Clinical impact of sarcopenia assessment in patients with liver cirrhosis

• Published in: Expert review of gastroenterology & hepatology Vol. 15; no. 4; p. 377
• Main Authors: Marasco, Giovanni, Dajti, Elton, Ravaioli, Federico, Brocchi, Stefano, Rossini, Benedetta, Alemanni, Luigina Vanessa, Peta, Giuliano, Bartalena, Laura, Golfieri, Rita, Festi, Davide, Colecchia, Antonio, Renzulli, Matteo
• Format: Journal Article
• Language: English
• Published: England 03.04.2021
• Subjects: malnutrition; chronic liver disease; body composition; Skeletal muscle mass; liver transplantation
• ISSN: 1747-4132
• DOI: 10.1080/17474124.2021.1848542

: Sarcopenia is defined as loss of skeletal muscle mass, strength, and function, and it is associated with increased morbidity and mortality in patients with chronic liver disease. : The aim of this review is to provide a detailed report on the pathophysiological mechanisms underlying sarcopenia in cirrhotic patients, the several imaging methods available for the assessment of sarcopenia and the clinical studies evaluating the prognostic role of sarcopenia presence in cirrhotic patients. : Sarcopenia pathogenesis is complex and multifaceted, as chronic catabolic conditions, increased energy expenditure, reduced appetite, side effects of multiple therapies, alterations in circulating levels of hormones, low protein synthesis, presence of ascites or portosystemic shunts are all factors contributing to muscle atrophy in cirrhotic patients. Computed tomography scan is the most validated method to evaluate muscle mass and quality. Sarcopenia is associated with a higher rate waitlist mortality, hepatic encephalopathy, and lower quality of life in patients with liver cirrhosis. Future studies should make an effort to unify and validate liver disease-specific cutoffs for the definition of sarcopenia.