Display options
Cite
Hyun Kim K, Kyung Kim B, Yong Park J, et al. Sarcopenia assessed using bioimpedance analysis is associated independently with significant liver fibrosis in patients with chronic liver diseases. Eur J Gastroenterol Hepatol. 2020;32(1):58-65doi: 10.1097/MEG.0000000000001475.
Hyun Kim, K., Kyung Kim, B., Yong Park, J., Young Kim, D., Hoon Ahn, S., Han, K. H., & Kim, S. U. (2020). Sarcopenia assessed using bioimpedance analysis is associated independently with significant liver fibrosis in patients with chronic liver diseases. European journal of gastroenterology & hepatology, 32(1), 58-65. https://doi.org/10.1097/MEG.0000000000001475
Hyun Kim, Kyung, et al. "Sarcopenia assessed using bioimpedance analysis is associated independently with significant liver fibrosis in patients with chronic liver diseases." European journal of gastroenterology & hepatology vol. 32,1 (2020): 58-65. doi: https://doi.org/10.1097/MEG.0000000000001475
Hyun Kim K, Kyung Kim B, Yong Park J, Young Kim D, Hoon Ahn S, Han KH, Kim SU. Sarcopenia assessed using bioimpedance analysis is associated independently with significant liver fibrosis in patients with chronic liver diseases. Eur J Gastroenterol Hepatol. 2020 Jan;32(1):58-65. doi: 10.1097/MEG.0000000000001475. PMID: 31283527.
Copy Download .nbib Format: NLM
Share it on

Eur J Gastroenterol Hepatol. 2020 Jan;32(1):58-65. doi: 10.1097/MEG.0000000000001475.

Sarcopenia assessed using bioimpedance analysis is associated independently with significant liver fibrosis in patients with chronic liver diseases.

European journal of gastroenterology & hepatology

Kyung Hyun Kim, Beom Kyung Kim, Jun Yong Park, Do Young Kim, Sang Hoon Ahn, Kwang-Hyub Han, Seung Up Kim

Affiliations

  1. Department of Internal Medicine.
  2. Institute of Gastroenterology, Yonsei University College of Medicine.
  3. Yonsei Liver Center, Severance Hospital, Seoul, Republic of Korea.

PMID: 31283527 DOI: 10.1097/MEG.0000000000001475

Abstract

AIM: Sarcopenia is common in patients with advanced fibrosis or cirrhosis. We investigated the correlation between sarcopenia and other clinical variables, in particular, significant liver fibrosis in patients with chronic liver diseases (CLDs).

PATIENTS AND METHODS: Patients with CLDs who underwent transient elastography (TE) and bioelectrical impedance analysis between 2015 and 2017 were retrospectively recruited. The sarcopenia index (SI) was calculated as follows: SI = total appendicular skeletal muscle mass (kg)/ body mass index (BMI) (kg/m). Sarcopenia was defined as SI less than 0.789 for men and less than 0.521 for women. Significant liver fibrosis and fatty liver were defined using TE liver stiffness value more than 7 kPa and controlled attenuation parameter more than 250 dB/m, respectively.

RESULTS: Of 2168 patients recruited, 218 (10.1%) had sarcopenia. Age, BMI, diabetes, hypertension, fasting glucose, aspartate aminotransferase, and liver stiffness value were correlated positively with sarcopenia (all P < 0.05), whereas male sex, viral etiology, obesity (BMI > 25 kg/m), total bilirubin, and serum albumin were correlated negatively with sarcopenia (all P < 0.05). On multivariate analysis, TE-defined significant liver fibrosis was associated independently with sarcopenia (odds ratio = 1.597; 95% confidence interval: 1.174-2.172; P = 0.003), together with age, male sex, viral etiology, and TE-defined fatty liver (all P < 0.05). Among the subgroups with ultrasonography-defined nonalcoholic fatty liver disease (n = 957), sarcopenia was also associated independently with TE-defined significant liver fibrosis (odds ratio = 1.887; 95% confidence interval: 1.261-2.823; P < 0.001).

