Journal Article

Sarcopenia impairs prognosis of patients with liver cirrhosis

Hanai, Tatsunori, Imai, Kenji, Suetsugu, Atsushi, Shiraki, Makoto, Shimizu, Masahito, Ohnishi, Sachiyo, Moriwaki, Hisataka, Takai, Koji, Nishimura, Kayoko

2015

Overview

Sarcopenia is characterized by the loss of skeletal muscle mass, and is reported to appear in patients with liver cirrhosis (LC). The aim of this study was to investigate the prevalence of sarcopenia in patients with LC, and to test the association between sarcopenia and patient outcomes. We also analyzed the effect of branched-chain amino acid (BCAA) supplementation on sarcopenic LC. Clinical and blood biochemical data of 130 patients with LC who underwent abdominal computed tomography scan were analyzed in this retrospective study. The cross-sectional area of skeletal muscles was measured at the level of the third lumbar vertebra on the scan. The skeletal muscle index was calculated to identify sarcopenia. Cirrhotic patients who were treated with BCAA supplementation of 12 g/d for ≥1 y were defined as the BCAA group, and the effect of BCAA on sarcopenic LC was evaluated. Sixty-eight percent of all patients (82% of men and 50% of women) were diagnosed with sarcopenia. Male sex (P = 0.01) and body mass index (P < 0.0001) were predictors of sarcopenia. The multivariate Cox proportional hazards model found BCAA supplementation (hazard ratio [HR], 0.38; P = 0.01), sarcopenia (HR, 3.03; P < 0.01), and Child-Pugh classes B (HR, 2.39; P = 0.03) and C (HR, 5.49; P < 0.001) to be independently associated with mortality. The mortality of sarcopenic LC was significantly higher than that of non-sarcopenic LC (P = 0.01). Moreover, BCAA supplementation improved the survival of sarcopenic patients in subgroup analysis (P < 0.01). Sarcopenia is significantly associated with mortality in patients with LC. BCAA supplementation might be associated with improved survival of such patients. •We investigate the incidence of sarcopenia in cirrhotic patients.•We examine the relation between sarcopenia and patient outcomes.•We analyze the effect of branched-chain amino acid supplementation on sarcopenic patients.•Sarcopenia is associated with mortality in patients with liver cirrhosis.•Branched-chain amino acid supplementation is associated with improved survival of sarcopenic patients.

• Publisher: Elsevier Inc,Elsevier Limited
• Subject: Adult / Aged / Aged, 80 and over / Amino acids / Amino Acids, Branched-Chain - administration & dosage / blood / Body Mass Index / Body Weight / Branched-chain amino acids / Computed tomography / Cross-Sectional Studies / Dietary Supplements / Female / Gastroenterology and Hepatology / Hepatitis / Humans / Liver cirrhosis / Liver Cirrhosis - mortality / Liver Cirrhosis - physiopathology / Male / males / Medical imaging / men / Middle Aged / Mortality / Muscle, Skeletal - pathology / Muscles / patients / Prevalence / Prognosis / Proportional Hazards Models / Protein–energy malnutrition / Retrospective Studies / Risk Factors / Sarcopenia / Sarcopenia - diagnosis / Sarcopenia - mortality / Sarcopenia - physiopathology / Severity of Illness Index / skeletal muscle / Skeletal muscle index / Survival / Tomography, X-Ray Computed / vertebrae / women