Hiroki Nishikawa1, Makoto Shiraki2, Akira Hiramatsu3, Nagisa Hara4, Kyoji Moriya5, Keisuke Hino6, Kazuhiko Koike7. 1. Division of Hepatobiliary and Pancreatic Disease, Department of Internal Medicine, Hyogo College of Medicine, Hyogo, Japan. 2. Department of Gastroenterology and Internal Medicine, Gifu University Graduate School of Medicine, Gifu, Japan. 3. Department of Gastroenterology and Metabolism, Applied Life Science, Institute of Biomedical and Health Science, Hiroshima University, Hiroshima, Japan. 4. Nutrition Unit, Mie University Hospital, Mie, Japan. 5. Department of Infection Control and Prevention, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. 6. Department of Hepatology and Pancreatology, Kawasaki Medical School, Okayama, Japan. 7. Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Japan.
Abstract
AIM: Sarcopenia has a high prevalence and can be an adverse predictor in patients with chronic liver diseases (CLDs). We sought to assess the prevalence of sarcopenia and its prognostic significance in patients with CLDs at multiple centers in Japan. METHODS: In this retrospective study, we collated the data of 1,624 patients with CLDs (976 males). The diagnosis of sarcopenia was determined by the sarcopenia assessment criteria of the Japan Society of Hepatology. Predictors of mortality were identified using univariate and multivariate analyses. RESULTS: Muscle weakness defined and skeletal muscle loss occurred in 33.5% and 29.3% of all subjects, respectively, while sarcopenia occurred in 13.9% of all patients. Patients with sarcopenia had a poorer prognosis among all patients, patients with hepatocellular carcinoma (HCC), and those without HCC by log-rank test. The multivariate Cox proportional hazards model identified female (hazard ratio [HR], 0.59; P = 0.03), alcoholic liver disease (HR, 4.25; P < 0.01), presence of HCC (HR, 6.77; P < 0.01), Child-Pugh classes A (HR, 1.42; P < 0.05), B (HR, 2.70; P < 0.01) and C (HR, 6.30; P < 0.01), and muscle strength weakness (HR, 2.24; P < 0.01) as significant adverse predictors. The cut-off values of handgrip strength (HGS) for prognosis determined by maximally selected rank statistics were calculated as 27.8 kg for males and 18.8 kg for females, respectively. CONCLUSIONS: Reduced HGS in CLDs was an independent adverse predictor, with cut-off values of 27.8 kg for males and 18.8 kg for females, respectively. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
AIM: Sarcopenia has a high prevalence and can be an adverse predictor in patients with chronic liver diseases (CLDs). We sought to assess the prevalence of sarcopenia and its prognostic significance in patients with CLDs at multiple centers in Japan. METHODS: In this retrospective study, we collated the data of 1,624 patients with CLDs (976 males). The diagnosis of sarcopenia was determined by the sarcopenia assessment criteria of the Japan Society of Hepatology. Predictors of mortality were identified using univariate and multivariate analyses. RESULTS:Muscle weakness defined and skeletal muscle loss occurred in 33.5% and 29.3% of all subjects, respectively, while sarcopenia occurred in 13.9% of all patients. Patients with sarcopenia had a poorer prognosis among all patients, patients with hepatocellular carcinoma (HCC), and those without HCC by log-rank test. The multivariate Cox proportional hazards model identified female (hazard ratio [HR], 0.59; P = 0.03), alcoholic liver disease (HR, 4.25; P < 0.01), presence of HCC (HR, 6.77; P < 0.01), Child-Pugh classes A (HR, 1.42; P < 0.05), B (HR, 2.70; P < 0.01) and C (HR, 6.30; P < 0.01), and muscle strength weakness (HR, 2.24; P < 0.01) as significant adverse predictors. The cut-off values of handgrip strength (HGS) for prognosis determined by maximally selected rank statistics were calculated as 27.8 kg for males and 18.8 kg for females, respectively. CONCLUSIONS: Reduced HGS in CLDs was an independent adverse predictor, with cut-off values of 27.8 kg for males and 18.8 kg for females, respectively. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
Authors: James S Kimber; Richard J Woodman; Sumudu K Narayana; Libby John; Jeyamani Ramachandran; David Schembri; John W C Chen; Kate R Muller; Alan J Wigg Journal: JGH Open Date: 2022-01-12