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Sarcopenia in liver cirrhosis: the role of computed tomography scan for the assessment of muscle mass compared with dual-energy X-ray absorptiometry and anthropometry.

Abstract

BACKGROUND

Sarcopenia evaluated by computed tomography (CT) scan at the lumbar site has been identified as a risk factor for morbidity and mortality in cirrhosis.

AIM

The aim of this study was to compare the measurement of muscle mass through CT scan, considered the gold standard, with other reliable techniques to evaluate the rate of agreement between different available methods for the assessment of muscle mass in cirrhosis. The correlation between measurements of muscle mass and of muscle strength was also investigated.

PATIENTS AND METHODS

Adult patients eligible for liver transplantation were studied. Lumbar skeletal muscle cross-sectional area was measured by CT and muscle depletion was defined using previously published cut-offs. Mid-arm muscle circumference was calculated following anthropometric measures. The Fat-Free Mass Index and the Appendicular Skeletal Muscle Index were calculated using dual-energy X-ray absorptiometry. Muscle strength was evaluated using the Hand Grip test.

RESULTS

Fifty-nine patients with cirrhosis were included. Sarcopenia was diagnosed in 76% of the patients according to CT evaluation. A significant reduction in Fat-Free Mass Index and Appendicular Skeletal Muscle Index was observed in 42-52% of the patients, whereas 52% showed a mid-arm muscle circumference less than 10th percentile. Skeletal muscle mass evaluation through CT was only weakly correlated with dual-energy X-ray absorptiometry and anthropometry evaluation. No correlation was observed between CT measurement of muscle mass and Hand Grip test.

CONCLUSION

CT scan can identify the highest percentage of sarcopenia in cirrhosis and no other techniques are actually available as a replacement. Future efforts should focus on approaches for assessing both skeletal muscle mass and function to provide a better evaluation of sarcopenia in cirrhotic patients.

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  • Authors+Show Affiliations

    ,

    aDepartment of Clinical Medicine bDepartment of Public Health and Infectious Diseases cDepartment of Radiological Sciences, Sapienza Università di Roma, Rome, Italy.

    , , , , , , , ,

    Source

    MeSH

    Absorptiometry, Photon
    Adult
    Aged
    Anthropometry
    Female
    Hand Strength
    Humans
    Liver Cirrhosis
    Liver Transplantation
    Male
    Middle Aged
    Muscle, Skeletal
    Organ Size
    Sarcopenia
    Severity of Illness Index
    Survival Analysis
    Tomography, X-Ray Computed

    Pub Type(s)

    Comparative Study
    Journal Article

    Language

    eng

    PubMed ID

    25569567

    Citation

    Giusto, Michela, et al. "Sarcopenia in Liver Cirrhosis: the Role of Computed Tomography Scan for the Assessment of Muscle Mass Compared With Dual-energy X-ray Absorptiometry and Anthropometry." European Journal of Gastroenterology & Hepatology, vol. 27, no. 3, 2015, pp. 328-34.
    Giusto M, Lattanzi B, Albanese C, et al. Sarcopenia in liver cirrhosis: the role of computed tomography scan for the assessment of muscle mass compared with dual-energy X-ray absorptiometry and anthropometry. Eur J Gastroenterol Hepatol. 2015;27(3):328-34.
    Giusto, M., Lattanzi, B., Albanese, C., Galtieri, A., Farcomeni, A., Giannelli, V., ... Merli, M. (2015). Sarcopenia in liver cirrhosis: the role of computed tomography scan for the assessment of muscle mass compared with dual-energy X-ray absorptiometry and anthropometry. European Journal of Gastroenterology & Hepatology, 27(3), pp. 328-34. doi:10.1097/MEG.0000000000000274.
    Giusto M, et al. Sarcopenia in Liver Cirrhosis: the Role of Computed Tomography Scan for the Assessment of Muscle Mass Compared With Dual-energy X-ray Absorptiometry and Anthropometry. Eur J Gastroenterol Hepatol. 2015;27(3):328-34. PubMed PMID: 25569567.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Sarcopenia in liver cirrhosis: the role of computed tomography scan for the assessment of muscle mass compared with dual-energy X-ray absorptiometry and anthropometry. AU - Giusto,Michela, AU - Lattanzi,Barbara, AU - Albanese,Carlina, AU - Galtieri,Alessia, AU - Farcomeni,Alessio, AU - Giannelli,Valerio, AU - Lucidi,Cristina, AU - Di Martino,Michele, AU - Catalano,Carlo, AU - Merli,Manuela, PY - 2015/1/9/entrez PY - 2015/1/9/pubmed PY - 2015/10/27/medline SP - 328 EP - 34 JF - European journal of gastroenterology & hepatology JO - Eur J Gastroenterol Hepatol VL - 27 IS - 3 N2 - BACKGROUND: Sarcopenia evaluated by computed tomography (CT) scan at the lumbar site has been identified as a risk factor for morbidity and mortality in cirrhosis. AIM: The aim of this study was to compare the measurement of muscle mass through CT scan, considered the gold standard, with other reliable techniques to evaluate the rate of agreement between different available methods for the assessment of muscle mass in cirrhosis. The correlation between measurements of muscle mass and of muscle strength was also investigated. PATIENTS AND METHODS: Adult patients eligible for liver transplantation were studied. Lumbar skeletal muscle cross-sectional area was measured by CT and muscle depletion was defined using previously published cut-offs. Mid-arm muscle circumference was calculated following anthropometric measures. The Fat-Free Mass Index and the Appendicular Skeletal Muscle Index were calculated using dual-energy X-ray absorptiometry. Muscle strength was evaluated using the Hand Grip test. RESULTS: Fifty-nine patients with cirrhosis were included. Sarcopenia was diagnosed in 76% of the patients according to CT evaluation. A significant reduction in Fat-Free Mass Index and Appendicular Skeletal Muscle Index was observed in 42-52% of the patients, whereas 52% showed a mid-arm muscle circumference less than 10th percentile. Skeletal muscle mass evaluation through CT was only weakly correlated with dual-energy X-ray absorptiometry and anthropometry evaluation. No correlation was observed between CT measurement of muscle mass and Hand Grip test. CONCLUSION: CT scan can identify the highest percentage of sarcopenia in cirrhosis and no other techniques are actually available as a replacement. Future efforts should focus on approaches for assessing both skeletal muscle mass and function to provide a better evaluation of sarcopenia in cirrhotic patients. SN - 1473-5687 UR - https://www.unboundmedicine.com/medline/citation/25569567/Sarcopenia_in_liver_cirrhosis:_the_role_of_computed_tomography_scan_for_the_assessment_of_muscle_mass_compared_with_dual_energy_X_ray_absorptiometry_and_anthropometry_ L2 - http://Insights.ovid.com/pubmed?pmid=25569567 DB - PRIME DP - Unbound Medicine ER -