Presence of Sarcopenia and Its Rate of Change Are Independently Associated with Long-term Mortality in Patients with Liver Cirrhosis

• Published in: Journal of Korean medical science Vol. 33; no. 50; pp. e299 - 13
• Main Authors: Jeong, Jae Yoon, Lim, Sanghyeok, Sohn, Joo Hyun, Lee, Jae Gon, Jun, Dae Won, Kim, Yongsoo
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Academy of Medical Sciences 10.12.2018; 대한의학회
• Subjects: Adult; Female; Hepatic Veins - physiology; Humans; International Normalized Ratio; Liver Cirrhosis - complications; Liver Cirrhosis - diagnosis; Liver Cirrhosis - mortality; Liver Cirrhosis - pathology; Male; Middle Aged; Muscle, Skeletal - diagnostic imaging; Muscle, Skeletal - physiology; Original; Prognosis; Proportional Hazards Models; Retrospective Studies; Sarcopenia - complications; Sarcopenia - diagnosis; Survival Rate; Tomography, X-Ray Computed; 의학일반; Sarcopenia; Prognosis; Liver Cirrhosis; Nutrition; Mortality
• ISSN: 1011-8934; 1598-6357; 1598-6357
• DOI: 10.3346/jkms.2018.33.e299

Sarcopenia is associated with a poor prognosis in patients with liver cirrhosis. However, it is not known whether the rate of skeletal muscle depletion is also associated with a poor prognosis. We investigated the prognostic impact of the rate of skeletal muscle depletion in patients with liver cirrhosis. We included retrospectively all patients with liver cirrhosis who underwent both multiple computed tomography scans and hepatic venous pressure gradient (HVPG) measurements. A total of 131 patients with liver cirrhosis were enrolled. The mean age of the patients was 53.7 years and alcoholic liver disease was the most common cause (61.8%). Sixty-four patients (48.9%) were diagnosed with sarcopenia. The median changes in skeletal muscle area per year (ΔSMA/y) were -0.89%. During a median follow-up period of 46.2 months (range, 3.4-87.6), 45 patients (34.4%) died. In multivariate analyses, age, Child-Pugh score, HVPG, presence of sarcopenia and ΔSMA/y were independently associated with mortality. Cumulative mortality was significantly higher in patients with ΔSMA/y < -2.4% than those with ΔSMA/y ≥ -2.4% (log-rank test, < 0.001). Both the presence and rate of change of sarcopenia are independently associated with long-term mortality in patients with liver cirrhosis.