FREQUENCY OF SARCOPENIA IN CIRRHOTIC PATIENTS DETERMINED ON ABDOMINAL COMPUTED TOMOGRAPHY

Authors

  • Rimsha Khan Foundation University Medical College, Islamabad, Pakistan
  • Amna Khalid Department of Diagnostic Radiology, Fauji Foundation Hospital, Rawalpindi, Pakistan
  • Faryal Asmat Department of Diagnostic Radiology, Fauji Foundation Hospital, Rawalpindi, Pakistan
  • Muhammad Bilal Department of Accident & Emergency, Quaid-e-Azam International Hospital, Islamabad, Pakistan
  • Kiran Fatima Farooq Department of Diagnostic Radiology, Fauji Foundation Hospital, Rawalpindi, Pakistan
  • Sarah Anwar Department of Diagnostic Radiology, Fauji Foundation Hospital, Rawalpindi, Pakistan

Keywords:

Sarcopenia, Cirrhosis, Liver, Hepatitis, Hepatocellular carcinoma, Computed tomography, CT

Abstract

Background: Fibrosis of the liver progresses to cirrhosis resulting in hepatocellular dysfunction. Sarcopenia is an early sign of liver malfunction. Early detection of sarcopenia may provide a chance to cure or delay deterioration of liver function. This study aimed to detect sarcopenia on abdominal computed tomography (CT). Methods: This descriptive, cross-sectional study was carried out at the Department of Diagnostic Radiology, Fauji Foundation Hospital Rawalpindi from 1st October 2022 to 31st March 2023. All patients suffering from Hepatitis B or C referred for evaluation of complications were included in the study. After informed consent and examination, at LV3 level an axial CT image in abdominal window was assessed on each scan using Radiant® software. Muscles including internal and external obliques and transversus abdominus, rector spinae, quadratus lumborum, and psoas were identified and evaluated. A threshold of -29 to -150 HU, and -29 to 150 HU for fatty tissue and skeletal muscles respectively was used. Cross-sectional area of each muscle was calculated on the vitrea and skeletal muscle index was calculated. Cut-off value for men was taken as 52.4 Cm2/m2, and for women it was 38.5 Cm2/m2. Results: A total 120 chronic liver disease patients (21 males and 99 female) were studied. All (100%) men, and 82 (83.8%) women had sarcopenia. Conclusion: Sarcopenia was a common finding with male predominance in patients suffering from Hepatitis B and/or C. CT evaluation is an effective and non-invasive tool for evaluation of sarcopenia as an indicator of liver dysfunction.

Pak J Physiol 2023;19(3):20–2

Downloads

Download data is not yet available.

References

Zambrano DN, Xiao J, Prado CM, Gonzalez MC. Patient-generated subjective global assessment and computed tomography in the assessment of malnutrition and sarcopenia in patients with cirrhosis: Is there any association? Clin Nutr 2020;39(5):1535–40.

Kim HY, Jang JW. Sarcopenia in the prognosis of cirrhosis: Going beyond the MELD score. World J Gastroenterol 2015;21:7637–47.

Tsochatzis EA, Bosch J, Burroughs AK. Liver cirrhosis. Lancet 2014;383(9930):1749–61.

Hanai T, Shiraki M, Nishimura K, Ohnishi S, Imai K, Suetsugu A, et al. Sarcopenia impairs prognosis of patients with liver cirrhosis. Nutrition 2015;31(1):193–9.

Carey EJ, Lai JC, Sonnenday C, Tapper EB, Tandon P, Duarte?Rojo A, et al. A North American expert opinion statement on sarcopenia in liver transplantation. Hepatology 2019;70(5):1816–29.

Dasarathy S, Merli M. Sarcopenia from mechanism to diagnosis and treatment in liver disease. J Hepatol 2016;65(6):1232–44.

Fujiwara N, Friedman SL, Goossens N, Hoshida Y. Risk factors and prevention of hepatocellular carcinoma in the era of precision medicine. J Hepatol 2018;68(3):526–49.

Dennison EM, Sayer AA, Cooper C. Epidemiology of sarcopenia and insight into possible therapeutic targets. Nat Rev Rheumatol 2017;13(6):340–7.

Tandon P, Low G, Mourtzakis M, Zenith L, Myers RP, Abraldes JG, et al. A model to identify sarcopenia in patients with cirrhosis. Clin Gastroenterol Hepatol 2016;14(10):1473–80.

