J Korean Med Sci.  2018 Dec;33(50):e299. 10.3346/jkms.2018.33.e299.

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

• Jeong JY
• Lim S
• Sohn JH
• Lee JG
• Jun DW
• Kim Y

• KMID: 2427971
• DOI: http://doi.org/10.3346/jkms.2018.33.e299

Abstract

BACKGROUND
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.
METHODS
We included retrospectively all patients with liver cirrhosis who underwent both multiple computed tomography scans and hepatic venous pressure gradient (HVPG) measurements.
RESULTS
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, P < 0.001).
CONCLUSION
Both the presence and rate of change of sarcopenia are independently associated with long-term mortality in patients with liver cirrhosis.

Keyword

Liver Cirrhosis; Sarcopenia; Nutrition; Mortality; Prognosis

MeSH Terms

Follow-Up Studies
Humans
Liver Cirrhosis*
Liver Diseases, Alcoholic
Liver*
Mortality*
Multivariate Analysis
Muscle, Skeletal
Prognosis
Retrospective Studies
Sarcopenia*
Venous Pressure