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Association between Low Testosterone Levels and Sarcopenia in Cirrhosis: A Cross-sectional Study.
Ann Hepatol 2018 July - August ,; 17(4):615-623AH

Abstract

INTRODUCTION AND AIM

Sarcopenia is an independent predictor of mortality in cirrhosis. Hypogonadism is common in cirrhosis and has been associated with sarcopenia in non-cirrhotic chronic liver disease populations. The aim of this study is to investigate if sarcopenia is associated with low testosterone levels in patients with cirrhosis.

MATERIAL AND METHODS

This is a retrospective analysis of prospectively collected data of 211 cirrhotic patients undergoing evaluation for liver transplantation. Sarcopenia was defined by computed tomography (CT) scan using specific cutoffs of the 3rd lumbar vertebra skeletal muscle index (L3 SMI). Morning testosterone levels were obtained in all patients.

RESULTS

Of the 211 patients, sarcopenia was noted in 94 (45%). Testosterone levels were lower in sarcopenic patients (10.7 ± 1.1 vs. 13.7 ± 1.4 nmol/L, p = 0.03) and hypotestosteronemia was more frequent in them too (34 vs. 16%, p = 0.004). In males, those with sarcopenia had lower testosterone levels (14.6 ± 1.4 vs. 21.9 ± 1.8, p = 0.002), and the corresponding frequency of hypotestosteronemia (42 vs. 19%, p = 0.006) was also higher. There were no significant differences in female patients. There was a weak correlation between L3 SMI and testosterone levels (r 0.37, p < 0.001). On multivariable regression analysis including sex, body mass index (BMI), hypotestosteronemia, MELD and etiology of cirrhosis, only hypotestosteronemia (RR 2.76, p = 0.005) and BMI (RR 0.88, p < 0.001) were independently associated with sarcopenia.

CONCLUSION

Low testosterone levels are associated with sarcopenia in male cirrhotic patients. The potential therapeutic effect of testosterone to reverse sarcopenia in these patients warrants evaluation in future trials.

Authors+Show Affiliations

Liver Unit, University of Alberta Hospital, Edmonton, Alberta, Canada.Department of Radiology, University of Alberta Hospital, Edmonton, Alberta, Canada.Department of Rehabilitation Medicine, University of Waterloo, Ontario, Canada.Liver Unit, University of Alberta Hospital, Edmonton, Alberta, Canada.Liver Unit, University of Calgary, Calgary, Canada.Liver Unit, University of Alberta Hospital, Edmonton, Alberta, Canada.Liver Unit, University of Alberta Hospital, Edmonton, Alberta, Canada.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29893704

Citation

Moctezuma-Velázquez, Carlos, et al. "Association Between Low Testosterone Levels and Sarcopenia in Cirrhosis: a Cross-sectional Study." Annals of Hepatology, vol. 17, no. 4, 2018, pp. 615-623.
Moctezuma-Velázquez C, Low G, Mourtzakis M, et al. Association between Low Testosterone Levels and Sarcopenia in Cirrhosis: A Cross-sectional Study. Ann Hepatol. 2018;17(4):615-623.
Moctezuma-Velázquez, C., Low, G., Mourtzakis, M., Ma, M., Burak, K. W., Tandon, P., & Montano-Loza, A. J. (2018). Association between Low Testosterone Levels and Sarcopenia in Cirrhosis: A Cross-sectional Study. Annals of Hepatology, 17(4), pp. 615-623. doi:10.5604/01.3001.0012.0930.
Moctezuma-Velázquez C, et al. Association Between Low Testosterone Levels and Sarcopenia in Cirrhosis: a Cross-sectional Study. Ann Hepatol. 2018;17(4):615-623. PubMed PMID: 29893704.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Association between Low Testosterone Levels and Sarcopenia in Cirrhosis: A Cross-sectional Study. AU - Moctezuma-Velázquez,Carlos, AU - Low,Gavin, AU - Mourtzakis,Marina, AU - Ma,Mang, AU - Burak,Kelly W, AU - Tandon,Puneeta, AU - Montano-Loza,Aldo J, PY - 2018/6/13/entrez PY - 2018/6/13/pubmed PY - 2019/4/23/medline KW - End-stage liver disease KW - Hypogonadism KW - Malnutrition KW - Muscular atrophy SP - 615 EP - 623 JF - Annals of hepatology JO - Ann Hepatol VL - 17 IS - 4 N2 - INTRODUCTION AND AIM: Sarcopenia is an independent predictor of mortality in cirrhosis. Hypogonadism is common in cirrhosis and has been associated with sarcopenia in non-cirrhotic chronic liver disease populations. The aim of this study is to investigate if sarcopenia is associated with low testosterone levels in patients with cirrhosis. MATERIAL AND METHODS: This is a retrospective analysis of prospectively collected data of 211 cirrhotic patients undergoing evaluation for liver transplantation. Sarcopenia was defined by computed tomography (CT) scan using specific cutoffs of the 3rd lumbar vertebra skeletal muscle index (L3 SMI). Morning testosterone levels were obtained in all patients. RESULTS: Of the 211 patients, sarcopenia was noted in 94 (45%). Testosterone levels were lower in sarcopenic patients (10.7 ± 1.1 vs. 13.7 ± 1.4 nmol/L, p = 0.03) and hypotestosteronemia was more frequent in them too (34 vs. 16%, p = 0.004). In males, those with sarcopenia had lower testosterone levels (14.6 ± 1.4 vs. 21.9 ± 1.8, p = 0.002), and the corresponding frequency of hypotestosteronemia (42 vs. 19%, p = 0.006) was also higher. There were no significant differences in female patients. There was a weak correlation between L3 SMI and testosterone levels (r 0.37, p < 0.001). On multivariable regression analysis including sex, body mass index (BMI), hypotestosteronemia, MELD and etiology of cirrhosis, only hypotestosteronemia (RR 2.76, p = 0.005) and BMI (RR 0.88, p < 0.001) were independently associated with sarcopenia. CONCLUSION: Low testosterone levels are associated with sarcopenia in male cirrhotic patients. The potential therapeutic effect of testosterone to reverse sarcopenia in these patients warrants evaluation in future trials. SN - 1665-2681 UR - https://www.unboundmedicine.com/medline/citation/29893704/Association_between_Low_Testosterone_Levels_and_Sarcopenia_in_Cirrhosis:_A_Cross_sectional_Study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/01.3001.0012.0930 DB - PRIME DP - Unbound Medicine ER -