Nutritional status in relation to lifestyle in patients with compensated viral cirrhosis

Hayashi, Fumikazu; Momoki, Chika; Yuikawa, Miho; Simotani, Yuko; Kawamura, Etsushi; Hagihara, Atsushi; Fujii, Hideki; Kobayashi, Sho; Iwai, Shuji; Morikawa, Hiroyasu; Enomoto, Masaru; Tamori, Akihiro; Kawada, Norifumi; Ohfuji, Satoko; Fukusima, Wakaba; Habu, Daiki

doi:10.3748/wjg.v18.i40.5759

Cited by 35 publications

(29 citation statements)

References 33 publications

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“…Compared with daily steps in other chronic diseases, shown for reference in Fig. , our patients' mean activity level was similar to that of persons with dialysis‐dependent chronic renal failure and chronic obstructive pulmonary disease (COPD) and less than that of patients with congestive heart failure (CHF) or compensated hepatitis C cirrhosis …”

Section: Resultssupporting

confidence: 49%

The gap between clinically assessed physical performance and objective physical activity in liver transplant candidates

Dunn

Josbeno²,

Schmotzer

et al. 2016

Liver Transpl

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Frailty with sarcopenia in cirrhosis causes liver transplant wait-list attrition and deaths. Regular physical activity is needed to protect patients with cirrhosis from frailty. We subjectively assess physical performance in selecting patients for transplant listing, but we do not know whether clinical assessments reflect the extent of activity patients actually perform. To investigate this question, 53 wait-listed patients self-assessed their performance of ordinary physical tasks using the Rosow-Breslau survey, and clinicians assessed their physical performance status with the Karnofsky index. We compared these assessments with actual activity measured using an accelerometer/thermal sensing armband worn from 4 to 7 days. We found that their measured activity was among the lowest reported in chronic disease, similar to that of patients with advanced chronic pulmonary disease or renal failure. Their percentages of waking hours spent in sedentary, light, and moderate-vigorous activity were 75.9% ± 18.9%, 18.9% ± 14.3%, and 4.9% ± 6.9%, respectively. Higher mean sedentary and lower mean moderate-vigorous activity was significantly associated with 9 wait-list deaths (P = 0.004). Compared with a range of 7000-13,000 steps/day in healthy adults, patients' mean steps/day were 3164 ± 2842. Both their activity percentage and step data were typical of other severely inactive populations. Neither their Rosow-Breslau scores (mean 2.3 ± 0.8, maximum 3.0) nor their Karnofsky scores (mean 79 ± 12, maximum 100) suggested major impairment or showed a correlation with patients' actual physical performance. In conclusion, physical activity in patients with cirrhosis wait-listed for transplantation is highly sedentary. Self-assessments and provider assessments of physical activity do not reliably indicate actual performance. Whether the gap between assessed and actual performance may be favorably modified by interventions to improve activity and ameliorate frailty merits further study. Liver Transplantation 22 1324-1332 2016 AASLD.

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Section: Resultssupporting

confidence: 49%

The gap between clinically assessed physical performance and objective physical activity in liver transplant candidates

Dunn

Josbeno²,

Schmotzer

et al. 2016

Liver Transpl

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“…This suggests that liver cirrhosis can induce muscle injury. Previously, we found that skeletal muscle mass and muscle strength assessed anthropometrically were significantly lower in patients with chronic liver disease than in healthy subjects . Moreover, the amount of exercise, expressed as active physical activity measured using an accelerometer, was significantly lower in cirrhotic patients with sarcopenia than in cirrhotic patients without sarcopenia .…”

Section: Discussionmentioning

confidence: 82%

“…Previously, we found that skeletal muscle mass and muscle strength assessed anthropometrically were significantly lower in patients with chronic liver disease than in healthy subjects. 59 Moreover, the amount of exercise, expressed as active physical activity measured using an accelerometer, was significantly lower in cirrhotic patients with sarcopenia than in cirrhotic patients without sarcopenia. 16 The results of these studies suggest that patients with chronic liver disease and loss of skeletal muscle have decreased exercise tolerance, possibly indicating that the reduction in physical activity may be a factor leading to the loss of skeletal muscle.…”