CONCLUSION: Sarcopenia is associated independently with significant liver fibrosis in patients with CLDs. Further studies are required to determine whether interventions to improve muscle mass can improve liver fibrosis.

References

  1. Rosenberg IH, Roubenoff R. Stalking sarcopenia. Ann Intern Med. 1995; 123:727–728 - PubMed
  2. Vetrano DL, Landi F, Volpato S, Corsonello A, Meloni E, Bernabei R, et al. Association of sarcopenia with short-and long-term mortality in older adults admitted to acute care wards: results from the CRIME study. J Gerontol A Biol Sci Med Sci. 2014; 69:1154–1161 - PubMed
  3. Janssen I, Heymsfield SB, Wang Z, Ross R. Skeletal muscle mass and distribution in 468 men and women aged 18–88 year. J Appl Physiol. 2000; 89:81–88 - PubMed
  4. Ali S, Garcia JM. Sarcopenia, cachexia and aging: diagnosis, mechanisms and therapeutic options – a mini-review. Gerontology. 2014; 60:294–305 - PubMed
  5. Muscaritoli M, Lucia S, Molfino A, Cederholm T, Rossi Fanelli F. Muscle atrophy in aging and chronic diseases: is it sarcopenia or cachexia?. Intern Emerg Med. 2013; 8:553–560 - PubMed
  6. Prado CM, Lieffers JR, McCargar LJ, Reiman T, Sawyer MB, Martin L, et al. Prevalence and clinical implications of sarcopenic obesity in patients with solid tumours of the respiratory and gastrointestinal tracts: a population-based study. Lancet Oncol. 2008; 9:629–635 - PubMed
  7. Van Vledder M, Levolger S, Ayez N, Verhoef C, Tran T, Ijzermans J. Body composition and outcome in patients undergoing resection of colorectal liver metastases. Br J Surg. 2012; 99:550–557 - PubMed
  8. Jones SE, Maddocks M, Kon SS, Canavan JL, Nolan CM, Clark AL, et al. Sarcopenia in COPD: prevalence, clinical correlates and response to pulmonary rehabilitation. Thorax. 2015; 70:213–218 - PubMed
  9. Sanada K, Miyachi M, Tanimoto M, Yamamoto K, Murakami H, Okumura S, et al. A cross-sectional study of sarcopenia in Japanese men and women: reference values and association with cardiovascular risk factors. Eur J Appl Physiol. 2010; 110:57–65 - PubMed
  10. Chang YT, Wu HL, Guo HR, Cheng YY, Tseng CC, Wang MC, et al. Handgrip strength is an independent predictor of renal outcomes in patients with chronic kidney diseases. Nephrol Dial Transplant. 2011; 26:3588–3595 - PubMed
  11. Dasarathy S. Consilience in sarcopenia of cirrhosis. J Cachexia Sarcopenia Muscle. 2012; 3:225–237 - PubMed
  12. Glass C, Hipskind P, Tsien C, Malin SK, Kasumov T, Shah SN, et al. Sarcopenia and a physiologically low respiratory quotient in patients with cirrhosis: a prospective controlled study. J Appl Physiol. 2013; 114:559–565 - PubMed
  13. Merli M, Eriksson LS, Hagenfeldt L, Wahren J. Splanchnic and leg exchange of free fatty acids in patients with liver cirrhosis. J Hepatol. 1986; 3:348–355 - PubMed
  14. Tsien CD, McCullough AJ, Dasarathy S. Late evening snack: exploiting a period of anabolic opportunity in cirrhosis. J Gastroenterol Hepatol. 2012; 27:430–441 - PubMed
  15. Chen X, Iqbal N, Boden G. The effects of free fatty acids on gluconeogenesis and glycogenolysis in normal subjects. J Clin Invest. 1999; 103:365–372 - PubMed
  16. Blonde-Cynober F, Aussel C, Cynober L. Abnormalities in branched-chain amino acid metabolismin cirrhosis: influence of hormonal and nutritional factors and directions for future research. Clin Nutr. 1999; 18:5–13 - PubMed
