Low Testosterone Levels Predict Sarcopenia Showing an Effect on Prognosis in Patients with Cirrhosis: A Retrospective Study

Abstract

Background: Sarcopenia and low serum testosterone levels are both associated with increased mortality in patients with advanced liver disease. Sarcopenia is a major stumbling block of liver cirrhosis and adversely affects other outcome variables. Objective: The aim of this study is to compare testosterone levels between sarcopenia and non-sarcopenia cirrhosis patients, to compare serum testosterone levels with cirrhosis severity (Child-Pugh Score), evaluate the correlation between serum testosterone levels and L3 SMI Index (Sarcopenia), the correlation between serum testosterone levels with other prognostic markers of cirrhosis (MELD score) Method: An observational study of 131 prospectively collected liver cirrhosis patients, who met the inclusion and exclusion criteria, was conducted in the Department of Gastroenterology, National Institute of Medical Sciences and Research, NIMS University, Jaipur, Rajasthan, India, between August 2019 and July 2021. Spearman’s correlation coefficient was used to evaluate the correlation between testosterone levels and L3 SMI. Results: The mean testosterone level in sarcopenia patients was significantly lowered compared to non-sarcopenia patients (152.05± 90.48 vs. 364.28 ±73.55; p=0.05). The mean testosterone level was highest in Child A than in Child B and lowest in Child C, which was statistically significant (383.50 ± 54.41 vs. 225.06 ± 58.43 vs. 83.38 ± 25.49, p=0.05). There was a significantly positive correlation between serum testosterone levels and L3 SMI index by MRI (r = 0.619 and p-value <0.000). There was a significant negative correlation between the MELD score and serum testosterone levels. Conclusion: Serum testosterone levels were significantly lower in sarcopenic as compared to non-sarcopenic patients. Serum testosterone levels progressively decreased as liver disease severity increased. There was a significant positive correlation between serum testosterone levels and L3-SMI Index (Sarcopenia)