Section: Discussionmentioning

confidence: 95%

Loss of skeletal muscle mass in patients with chronic liver disease is related to decrease in bone mineral density and exercise tolerance

Hayashi

Kaibori

Sakaguchi

et al. 2017

Hepatology Research

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“…In the present analysis, a finger‐circle test result other than Bigger in male patients and Smaller in female patients predicted early occurrence of MA. Daily physical activity has been reported to be lower in CLD patients as compared with healthy subjects . To confirm the relationships among total muscle volume or area of L3, maximum calf circumference, and level of daily physical activity, an additional study is necessary.…”

Section: Discussionmentioning

confidence: 99%

“…Daily physical activity has been reported to be lower in CLD patients as compared with healthy subjects. 18,19 To confirm the relationships among total muscle volume or area of L3, maximum calf circumference, and level of daily physical activity, an additional study is necessary. In addition, number of obese individuals was too small in the present cohort (3.4%) for confirming the predictive value of finger-circle test in obese individuals with CLD.…”

Section: Discussionmentioning

confidence: 99%

Easy surveillance of muscle volume decline in chronic liver disease patients using finger‐circle (yubi‐wakka) test

Hiraoka

Izumoto

Ueki

et al. 2019

J cachexia sarcopenia muscle

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Background Muscle atrophy (MA) and muscle strength decline are important clinical features in chronic liver disease (CLD) patients. An easy to perform MA screening method without need for special equipment would be helpful. We evaluated the usefulness of the previously reported finger‐circle test as screening for MA in CLD patients. Methods We retrospectively enrolled 358 Japanese CLD outpatients (70.8 ± 10.2 years, male/female = 234/124) who had undergone a computed tomography examination from December 2017 to March 2018, of whom 137 had chronic hepatitis, 169 had liver cirrhosis Child–Pugh A, and 52 had liver cirrhosis Child–Pugh B/C. Bilateral psoas muscle area at the middle of the third lumber vertebra (L3) was evaluated with computed tomography findings, which was performed as a screening of hepatocellular carcinoma, using a previously reported parameter for MA [psoas index (PI): total psoas muscle area (cm 2 )/height (m) 2 ] [mean PI ± standard deviation (SD) of male patients: 6.50 ± 1.13 cm 2 /m 2 and those of female patients: 4.30 ± 0.90 cm 2 /m 2 ]. We then evaluated the correlation between MA and finger‐circle test results in these patients. Results The mean PI values for finger‐circle test results Bigger, Just‐fits, and Smaller were 5.64 ± 1.34, 5.00 ± 1.25, and 4.83 ± 1.46 cm 2 /m 2 , respectively, in male patients ( P < 0.001) and 4.31 ± 1.06, 3.93 ± 0.97, and 3.42 ± 0.94 cm 2 /m 2 , respectively, in female patients ( P = 0.001). We found that a finger‐circle test result in male patients other than Bigger (Just‐fits and Smaller) predicted a decline in psoas muscle area of L3 to PI 5.25 cm 2 /m 2 (sensitivity/specificity 0.619/0.667, area under the curve 0.654, 95% confidence interval 0.583–0.724), which was approximately mean minus 1 SD (5.37 cm 2 /m 2 ). On the other hand, a Smaller test result in female patients predicted a decline in psoas muscle area of L3 to PI 3.33 cm 2 /m 2 (sensitivity/specificity 0.740/0.583, area under the curve 0.698, 95% confidence interval 0.583–0.813), approximately mean minus 1 SD (3.40 cm 2 /m 2 ). Conclusions The finger‐circle test is an easy to perform and effective screening method for predicting earlier stage of MA in CLD patients without the need for special equipment.

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Nutritional status in relation to lifestyle in patients with compensated viral cirrhosis

Abstract: Non-hospitalized cirrhotic patients may need to maintain an adequate dietary intake and receive lifestyle guidance to increase their physical activity levels.

Cited by 35 publications

References 33 publications

The gap between clinically assessed physical performance and objective physical activity in liver transplant candidates

The gap between clinically assessed physical performance and objective physical activity in liver transplant candidates

Loss of skeletal muscle mass in patients with chronic liver disease is related to decrease in bone mineral density and exercise tolerance

Easy surveillance of muscle volume decline in chronic liver disease patients using finger‐circle (yubi‐wakka) test

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