  17. Lee YH, Jung KS, Kim SU, Yoon HJ, Yun YJ, Lee BW, et al. Sarcopaenia is associated with NAFLD independently of obesity and insulin resistance: Nationwide surveys (KNHANES 2008–2011). J Hepatol. 2015; 63:486–493 - PubMed
  18. Lee YH, Kim SU, Song K, Park JY, Ahn SH, Lee BW, et al. Sarcopenia is associated with significant liver fibrosis independently of obesity and insulin resistance in nonalcoholic fatty liver disease: Nationwide surveys (KNHANES 2008–2011). Hepatology. 2016; 63:776–786 - PubMed
  19. Han E, Lee YH, Kim B, Park J, Kim D, Ahn S, et al. Sarcopenia is associated with the risk of significant liver fibrosis in metabolically unhealthy subjects with chronic hepatitis B. Aliment Pharmacol Ther. 2018; 48:300–312 - PubMed
  20. Vallet-Pichard A, Mallet V, Nalpas B, Verkarre V, Nalpas A, Dhalluin-Venier V, et al. FIB-4: an inexpensive and accurate marker of fibrosis in HCV infection. Comparison with liver biopsy and fibrotest. Hepatology. 2007; 46:32–36 - PubMed
  21. Kotronen A, Peltonen M, Hakkarainen A, Sevastianova K, Bergholm R, Johansson LM, et al. Prediction of non-alcoholic fatty liver disease and liver fat using metabolic and genetic factors. Gastroenterology. 2009; 137:865–872 - PubMed
  22. Forns X, Ampurdanes S, Llovet JM, Aponte J, Quintó L, Martínez-Bauer E, et al. Identification of chronic hepatitis C patients without hepatic fibrosis by a simple predictive model. Hepatology. 2002; 36:986–992 - PubMed
  23. Studenski SA, Peters KW, Alley DE, Cawthon PM, McLean RR, Harris TB, et al. The FNIH sarcopenia project: rationale, study description, conference recommendations, and final estimates. J Gerontol A Biol Sci Med Sci. 2014; 69:547–558 - PubMed
  24. Kim SU, Kim JK, Park JY, Ahn SH, Lee JM, Baatarkhuu O, et al. Variability in liver stiffness values from different intercostal spaces. Liver Int. 2009; 29:760–766 - PubMed
  25. Chon YE, Jung KS, Kim SU, Park JY, Park YN, Kim DY, et al. Controlled attenuation parameter (CAP) for detection of hepatic steatosis in patients with chronic liver diseases: a prospective study of a native Korean population. Liver Int. 2014; 34:102–109 - PubMed
  26. Jung KS, Kim SU. Clinical applications of transient elastography. Clin Mol Hepatol. 2012; 18:163–173 - PubMed
  27. Carvalhana S, Leitão J, Alves AC, Bourbon M, Cortez-Pinto H. How good is controlled attenuation parameter and fatty liver index for assessing liver steatosis in general population: correlation with ultrasound. Liver Int. 2014; 34:e111–e117 - PubMed
  28. Oh SW. Obesity and metabolic syndrome in Korea. Diabetes Metab J. 2011; 35:561–566 - PubMed
  29. Castera L, Forns X, Alberti A. Non-invasive evaluation of liver fibrosis using transient elastography. J Hepatol. 2008; 48:835–847 - PubMed
  30. Hong HC, Hwang SY, Choi HY, Yoo HJ, Seo JA, Kim SG, et al. Relationship between sarcopenia and nonalcoholic fatty liver disease: The Korean Sarcopenic Obesity Study. Hepatology. 2014; 59:1772–1778 - PubMed
  31. Petta S, Ciminnisi S, Di Marco V, Cabibi D, Cammà C, Licata A, et al. Sarcopenia is associated with severe liver fibrosis in patients with non-alcoholic fatty liver disease. Aliment Pharmacol Ther. 2017; 45:510–518 - PubMed
