Relative changes in handgrip strength and skeletal muscle volume in patients with chronic liver disease over a 2‐year observation period

Self Cite

Aim Falling is known to be associated with cognitive function. We evaluated the relationship between muscle function and falls in patients with chronic liver disease (CLD). Methods We enrolled 100 sequential CLD patients without dementia who were admitted to our institution for scheduled treatment from July 2017 to May 2018 (age 71.0 ± 10.2 years; 76 men). All subjects were self‐reliant in regard to activities of daily living. On admission, handgrip strength was determined and falls within 1 month of admission were noted. For determining handgrip strength decline (HSD), previously reported values were used (men, <26 kg; women, <18 kg). The relationship between HSD and falls in CLD patients was evaluated in a retrospective manner. Results Thirty‐two patients had chronic hepatitis and 49 had liver cirrhosis (LC) Child–Pugh A, 17 had LC Child–Pugh B, and 2 had LC Child–Pugh C. Twelve (12.0%) had a history of falling, including 8 (26.7%) of 30 with and 4 (5.7%) of 70 without HSD (P = 0.006). The cut‐off value for age in relationship to falling was 69.0 years old (area under the receiver operating characteristic curve, 0.668; 95% confidence interval, 0.514–0.821). A fall during hospitalization was noted more often in patients with a history of falling than in those without (16.7% [2/12] vs. 2.3% [2/88], P = 0.018). Conclusion In CLD patients, the presence of HSD and older age might be independent risk factors for predicting a fall. Assessment of handgrip strength could be an effective clinical tool for easily assessing the risk of falling, especially in elderly CLD patients.

Section: Discussionmentioning

confidence: 99%

Prediction of risk of falls based on handgrip strength in chronic liver disease patients living independently

Hiraoka

Tamura

Oka

et al. 2019

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“…Previously, we showed that high WFA + ‐M2BP levels were strongly correlated with the Child–Pugh score . As the Child–Pugh class was an independent predictor linked to skeletal muscle mass decline, it is reasonable to consider that the WFA + ‐M2BP level is a good biomarker and a surrogate for LSMM in patients with liver cirrhosis …”

Section: Discussionmentioning

confidence: 99%

“…Hiraoka et al . reported that decline in the Child–Pugh score showed a significant relationship with muscle function reduction and muscle volume loss . The change in muscle mass is more significant in the severe stages of chronic liver diseases, such as decompensated cirrhosis with complications of hypoalbuminemia, hyposodium, encephalopathy, ascites, and/or hepatic cachexia …”

Section: Introductionmentioning

confidence: 99%

Risk factors for loss of skeletal muscle mass in patients with cirrhosis

Sung

Uojima

Hidaka

et al. 2019

Aim The present study aimed to assess the correlation between loss of skeletal muscle mass (LSMM) and the clinical characteristics of patients with liver cirrhosis. Methods This multicenter, prospective study was undertaken at five locations in Japan and involved a 12‐month observation period. After baseline assessment, the change in the skeletal muscle index per year (ΔSMI/y) was evaluated in the enrolled patients; LSMM was defined as ΔSMI/y < 0. We evaluated the relationships between LSMM and baseline clinical characteristics in patients with liver cirrhosis. Results A total of 166 patients with cirrhosis were enrolled and, of these, 123 patients (74.1%) showed LSMM. Multivariate analysis confirmed that hepatic encephalopathy, Wisteria floribunda agglutinin‐positive Mac‐2 binding protein (WFA+‐M2BP) (≥1.86), age (≥60 years), and grip strength (<18 kg for women and <26 kg for men) were independent predictors of skeletal muscle decline (P = 0.042, odds ratio [OR] 8.997, 95% confidence interval [CI] 1.083–74.71; P = 0.023, OR 3.970, 95% CI 1.468–6.177; P = 0.037, OR 2.526, 95% CI 1.056–6.045; and P = 0.002, OR 3.970, 95% CI 1.691–9.322, respectively). Conclusions Advanced age, low grip strength, hepatic encephalopathy, and high WFA+‐M2BP might be risk factors for LSMM in liver cirrhosis patients.

“…Next, we investigated the relationship between sarcopenia‐related indices and changes in liver function. In a previous study, muscle function reduction and muscle volume loss in patients with liver cirrhosis showed a significant relationship with decreasing serum albumin levels . We also previously reported that Japanese patients with NASH whose serum ALT level did not decrease by at least 30% from baseline have a higher risk of disease progression, including both liver fibrosis and NAS .…”

Section: Discussionmentioning

confidence: 64%

“…In a previous study, muscle function reduction and muscle volume loss in patients with liver cirrhosis showed a significant relationship with decreasing serum albumin levels. 28 We also previously reported that Results are the median (range) for quantitative data. †Bold font for P-values indicates <0.05.…”

Section: W E Investigated the Features Of Severalmentioning

confidence: 90%

Clinical and pathological features of sarcopenia‐related indices in patients with non‐alcoholic fatty liver disease

Seko

Mizuno

Okishio

et al. 2019

Background Sarcopenia is diagnosed with the skeletal muscle index (SMI) or the sarcopenia index (SI). We previously reported that the ratio of skeletal muscle mass to body fat mass (SF ratio) was a novel index of sarcopenia in patients with non‐alcoholic fatty liver disease (NAFLD). The aim of this retrospective study was to evaluate sarcopenia with these indices in patients with NAFLD. Methods One hundred and fifty‐six consecutive patients with biopsy‐proven NAFLD and alanine aminotransferase (ALT) >40 IU/L were enrolled. Liver function and body composition were evaluated in 121 patients after 12 months. We evaluated the relationship between histological findings, changes in liver function, and the SMI, SI, and SF ratio. Results Of the 156 patients enrolled, 13.5% and 26.3% were diagnosed with sarcopenia with the SMI and SI. In patients with hepatic fibrosis stage <2, the SI and the SF ratio were significantly greater than in patients with fibrosis stage ≥2. There was no difference in SMI between groups. In the cohort assessed at baseline and 12 months later, transaminase activity and SMI decreased significantly, and the SF ratio increased over time. A multivariate analysis revealed the presence of the PNPLA3 G allele and an increase in SF ratio (odds ratio, 7.406) as predictive factors of ALT reduction >30% from baseline. Conclusions Due to the high prevalence of obesity, we should consider both skeletal muscle mass and body fat mass in the diagnosis and treatment of NAFLD. The SF ratio could be a useful index in sarcopenic NAFLD.