Sarcopenia impairs health-related quality of life in cirrhotic patients

Abstract

Aim Sarcopenia is associated with poor health-related quality of life (HRQOL) in the general population. However, in cirrhotic patients, as the development of sarcopenia is closely related to declined liver function, which also impairs HRQOL, whether sarcopenia deteriorates HRQOL independently from declined liver function remains unclear. The aim of this study was to clarify the impact of sarcopenia on HRQOL impairment in cirrhotic patients. Patients and methods A total of 88 cirrhotic patients [median age, 69 years; range: 31–79 years; 49 male (55.7%), 45 with hepatocellular carcinoma (51.1%)] were analyzed. We measured HRQOL using the 36-item Short-Form Health Survey version 2 questionnaire and identified factors contributing to scores lower than 50 in physical component summary (PCS), mental component summary, and role-social component summary (RCS) scores. Results Twenty-four (27.2%) patients had sarcopenia. PCS and RCS scores were significantly lower in patients with sarcopenia compared with those without sarcopenia. Patients with Child–Pugh (CP) classification B or C showed significantly lower scores in PCS and RCS than those with CP classification A. On multivariate analysis, the presence of sarcopenia was the only factor associated with low PCS scores [odds ratio (OR): 11.6; P = 0.031]. Female sex (OR: 3.34; P = 0.034), CP classification B or C (OR: 3.19; P = 0.037), and presence of sarcopenia (OR: 4.64; P = 0.016) were identified as independent factors for low RCS scores. Conclusion Sarcopenia independently impairs physical and role-social HRQOL in cirrhotic patients.

Malnutrition, Frailty, and Sarcopenia in Patients With Cirrhosis: 2021 Practice Guidance by the American Association for the Study of Liver Diseases

“…Sarcopenia has been shown to be a robust predictor of a wide spectrum of outcomes in adults with cirrhosis both with and without HCC. 70,73,131,142,147,151,154,[157][158][159][160][161][162][163][164][165] These outcomes have included not only mortality both before and after liver transplantation 131,160,161 but also hepatic decompensation, 166 reduced quality of life, 167 increased risk for infection, 157 and prolonged hospitalization. 44,73,168 In a metaanalysis of 3,803 liver transplant candidates across 19 studies in partly overlapping cohorts published between 2000 and 2015, "sarcopenia," as defined by a wide range of CT-assessed skeletal muscle mass cut-…”

Sarcopenia as a predictor of mortality among the critically ill in an intensive care unit: a systematic review and meta-analysis

“…It is estimated that the prevalence of sarcopenia is approximately 30-70 % in intensive care units [ 10 , 11 ]. Sarcopenia has been confirmed to have an association with adverse clinical outcomes, such as falls, fractures, poor quality of life, mortality, and cognitive dysfunction among older adults in the community, nursing homes, or ICU [ 12 – 15 ]. Recently, Xia and colleagues published a meta-analysis concluding that injured patients with sarcopenia are at increased risk of mortality, with a two-fold increased risk compared to patient groups without sarcopenia [ 16 ].…”

Review article: prognostic significance of body composition abnormalities in patients with cirrhosis

“…Mortality in these patients appears to be related to infection and sepsis, 37 rather than liver dysfunction. Sarcopenia is also a predictor of longer hospital and intensive care unit stay, 38 poor quality of life 39 and post‐liver transplant mortality 40 …”

“…36 Mortality in these patients appears to be related to infection and sepsis, 37 rather than liver dysfunction. Sarcopenia is also a predictor of longer hospital and intensive care unit stay, 38 poor quality of life 39 and post-liver transplant mortality. 40 Many organs participate in whole body ammonia homoeostasis, with the liver playing a significant role; thus, decline in the liver capability to detoxify ammonia contributes to hyperammonemia seen in cirrhosis.…”