Sex Differences in the Association Between Frailty and Sarcopenia in Patients With Cirrhosis

Fozouni, Laila; Wang, Connie W.; Lai, Jennifer C.

doi:10.14309/ctg.0000000000000102

Cited by 23 publications

(22 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Sarcopenia in CLDs is indeed similar to physical frailty (41). Sarcopenia may be the dominant driver of the physical frailty phenotype, especially in LC patients where hepatic synthetic impairment may accelerate the skeletal muscle mass decrease (14,42,43). In our data, 13.5% of our patients had frailty, while Fozouni et al have reported that out of 291 LC patients, 54 LC patients (19%) had frailty (42).…”

Section: Discussionsupporting

confidence: 63%

“…In our data, 13.5% of our patients had frailty, while Fozouni et al have reported that out of 291 LC patients, 54 LC patients (19%) had frailty (42). This is probably due to the difference of background patient population (prevalence of LC: 35.8% in our data vs. 100% in the study by Fozouni et al) (42). Age-stratified meta-analyses reported by Kojima et al have demonstrated that the pooled prevalence of frailty among elderly people living in Japan was 1.9% (65-69 years), 3.8% (70-74 years), 10.0% (75-79 years), 20.4% (80-84 years), and 35.1% (85 years or more) (44).…”

Section: Discussioncontrasting

confidence: 40%

“…Sarcopenia may be the dominant driver of the physical frailty phenotype, especially in LC patients where hepatic synthetic impairment may accelerate the skeletal muscle mass decrease (14,42,43). In our data, 13.5% of our patients had frailty, while Fozouni et al have reported that out of 291 LC patients, 54 LC patients (19%) had frailty (42). This is probably due to the difference of background patient population (prevalence of LC: 35.8% in our data vs. 100% in the study by Fozouni et al) (42).…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Sarcopenia and Frailty in Chronic Liver Damage: Common and Different Points

Nishikawa

Enomoto

Iwata

et al. 2020

In Vivo

View full text Add to dashboard Cite

Aim: To elucidate the common and different points between sarcopenia and frailty in chronic liver damage (CLD). Patients and Methods: Patients with both grip strength decline and skeletal muscle index decline were regarded as sarcopenia. Frailty was defined as a syndrome in which 3 or more of the following criteria were met: i) exhaustion, ii) body weight loss, iii) slow walking speed, iv) muscle weakness, and v) low physical activity. Results: Sarcopenia and frailty were identified in 52 patients (15.2%) and 46 (13.5%), respectively. The prevalence of sarcopenia and frailty was well stratified according to age and the liver cirrhosis (LC) status. In the multivariate analysis, we identified significant factors for sarcopenia: i) age, ii) LC, iii) body mass index and iv) extracellular water (ECW) to total body water (TBW) ratio, while only the ECW to TBW ratio was significant for frailty. Conclusion: Sarcopenia and frailty in CLD should be separately evaluated. In individuals with chronic liver damage (CLD), metabolic functions are frequently damaged leading to several nutritional disorders, including protein-energy-malnutrition, or muscle abnormalities (1). Since sarcopenia, as assessed by muscle mass decrease and muscle strength impairment in patients with CLD, can be related to falls, poor quality of life or poor prognosis, it has become a very interesting topic to examine for physicians (2-8). Sarcopenia is one of the most common consequences found in patients with liver cirrhosis (LC), affecting 30% to 70% of LC patients, and it can be a main determinant for the incidence of hepatic encephalopathy in LC patients (1, 9, 10-13). Japanese CLD patients can now be found in aging populations, and this fact is also a crucial public health issue since aging itself can cause sarcopenia (14-16). To avoid unfavorable consequences related to sarcopenia one needs to assess this disease as a condition with a systemic involvement (17-19). Improving physical activity or nutrition and adequately managing any underlying diseases are essential steps for avoiding sarcopenia (6). Frailty is a concept globally used in geriatrics that precedes disability, and is defined as a condition of increased vulnerability associated with physiological decline (20-22). Originally, it was proposed to identify elderly people at an elevated risk of adverse health outcomes, dependencies, falls, disabilities, and mortality (20-22). Frailty is determined based on the evaluation of physical, functional and cognitive abilities. The frailty phenotype is defined as the presence of 3 or more of the following criteria: i) body weight (BW) loss, ii) self-reported exhaustion, iii) skeletal muscle function decline, iv) slow walking speed (WS) and v) low physical activity (23, 24). Sarcopenia is an important component of frailty (22). Aging is indeed closely linked to changes in body composition, especially skeletal muscle mass decline, resulting in disability and mortality (14, 16, 24). While any chronic organ dysfunction can also lead to physiological vulne...

