Sarcopenia as a prognostic predictor of liver cirrhosis: a multicentre study in China

Abstract

Background Diagnostic criteria for sarcopenia have not been established in Chinese. This study established criteria based on the L3-skeletal muscle index (L3-SMI) and assessed its value for outcomes predicting in cirrhotic Chinese patients. Methods Totally 911 subjects who underwent a CT scan at two centres were enrolled in Cohort 1 (394 male and 417 female subjects, aged 20-80 years). The data of those subjects younger than 60 years (365 male and 296 female subjects) were used to determine the reference intervals of the L3-SMI and its influencing factors. Cohort 2 consisted of 480 patients (286 male and 184 female patients) from three centres, and their data were used to investigate the prevalence of sarcopenia and evaluate the value of L3-SMI for predicting the prognosis and complications of cirrhosis. Results Age and sex had the greatest effects on the L3-SMI (P < 0.001). The L3-SMI scores were clearly higher in male patients than in female patients (52.94 ± 8.41 vs. 38.91 ± 5.65 cm 2 /m 2 , P < 0.001) and sharply declined in subjects aged ≥ 60 years. Based on the mean À1.28 × SD among adults aged < 60 years, the L3-SMI cut-off value for sarcopenia was 44.77 cm 2 /m 2 in male patients and 32.50 cm 2 /m 2 in female patients. Using these values, 22.5% of the cirrhotic patients (28.7% of male patients and 11.9% of female patients) were diagnosed with sarcopenia. Compared with non-sarcopenia individuals, sarcopenia patients had lower body mass index (21.28 ± 3.01 vs. 24.09 ± 3.39 kg/m 2 ,

Psoas Muscle Index Can Be Used to Predict Long-Term Mortality in Young Male Patients With Acute-on-Chronic Liver Failure

“…The predictive value of sarcopenia in chronic liver disease has been paid more and more attention (7,19). Recently, a meta-analysis (20) confirmed that sarcopenia was highly and independently associated with higher risk of mortality in patients with cirrhosis, which was consistent with a large sample multicenter study in China (21). In addition, studies (22,23) have reported that sarcopenia increases the risk of progression to ACLF and mortality in cirrhotic patients receiving transjugular intrahepatic portosystemic shunt.…”

Ammonia and the Muscle: An Emerging Point of View on Hepatic Encephalopathy

“…The presence of myosteatosis and sarcopenia has been associated with a poor prognosis in patients with liver cirrhosis [27]. Moreover, these conditions are associated to several complications of liver cirrhosis, such as ascites [28], Spontaneous bacterial peritonitis (SBP) [29], variceal bleeding [30], hepatocellular carcinoma [31] and infections [32,33].…”

Peking Prognostic Score, Based on Preoperative Sarcopenia Status, Is a Novel Prognostic Factor in Patients With Gastric Cancer

“…Sarcopenia, which is a kind of age-associated losses of muscle strength, mass, and function, has become a serious medical issue in aging societies ( 2 ). Sarcopenia is significantly related to non-alcoholic fatty liver disease, liver cirrhosis, or cardiovascular events ( 3 – 5 ). It is recognized that sarcopenia plays a more and more important role in cancer, since low muscularity represents an important predicting factor for dismal survival of different tumors ( 6 , 7 ).…”