Sarcopenia is associated with the risk of significant liver fibrosis in metabolically unhealthy subjects with chronic hepatitis B

Han, Eugene; Lee, Yong-Ho; Kim, B. K.; Park, Jun Yong; Kim, D. Y.; Ahn, Sang Hoon; Lee, B.-W.; Kang, Eun Seok; Cha, Bong‐Soo; Han, Kwang Hyub; Kim, Seung Up

doi:10.1111/apt.14843

Cited by 39 publications

(46 citation statements)

References 47 publications

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“…These questions need to be explored to provide an understanding of gender differences, and to develop new non‐invasive biomarkers and targets to treat and prevent muscle wasting. There is a well described closed correlation with the degree of liver fibrosis and thus severity of liver disease . Nevertheless, it does not provide further insights into molecular mechanisms behind this observation.…”

Section: Discussionmentioning

confidence: 93%

“…There is a well described closed correlation with the degree of liver fibrosis and thus severity of liver disease. 25,26 Nevertheless, it does not provide further insights into molecular mechanisms behind this observation. Sex hormones such as testosterone and inappropriate autophagy may play an important role.…”

Section: The Gender Does Not Influence the Predictive Capacity Of Mmentioning

confidence: 98%

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Loss of paraspinal muscle mass is a gender‐specific consequence of cirrhosis that predicts complications and death

Engelmann

Schob

Nonnenmacher

et al. 2018

Aliment Pharmacol Ther

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Summary Background Loss of skeletal muscle mass is a recognised complication with a prognostic impact in patients with cirrhosis. Aim To explore in a retrospective analysis which muscle compartment most reliably predicts the occurrence of cirrhosis‐associated complications and if there are gender‐related differences. Methods 795 patients with cirrhosis listed for liver transplantation between 2001 and 2014 met the inclusion and exclusion criteria including an abdominal CT scan (±200). Controls were 109 patients who underwent a CT scan after polytrauma. The paraspinal muscles index (PSMI), the abdominal wall muscles index (AWMI) and its combination skeletal muscle index (SMI) were assessed at L3/L4, normalised to the height (cm2/m2). Results 62.0% of patients with cirrhosis had alcoholic liver disease, and 70.6% were male. As compared to controls, a reduction in PSMI and SMI but not AWMI was associated with high model of end‐stage liver disease (MELD) score, high Child‐Pugh class, and the presence or history of cirrhosis‐associated complications in males but not females. PSMI independently predicted the occurrence of bacterial infections (HR 0.932), spontaneous bacterial peritonitis (HR 0.901), hepatic encephalopathy (HR 0.961), and hepatorenal syndrome (HR 0.946) by multivariate Cox regression analysis in a gender‐independent manner. Post‐transplant survival was not associated with the PSMI; neither AWMI nor SMI predicted any clinical endpoints. Conclusions This study links muscle wasting in patients with cirrhosis predominantly to males. However, the presence of a low PSMI mass is a gender‐independent predictor of developing cirrhosis‐associated complications and death. Scores combining the MELD with muscle parameters should be re‐validated by utilizing the PSMI.

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Section: Discussionmentioning

confidence: 93%

Section: The Gender Does Not Influence the Predictive Capacity Of Mmentioning

confidence: 98%

Loss of paraspinal muscle mass is a gender‐specific consequence of cirrhosis that predicts complications and death

Engelmann

Schob

Nonnenmacher

et al. 2018

Aliment Pharmacol Ther

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“…Han et al investigated the association between sarcopenia and liver fibrosis in a large cohort of 506 Korean CHB patients derived from a nationwide cross‐sectional health survey . Sarcopenia was defined by sex‐specific measurements of appendicular skeletal muscle mass using dual‐energy X‐ray absorptiometry.…”

Section: Methods To Quantify Sarcopeniamentioning

confidence: 95%

Editorial: putting more muscle into treating our chronic hepatitis B patients—the importance of assessing sarcopenia

Mudaliar

Liu²

2018

Aliment Pharmacol Ther

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“…5,32,33 Further, there remains a substantial need for noninvasive predictors of fatty liver in patients with CHB, and recently several noninvasive surrogates, such as the HSI, have been implemented. 34 However, these surrogate tests rely on biochemical laboratory results, results such as AST or ALT, which are significantly influenced by AVT in patients with CHB. Thus, the diagnostic accuracy of the HSI should be confirmed in patients with CHB undergoing AVT.…”

Section: Discussionmentioning

confidence: 99%

Hepatic Steatosis Index in the Detection of Fatty Liver in Patients with Chronic Hepatitis B Receiving Antiviral Therapy

et al. 2021

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Background/Aims: The hepatic steatosis index (HSI) is a noninvasive method to assess the severity of hepatic steatosis. Antiviral therapy (AVT) can impact aspartate aminotransferase and alanine aminotransferase levels, which are the main components of the HSI. Thus, we investigated the accuracy of the HSI in detecting hepatic steatosis in patients with chronic hepatitis B (CHB) receiving AVT, compared with those not receiving AVT and in those with nonalcoholic fatty liver disease (NAFLD). Methods: Patients with CHB or NAFLD who underwent a magnetic resonance imaging proton density fat fraction (MRI-PDFF) evaluation between March 2010 and March 2019 were recruited. Hepatic steatosis was diagnosed when the PDFF exceeded 5%. Area under the receiver operating characteristic curve (AUROC) analysis was used to assess the diagnostic accuracy of the HSI in the detection of hepatic steatosis. Results: The mean age of the study population (189 men and 116 women; 244 with CHB [184 with and 60 without AVT] and 61 with NAFLD) was 55.6 years. The AUROC values for detecting hepatic steatosis were similar between patients with CHB (0.727; p<0.001) and those with NAFLD (0.739; p=0.002). However, when patients with CHB were subdivided into those receiving and not receiving AVT, the AUROC value decreased slightly in patients with CHB receiving AVT compared to those without not receiving AVT (0.707; p=0.001 vs 0.779; p=0.001). Conclusions: Despite a slight attenuation, the diagnostic accuracy of the HSI in patients with CHB receiving AVT in detecting hepatic steatosis was still acceptable. Further large-scale studies are required for validation.

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Sarcopenia is associated with the risk of significant liver fibrosis in metabolically unhealthy subjects with chronic hepatitis B

Abstract: Sarcopenia is associated with significant fibrosis in subjects with chronic hepatitis B, specifically those with obesity, insulin resistance, metabolic syndrome and liver steatosis.

Cited by 39 publications

References 47 publications

Loss of paraspinal muscle mass is a gender‐specific consequence of cirrhosis that predicts complications and death

Loss of paraspinal muscle mass is a gender‐specific consequence of cirrhosis that predicts complications and death

Editorial: putting more muscle into treating our chronic hepatitis B patients—the importance of assessing sarcopenia

Hepatic Steatosis Index in the Detection of Fatty Liver in Patients with Chronic Hepatitis B Receiving Antiviral Therapy

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