Gad, M., Mokhtar, A., Ibrahim, A., Abbas, N. (2019). Assessment of muscle status and Sarcopenia in patients with liver cirrhosis. Medical Journal of Viral Hepatitis, 4.1(1), 23-33. doi: 10.21608/mjvh.2019.59523
Marwa Gad; Abdelrahman Mokhtar; Adel Ibrahim; Neven Abbas. "Assessment of muscle status and Sarcopenia in patients with liver cirrhosis". Medical Journal of Viral Hepatitis, 4.1, 1, 2019, 23-33. doi: 10.21608/mjvh.2019.59523
Gad, M., Mokhtar, A., Ibrahim, A., Abbas, N. (2019). 'Assessment of muscle status and Sarcopenia in patients with liver cirrhosis', Medical Journal of Viral Hepatitis, 4.1(1), pp. 23-33. doi: 10.21608/mjvh.2019.59523
Gad, M., Mokhtar, A., Ibrahim, A., Abbas, N. Assessment of muscle status and Sarcopenia in patients with liver cirrhosis. Medical Journal of Viral Hepatitis, 2019; 4.1(1): 23-33. doi: 10.21608/mjvh.2019.59523
Assessment of muscle status and Sarcopenia in patients with liver cirrhosis
2Occupational Medicine-Public Health dept, Faculty of Medicine, Mansoura Univ., Egypt.
Abstract
Background and objectives: Sarcopenia characterized by progressive and generalized loss of skeletal muscle mass and function with a risk of adverse outcomes such as. There is an important relationship between cirrhosis and muscle weakness (sarcopenia), as the liver plays a major role in the metabolism of all nutrients. The Aim of this study to assess muscle status and sarcopenia among patients with liver cirrhosis and its relation to patient physical activity and dietary history as well as liver disease progression. Method: This was a cross-sectional study conducted on 150 cirrhotic patients attending to hepatology and gastroenterology department at Specialized Medical Hospital, Mansoura University. All patients underwent through clinical evaluation, laboratory investigation, and assessment of muscle status by anthropometric parameters and grip strength. In addition, assessment of nutritional status and physical activity was done. Results: Of included participants, 80 patients (53.3%) were diagnosed with sarcopenia and pre-sarcopenia (39.3% sarcopenic and 14% pre-sarcopenia) and 70 patients with non sarcopenia or presarcopenia. Almost two-third of sarcopenic patients were men (66.4%) versus (33.6%) were women. The sarcopenia and pre-sarcopenia patients were older than non-sarcopenia patients and had lower BMI with statistically significant difference. The majority of patients with sarcopenia consumed diet with low protein, low vitamin and iron contents with statistically significant difference versus non sarcopenic patients. On other hand, excess salt and minerals intake were common among sarcopenic and pre-sarcopenic patients. Assessment of physical activity among studied group by International Physical Activity Questionnaires (IPAQ) demonstrated that, 53% of sarcopenic and pre-sarcopenic patients exerted low or no exercise with statistically significant difference compared to non-sarcopenic group (only 12%). Frequency of complications of liver cirrhosis as ascites, hepatic encephalopathy and variceal bleeding were statistically significant higher in those patients with sarcopenia and pre-sarcopenia versus those without sarcopenia. There was significant hypoalbuminemia, hyperbilurbinemia and rising serum creatinine among sarcopenic patients versus nonsarcopenic patients. Positive statistically significant association detected between Sarcopenia and progression of liver diseases assessed by Child Pugh score and MELD score versus non sarcopenic patients. The independent predictive factors of sarcopenia analysed by logistic regression were increasing age, low BMI, low protein intake and hypoalbuminemia. Conclusion: The prevalence of sarcopenia is high in cirrhotic patients. It was highest in patients with older age, low BMI and low protein intake. Also, the worse the condition of the liver the greater the degree of muscle weakness was detected.
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