Lee JT. Sarcopenia at abdominal CT in patients with cirrhosis. Radiology 2022;303(3):720–1.

Tandon P, Montano-Loza AJ, Lai JC, Dasarathy S, Merli M. Sarcopenia and frailty in decompensated cirrhosis. J Hepatol 2021;75(Suppl 1):S147–162.

Liu J, Ma J, Yang C, Chen M, Shi Q, Zhou C, et al. Sarcopenia in patients with cirrhosis after transjugular intrahepatic portosystemic shunt placement. Radiol 2022;303(3):711–9.

Benjamin J, Shasthry V, Kaal CR, Anand L, Bhardwaj A, Pandit V, et al. Characterization of body composition and definition of sarcopenia in patients with alcoholic cirrhosis: A computed tomography based study. Liver Int 2017;37(11):1668–74.

Aby ES, Lee E, Saggi SS, Viramontes MR, Grotts JF, Agopian VG, et al. Pretransplant sarcopenia in patients with NASH cirrhosis does not impact rehospitalization or mortality. J Clin Gastroenterol 2019;53(9):680–5.

Hanai T, Shiraki M, Imai K, Suetugu A, Takai K, Shimizu M. Usefulness of carnitine supplementation for the complications of liver cirrhosis. Nutrients 2020;12(7):1915.

Tantai X, Liu Y, Yeo YH, Praktiknjo M, Mauro E, Hamaguchi Y, et al. Effect of sarcopenia on survival in patients with cirrhosis: a meta-analysis. J Hepatol 2022;76(3):588–99.

Masuda T, Shirabe K, Ikegami T, Harimoto N, Yoshizumi T, Soejima Y, et al. Sarcopenia is a prognostic factor in living donor liver transplantation. Liver Transpl 2014;20(4):401–7.

Topan MM, Sporea I, D?nil? M, Popescu A, Ghiuchici AM, Lupu?oru R, et al. Impact of sarcopenia on survival and clinical outcomes in patients with liver cirrhosis. Front Nutr 2021;8:766451.

Cruz Jr RJ, Dew MA, Myaskovsky L, Goodpaster B, Fox K, Fontes P, et al. Objective radiological assessment of body composition in patients with end-stage liver disease: going beyond the BMI. Transplantation 2013;95(4):617–22.

DiMartini A, Cruz RJ Jr, Dew MA, Myaskovsky L, Goodpaster B, Fox K, et al. Muscle mass predicts outcomes following liver transplantation. Liver Transpl 2013;19(11):1172–80.

Montano-Loza AJ, Meza–Junco J, Prado CM, Lieffers JR, Baracos VE, Bain VG, et al. Muscle wasting is associated with mortality in patients with cirrhosis. Clin Gastroenterol Hepatol 2012;10:166–73.

Tandon P, Ney M, Irwin I, Ma MM, Gramlich L, Bain VG, et al. Severe muscle depletion in patients on the liver transplant wait list: its prevalence and independent prognostic value. Liver Transpl 2012;18(10):1209–16.

Meza-Junco J, Montano-Loza AJ, Baracos VE, Prado CM, Bain VG, Beaumont C, et al. Sarcopenia as a prognostic index of nutritional status in concurrent cirrhosis and hepatocellular carcinoma. J Clin Gastroenterol 2013;47(10):861–70.

Montano?Loza AJ, Meza?Junco J, Baracos VE, Prado CM, Ma M, Meeberg G, et al. Severe muscle depletion predicts postoperative length of stay but is not associated with survival after liver transplantation. Liver Transpl 2014;20(6):640–8.

Downloads

Published

30-09-2023

How to Cite

1.
Khan R, Khalid A, Asmat F, Bilal M, Farooq KF, Anwar S. FREQUENCY OF SARCOPENIA IN CIRRHOTIC PATIENTS DETERMINED ON ABDOMINAL COMPUTED TOMOGRAPHY. Pak J Phsyiol [Internet]. 2023 Sep. 30 [cited 2024 May 17];19(3):20-2. Available from: https://www.pjp.pps.org.pk/index.php/PJP/article/view/1564

Issue

Vol. 19 No. 3 (2023): Pakistan Journal of Physiology

Section

Original Article

License

Copyright (c) 2023 Pakistan Journal of Physiology

Creative Commons License

This work is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License.

Pakistan Journal of Physiology, Pak J Physiol, PJP is FREE for research and academic purposes. It can be freely downloaded and stored, printed, presented, cited and quoted with full reference of, and acknowledgement to the PJP.