show abstract

Section: Discussionsupporting

confidence: 63%

Section: Discussioncontrasting

confidence: 40%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Sarcopenia and Frailty in Chronic Liver Damage: Common and Different Points

Nishikawa

Enomoto

Iwata

et al. 2020

In Vivo

View full text Add to dashboard Cite

show abstract

“…144 Sarcopenia can also manifest as frailty, which is an independent predictor of mortality in patients with cirrhosis. 145,146 The relationship between frailty and sarcopenia is stronger in men than in women. 145 The direct impact of frailty on the risk of HE is unknown.…”

Section: Malnutritionmentioning

confidence: 99%

Hepatic encephalopathy: Novel insights into classification, pathophysiology and therapy

Rose

Amodio

Bajaj

et al. 2020

Journal of Hepatology

269

223

View full text Add to dashboard Cite

Hepatic encephalopathy (HE) is a frequent and serious complication of both chronic liver disease and acute liver failure. HE manifests as a wide spectrum of neuropsychiatric abnormalities, from subclinical changes (mild cognitive impairment) to marked disorientation, confusion and coma. The clinical and economic burden of HE is considerable, and it contributes greatly to impaired quality of life, morbidity and mortality. This review will critically discuss the latest classification of HE, as well as the pathogenesis and pathophysiological pathways underlying the neurological decline in patients with end-stage liver disease. In addition, management strategies, diagnostic approaches, currently available therapeutic options and novel treatment strategies are discussed.

show abstract

“…Given that the liver plays a vital role in protein, glucose, lipid, and energy metabolism, LC is frequently complicated by protein–energy malnutrition (PEM), which can lead to sarcopenia [ 1 ]. In real-world clinical settings, the prevalence of sarcopenia in patients with LC ranges from 16.7% to 36.1% [ 4 , 5 , 6 , 7 ]. Accordingly, early comprehensive assessment and treatment intervention for sarcopenia are indispensable in patients with LC.…”

Section: Introductionmentioning

confidence: 99%

Low Serum Branched-chain Amino Acid and Insulin-Like Growth Factor-1 Levels Are Associated with Sarcopenia and Slow Gait Speed in Patients with Liver Cirrhosis

Saeki

Kanai

Nakano

et al. 2020

JCM

View full text Add to dashboard Cite

Branched-chain amino acid (BCAA) and insulin-like growth factor 1 (IGF-1) are essential for muscle protein synthesis. We investigated the association of serum BCAA and IGF-1 levels with sarcopenia and gait speed in 192 patients with liver cirrhosis (LC). Sarcopenia was diagnosed according to the Japan Society of Hepatology criteria. Slow gait speed was defined as <1.0 m/s. Subjects were divided into three groups based on baseline BCAA or IGF-1 levels: low (L), intermediate (I), and high (H) groups. The L-BCAA group had the highest prevalence of sarcopenia (60.4%, p < 0.001) and slow gait speed (56.3%, p = 0.008), whereas the H-BCAA group had the lowest prevalence of sarcopenia (8.5%, p < 0.001). The L-IGF-1 group showed the highest prevalence of sarcopenia (46.9%, p < 0.001), whereas the H-IGF-1 group had the lowest prevalence of sarcopenia (10.0%, p < 0.001) and slow gait speed (18.0%, p = 0.003). Using the optimal BCAA and IGF-1 cutoff values for predicting sarcopenia (372 μmol/L and 48.5 ng/mL, respectively), the sensitivity and specificity were 0.709 and 0.759 for BCAA and 0.636 and 0.715 for IGF-1, respectively. Low serum BCAA and IGF-1 levels were associated with sarcopenia and slow gait speed in patients with LC.

show abstract

Sex Differences in the Association Between Frailty and Sarcopenia in Patients With Cirrhosis

Cited by 23 publications

References 18 publications

Sarcopenia and Frailty in Chronic Liver Damage: Common and Different Points

Sarcopenia and Frailty in Chronic Liver Damage: Common and Different Points

Hepatic encephalopathy: Novel insights into classification, pathophysiology and therapy

Low Serum Branched-chain Amino Acid and Insulin-Like Growth Factor-1 Levels Are Associated with Sarcopenia and Slow Gait Speed in Patients with Liver Cirrhosis

Contact Info

Product

Resources

About