by 16 publications

References 56 publications

Impact of Grip Strength in Patients with Unresectable Hepatocellular Carcinoma Treated with Lenvatinib

Impact of Grip Strength in Patients with Unresectable Hepatocellular Carcinoma Treated with Lenvatinib

Calf and arm circumference as simple markers for screening sarcopenia in patients with chronic liver disease

Impact of Grip Strength in Patients with Unresectable Hepatocellular Carcinoma Treated with Lenvatinib

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