Sarcopenia in chronic liver disease, can we predict complications?

Abstract

Introduction. Sarcopenia is a common complication of chronic liver disease. Today many studies are devoted to sarcopenia impact on the course of liver diseases. At the same time, many studies are being performed on the correlation of sarcopenia in patients with cirrhosis of the liver and the incidence of early complications after liver transplantation. In this regard, we conducted our own retrospective study of the correlation relationship of sarcopenia in patients with chronic liver diseases.Aim. To determine the correlation between the severity of sarcopenia and the incidence of complications of liver cirrhosis in patients on the waiting list for liver transplantation.Material and methods. In our own retrospective observational study, 87 patients suffering from chronic liver diseases and treated at the Minsk Scientific and Practical Center of Surgery, Transplantation and Hematology were included. The assessment of sarcopenia was carried out using the CT technique for assessing indexed parameters of the patient's muscle mass. Mathematical processing was performed using the FDA-approved OsirixTM software. The study was conducted within the framework of the project "ClinicalTrials: NCT04281797"Results. Body mass index was significantly correlated with the presence of sarcopenia (rpb=-0.48, 95% CI [-0.65;-0.27]). At the same time, the groups of patients with and without sarcopenia differed significantly (p<0.0001), (Hedges g=-0.93, 95% CI [-1.37;-0.48]). In groups of patients with various etiological factors of chronic liver diseases, sarcopenia occurredmost often among patients with autoimmune hepatitis, while the uneven distribution of the incidence of sarcopenia in different nosological groups was significant (p=0.028; 2=14.1).Conclusion. Body mass index plays an important prognostic role in muscle mass loss among patients with clinically advanced liver disease. However, skeletal muscle index and Body Mass Index differ significantly between patients with and without sarcopenia. In addition, our study showed a significant difference in the occurrence of sarcopenia in patients on the waiting list of different etiological groups. Thus, further extensive randomized studies in this direction are needed today.

Keywords

• sarcopenia
• hepatic encephalopathy
• hepatic encephalopathy
• liver cirrhosis
• decompensated cirrhosis
• chronic liver disease
• computed tomography
• liver muscle axis
• gut liver axis