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Sarcopenia impairs prognosis of patients with liver cirrhosis.

Abstract

OBJECTIVE

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.

METHODS

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.

RESULTS

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).

CONCLUSIONS

Sarcopenia is significantly associated with mortality in patients with LC. BCAA supplementation might be associated with improved survival of such patients.

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  • Authors+Show Affiliations

    ,

    First Department of Internal Medicine, Gifu University School of Medicine, Yanagido, Gifu, Japan.

    ,

    First Department of Internal Medicine, Gifu University School of Medicine, Yanagido, Gifu, Japan. Electronic address: Mshiraki-gif@umin.ac.jp.

    ,

    Center of Nutrition Support and Infection Control, Gifu University Hospital, Yanagido, Gifu, Japan.

    ,

    First Department of Internal Medicine, Gifu University School of Medicine, Yanagido, Gifu, Japan.

    ,

    First Department of Internal Medicine, Gifu University School of Medicine, Yanagido, Gifu, Japan.

    ,

    First Department of Internal Medicine, Gifu University School of Medicine, Yanagido, Gifu, Japan.

    ,

    First Department of Internal Medicine, Gifu University School of Medicine, Yanagido, Gifu, Japan.

    ,

    First Department of Internal Medicine, Gifu University School of Medicine, Yanagido, Gifu, Japan.

    First Department of Internal Medicine, Gifu University School of Medicine, Yanagido, Gifu, Japan.

    Source

    MeSH

    Adult
    Aged
    Aged, 80 and over
    Amino Acids, Branched-Chain
    Body Mass Index
    Body Weight
    Cross-Sectional Studies
    Dietary Supplements
    Female
    Humans
    Liver Cirrhosis
    Male
    Middle Aged
    Muscle, Skeletal
    Prevalence
    Prognosis
    Proportional Hazards Models
    Retrospective Studies
    Risk Factors
    Sarcopenia
    Severity of Illness Index
    Tomography, X-Ray Computed

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    25441595

    Citation

    Hanai, Tatsunori, et al. "Sarcopenia Impairs Prognosis of Patients With Liver Cirrhosis." Nutrition (Burbank, Los Angeles County, Calif.), vol. 31, no. 1, 2015, pp. 193-9.
    Hanai T, Shiraki M, Nishimura K, et al. Sarcopenia impairs prognosis of patients with liver cirrhosis. Nutrition. 2015;31(1):193-9.
    Hanai, T., Shiraki, M., Nishimura, K., Ohnishi, S., Imai, K., Suetsugu, A., ... Moriwaki, H. (2015). Sarcopenia impairs prognosis of patients with liver cirrhosis. Nutrition (Burbank, Los Angeles County, Calif.), 31(1), pp. 193-9. doi:10.1016/j.nut.2014.07.005.
    Hanai T, et al. Sarcopenia Impairs Prognosis of Patients With Liver Cirrhosis. Nutrition. 2015;31(1):193-9. PubMed PMID: 25441595.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Sarcopenia impairs prognosis of patients with liver cirrhosis. AU - Hanai,Tatsunori, AU - Shiraki,Makoto, AU - Nishimura,Kayoko, AU - Ohnishi,Sachiyo, AU - Imai,Kenji, AU - Suetsugu,Atsushi, AU - Takai,Koji, AU - Shimizu,Masahito, AU - Moriwaki,Hisataka, Y1 - 2014/07/30/ PY - 2014/01/09/received PY - 2014/06/30/revised PY - 2014/07/20/accepted PY - 2014/12/3/entrez PY - 2014/12/3/pubmed PY - 2016/1/12/medline KW - Branched-chain amino acids KW - Liver cirrhosis KW - Protein–energy malnutrition KW - Sarcopenia KW - Skeletal muscle index KW - Survival SP - 193 EP - 9 JF - Nutrition (Burbank, Los Angeles County, Calif.) JO - Nutrition VL - 31 IS - 1 N2 - OBJECTIVE: 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. METHODS: 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. RESULTS: 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). CONCLUSIONS: Sarcopenia is significantly associated with mortality in patients with LC. BCAA supplementation might be associated with improved survival of such patients. SN - 1873-1244 UR - https://www.unboundmedicine.com/medline/citation/25441595/Sarcopenia_impairs_prognosis_of_patients_with_liver_cirrhosis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0899-9007(14)00344-X DB - PRIME DP - Unbound Medicine ER -