Validity of Japanese version of SARC‐F questionnaire in patients with chronic liver disease

Aim To prevent the progression of sarcopenia, early identification is important. We investigated the usefulness of sarcopenia screening tests using the arm and calf circumferences in patients with chronic liver disease. Methods This was a single‐center cross‐sectional study based on data collected from a university hospital. We analyzed simple anthropometric data and sarcopenia‐related chemical data or imaging data between April and December 2019. Sarcopenia was defined according to the Japan Society of Hepatology guidelines. Results In total, 661 patients participated. Low muscle mass and low muscle strength were found in 245 (37.1%) and 153 (23.1%) patients, respectively. Ultimately, 90 (13.6%) patients were diagnosed with sarcopenia. The sarcopenia group was significantly older and had a higher cirrhosis ratio and poorer liver function than the non‐sarcopenia group. The sarcopenia group had a significantly lower body mass index, arm circumferences and calf circumferences than the non‐sarcopenia group. A receiver operating characteristics analysis for diagnosing sarcopenia by arm and calf circumferences showed respective areas under the curve of 0.89 and 0.91 for men and 0.84 and 0.89 for women. The optimal cut‐off values of arm and calf circumferences were respectively determined to be 25.0 and 32.6 cm for men (sensitivity 88.4% and 83.7%; specificity 74.0% and 84.7%) and 22.7 and 32.1 cm for women (sensitivity 66.0% and 85.1%; specificity 90.0% and 81.3%). Conclusions The arm and calf circumferences seem useful as simple surrogate markers for screening sarcopenia in patients with chronic liver disease.

Section: Discussionmentioning

confidence: 99%

Calf and arm circumference as simple markers for screening sarcopenia in patients with chronic liver disease

Endo

Sato

Kakisaka

et al. 2020

“…Additionally, although SIs are useful for evaluating muscle mass, they are weak indices for GS and sarcopenia. Recently, EWGSOP2 recommended the use of the SARC‐F questionnaire for screening . In the Japanese version, a SARC‐F score of ≥4 points indicates sarcopenia with high specificity (0.953 in men and 0.903 in women) and low sensitivity (0.163 in men and 0.45 in women) .…”

Section: Discussionmentioning

confidence: 99%

Calculated body muscle mass as a useful screening marker for low skeletal muscle mass and sarcopenia in chronic liver disease

Ichikawa

Miyaaki

Miuma

et al. 2020

Aim Sarcopenia is a harmful condition in patients with chronic liver disease. However, the evaluation of body muscle mass requires expensive instrumentation. The sarcopenia index (SI): (creatinine / cystatin C × 100) has been reported to correlate with muscle volume. A calculated body muscle mass (CBMM) using creatinine, cystatin C, and bodyweight also correlates with muscle mass. We evaluated the applicability of using SIs and CBMMs as screening methods for sarcopenia. Methods Patients (n = 303) with liver damage were evaluated for creatinine, cystatin C, and grip strength (GS). All patients were evaluated using cross‐sectional computed tomography images of the third lumbar vertebrae to determine their skeletal muscle (SM) mass. CBMMs and SIs were compared with SMs, GSs, and sarcopenia. Results Correlation coefficients (R) between SMI (SM / height2 [m2]) and CBMM, and between GS and CBMM were 0.643 and 0.723, respectively. Factors contributing to low GSs; low SM indices; and sarcopenia were age and SM; sex, age, GS, SI, and CBMM indices; and sex, bodyweight, and CBMM, respectively, in the multivariate logistic analyses. Receiver operating characteristic curve analysis between sarcopenia and CBMM showed an area under the receiver operating characteristic curve of 0.78504 in women and 0.86067 in men. Cut‐off CBMM values for sarcopenia were 27.903 (sensitivity 0.73958) in women and 39.731 (sensitivity 0.7941) in men. Conclusions CBMMs and SIs are simple and minimally invasive screening methods in which low levels are indicative of sarcopenia in patients with liver disease.

“…Recently, Ida et al . reported the usefulness of EWGSOP‐2 in 140 patients with cut‐off values for handgrip strength and muscle volume based on the JSH sarcopenia criteria . That report noted sensitivity and specificity for sarcopenia in men of 16.3% and 95.3%, respectively (PPV/NPV: 81.8%/47.1%), and 45.0% and 90.8%, respectively, in women (PPV/NPV: 81.8%/64.5%).…”

Section: Discussionmentioning

confidence: 99%

SARC‐F combined with a simple tool for assessment of muscle abnormalities in outpatients with chronic liver disease

Hiraoka

Nagamatsu

Izumoto

et al. 2020

Aim An easily performed method for examination of muscle abnormalities is anticipated. We aimed to elucidate the clinical usefulness of simple assessments for muscle abnormality including a simple five‐item questionnaire (SARC‐F) in chronic liver disease patients. Methods From February to July 2019, 383 outpatients (median age 71 years, 259 men; chronic hepatitis (CH) : liver cirrhosis Child–Pugh A : liver cirrhosis Child–Pugh B : liver cirrhosis Child–Pugh C = 157:176:39:11) who underwent a computed tomography examination were enrolled. SARC‐F, previously reported cut‐off values for muscle strength decline (MSD; handgrip), pre‐muscle volume loss (pre‐MVL), calf circumference and finger‐circle test results were used, and these results were analyzed retrospectively. Results A high SARC‐F score (≥4) was observed in 25 patients, and a low score (<4) in 358 patients. The frequency of high SARC‐F increased significantly with progression of chronic liver disease (chronic hepatitis : liver cirrhosis Child–Pugh A : liver cirrhosis Child–Pugh B/C = 2.5%:8.0%:14.0%, P=0.010). MSD frequency was 22.4% in men and 41.1% in women. Muscle volume loss and pre‐MVL were noted in 22% and 30.5%, respectively, of the male patients, and 9.7% and 32.3%, respectively, of the female patients. In cases with high SARC‐F and MSD, calf circumference and finger‐circle abnormalities were found in 56% and 40.0% of patients, respectively, whereas those values for patients with low SARC‐F and MSD were 14.5% and 10.6%, respectively (P < 0.001, for each; positive/negative predictive values: 0.560/0.855 and 0.400/0.894, respectively). Each SARC‐F item showed a good area under the curve for MSD, but not pre‐MVL. Conclusion SARC‐F score in combination with MSD and calf circumference or finger‐circle test results may be an easy and simple method for surveillance of chronic liver disease patients with a high risk of sarcopenia and decline of quality of life.