  32. Sandrin L, Fourquet B, Hasquenoph JM, Yon S, Fournier C, Mal F, et al. Transient elastography: a new noninvasive method for assessment of hepatic fibrosis. Ultrasound Med Biol. 2003; 29:1705–1713 - PubMed
  33. Kim DY, Song KJ, Kim SU, Yoo EJ, Park JY, Ahn SH, et al. Transient elastography-based risk estimation of hepatitis B virus-related occurrence of hepatocellular carcinoma: development and validation of a predictive model. Onco Targets Ther. 2013; 6:1463–1469 - PubMed
  34. Kim MN, Kim SU, Kim BK, Park JY, Kim DY, Ahn SH, et al. Increased risk of hepatocellular carcinoma in chronic hepatitis B patients with transient elastography-defined subclinical cirrhosis. Hepatology. 2015; 61:1851–1859 - PubMed
  35. Kim JH, Kim MN, Han KH, Kim SU. Clinical application of transient elastography in patients with chronic viral hepatitis receiving antiviral treatment. Liver Int. 2015; 35:1103–1115 - PubMed
  36. Hiraoka A, Michitaka K, Ueki H, Kaneto M, Aibiki T, Okudaira T, et al. Sarcopenia and two types of presarcopenia in Japanese patients with chronic liver disease. Eur J Gastroenterol Hepatol. 2016; 28:940–947 - PubMed
  37. Kim HS, Kim BK, Kim SU, Park JY, Song KJ, Park JW, et al. Association between level of fibrosis, rather than antiviral regimen, and outcomes of patients with chronic hepatitis B. Clin Gastroenterol Hepatol. 2016; 14:1647–1656e6 - PubMed
  38. Ekstedt M, Franzen LE, Mathiesen UL, Thorelius L, Holmqvist M, Bodemar G, et al. Long-term follow-up of patients with NAFLD and elevated liver enzymes. Hepatology. 2006; 44:865–873 - PubMed
  39. Wang C, Bai L. Sarcopenia in the elderly: basic and clinical issues. Geriatr Gerontol Int. 2012; 12:388–396 - PubMed
  40. Abbatecola AM, Paolisso G, Fattoretti P, Evans W, Fiore V, Dicioccio L, et al. Discovering pathways of sarcopenia in older adults: a role for insulin resistance on mitochondria dysfunction. J Nutr Health Aging. 2011; 15:890–895 - PubMed
  41. Bravo AA, Sheth SG, Chopra S. Liver biopsy. N Engl J Med. 2001; 344:495–500 - PubMed
  42. Cadranel JF, Rufat P, Degos F. Practices of liver biopsy in France: results of a prospective nationwide survey. For the Group of Epidemiology of the French Association for the Study of the Liver (AFEF). Hepatology. 2000; 32:477–481 - PubMed
  43. Castera L, Negre I, Samii K, Buffet C. Pain experienced during percutaneous liver biopsy. Hepatology. 1999; 30:1529–1530 - PubMed
  44. Bedossa P, Dargere D, Paradis V. Sampling variability of liver fibrosis in chronic hepatitis C. Hepatology. 2003; 38:1449–1457 - PubMed
  45. Rousselet MC, Michalak S, Dupre F, Croue A, Bedossa P, Saint-Andre JP, et al. Sources of variability in histological scoring of chronic viral hepatitis. Hepatology. 2005; 41:257–264 - PubMed
  46. Foucher J, Chanteloup E, Vergniol J, Castera L, Le Bail B, Adhoute X, et al. Diagnosis of cirrhosis by transient elastography (FibroScan): a prospective study. Gut. 2006; 55:403–408 - PubMed
  47. Miyauchi S, Miyake T, Miyazaki M, Eguchi T, Niiya T, Yamamoto S, et al. Free testosterone concentration is inversely associated with markers of liver fibrosis in men with type 2 diabetes mellitus. Endocr J. 2017; 64:1137–1142 - PubMed
  48. Johnson TM, Overgard EB, Cohen AE, DiBaise JK. Nutrition assessment and management in advanced liver disease. Nutr Clin Pract. 2013; 28:15–29 - PubMed

MeSH terms

Publication Types