Sarcopenia in Children With End‐Stage Liver Disease on the Transplant Waiting List
Sarcopenia predicts morbidity and mortality in adults with end‐stage liver disease (ESLD) and is determined by total psoas muscle area (tPMA) measurement from computed tomography (CT) imaging. Recently developed pediatric age‐ and sex‐specific tPMA growth curves provide the opportunity to ascertain...
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Published in | Liver transplantation Vol. 27; no. 5; pp. 641 - 651 |
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Main Authors | , , , , , , |
Format | Journal Article |
Language | English |
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United States
Wiley Subscription Services, Inc
01.05.2021
John Wiley and Sons Inc |
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Abstract | Sarcopenia predicts morbidity and mortality in adults with end‐stage liver disease (ESLD) and is determined by total psoas muscle area (tPMA) measurement from computed tomography (CT) imaging. Recently developed pediatric age‐ and sex‐specific tPMA growth curves provide the opportunity to ascertain prevalence and impact of sarcopenia in children awaiting liver transplantation (LT). This retrospective single‐center study evaluated sarcopenia in children between 1 and 16 years with ESLD and a clinically indicated abdominal CT less than 3 months before first isolated LT. Sarcopenia was defined as tPMA z score less than −2 measured at the intervertebral L4‐5 level. Patient demographic, biochemical, and outcome data were recorded. tPMA was compared with other measures of nutritional status using univariate and multivariate logistic analyses. Outcome measures included 1‐year morbidity events and mortality after LT. CT images from 25 (64% female) children with median age of 5.50 (interquartile range [IQR], 3.75‐11.33) years were reviewed. Ten children (40%) had a tPMA z score less than −2. Sarcopenia was associated with lower z scores for weight (odds ratio [OR], 0.38; P = 0.02), height (OR, 0.32; P = 0.03), and nutritional support before LT (OR, 12.93; P = 0.01). Sarcopenic children had a longer duration of pediatric intensive care unit (PICU) stay (3.50 [IQR, 3.00‐6.00] versus 2.00 [IQR, 2.00‐3.50] days; P = 0.03). Sarcopenia was prevalent in 40% of children with ESLD awaiting LT, and lower tPMA z score was associated with deficient anthropometrics and need for nutritional support before LT. Post‐LT PICU duration was increased in children with sarcopenia, reflecting adverse outcomes associated with muscle loss. Further studies are needed to elucidate the underlying mechanisms of sarcopenia in children with ESLD. |
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AbstractList | Sarcopenia predicts morbidity and mortality in adults with end‐stage liver disease (ESLD) and is determined by total psoas muscle area (tPMA) measurement from computed tomography (CT) imaging. Recently developed pediatric age‐ and sex‐specific tPMA growth curves provide the opportunity to ascertain prevalence and impact of sarcopenia in children awaiting liver transplantation (LT). This retrospective single‐center study evaluated sarcopenia in children between 1 and 16 years with ESLD and a clinically indicated abdominal CT less than 3 months before first isolated LT. Sarcopenia was defined as tPMA
z
score less than −2 measured at the intervertebral L4‐5 level. Patient demographic, biochemical, and outcome data were recorded. tPMA was compared with other measures of nutritional status using univariate and multivariate logistic analyses. Outcome measures included 1‐year morbidity events and mortality after LT. CT images from 25 (64% female) children with median age of 5.50 (interquartile range [IQR], 3.75‐11.33) years were reviewed. Ten children (40%) had a tPMA
z
score less than −2. Sarcopenia was associated with lower
z
scores for weight (odds ratio [OR], 0.38;
P
= 0.02), height (OR, 0.32;
P
= 0.03), and nutritional support before LT (OR, 12.93;
P
= 0.01). Sarcopenic children had a longer duration of pediatric intensive care unit (PICU) stay (3.50 [IQR, 3.00‐6.00] versus 2.00 [IQR, 2.00‐3.50] days;
P
= 0.03). Sarcopenia was prevalent in 40% of children with ESLD awaiting LT, and lower tPMA
z
score was associated with deficient anthropometrics and need for nutritional support before LT. Post‐LT PICU duration was increased in children with sarcopenia, reflecting adverse outcomes associated with muscle loss. Further studies are needed to elucidate the underlying mechanisms of sarcopenia in children with ESLD. Sarcopenia predicts morbidity and mortality in adults with end‐stage liver disease (ESLD) and is determined by total psoas muscle area (tPMA) measurement from computed tomography (CT) imaging. Recently developed pediatric age‐ and sex‐specific tPMA growth curves provide the opportunity to ascertain prevalence and impact of sarcopenia in children awaiting liver transplantation (LT). This retrospective single‐center study evaluated sarcopenia in children between 1 and 16 years with ESLD and a clinically indicated abdominal CT less than 3 months before first isolated LT. Sarcopenia was defined as tPMA z score less than −2 measured at the intervertebral L4‐5 level. Patient demographic, biochemical, and outcome data were recorded. tPMA was compared with other measures of nutritional status using univariate and multivariate logistic analyses. Outcome measures included 1‐year morbidity events and mortality after LT. CT images from 25 (64% female) children with median age of 5.50 (interquartile range [IQR], 3.75‐11.33) years were reviewed. Ten children (40%) had a tPMA z score less than −2. Sarcopenia was associated with lower z scores for weight (odds ratio [OR], 0.38; P = 0.02), height (OR, 0.32; P = 0.03), and nutritional support before LT (OR, 12.93; P = 0.01). Sarcopenic children had a longer duration of pediatric intensive care unit (PICU) stay (3.50 [IQR, 3.00‐6.00] versus 2.00 [IQR, 2.00‐3.50] days; P = 0.03). Sarcopenia was prevalent in 40% of children with ESLD awaiting LT, and lower tPMA z score was associated with deficient anthropometrics and need for nutritional support before LT. Post‐LT PICU duration was increased in children with sarcopenia, reflecting adverse outcomes associated with muscle loss. Further studies are needed to elucidate the underlying mechanisms of sarcopenia in children with ESLD. Sarcopenia predicts morbidity and mortality in adults with end-stage liver disease (ESLD) and is determined by total psoas muscle area (tPMA) measurement from computed tomography (CT) imaging. Recently developed pediatric age- and sex-specific tPMA growth curves provide the opportunity to ascertain prevalence and impact of sarcopenia in children awaiting liver transplantation (LT). This retrospective single-center study evaluated sarcopenia in children between 1 and 16 years with ESLD and a clinically indicated abdominal CT less than 3 months before first isolated LT. Sarcopenia was defined as tPMA z score less than -2 measured at the intervertebral L4-5 level. Patient demographic, biochemical, and outcome data were recorded. tPMA was compared with other measures of nutritional status using univariate and multivariate logistic analyses. Outcome measures included 1-year morbidity events and mortality after LT. CT images from 25 (64% female) children with median age of 5.50 (interquartile range [IQR], 3.75-11.33) years were reviewed. Ten children (40%) had a tPMA z score less than -2. Sarcopenia was associated with lower z scores for weight (odds ratio [OR], 0.38; P = 0.02), height (OR, 0.32; P = 0.03), and nutritional support before LT (OR, 12.93; P = 0.01). Sarcopenic children had a longer duration of pediatric intensive care unit (PICU) stay (3.50 [IQR, 3.00-6.00] versus 2.00 [IQR, 2.00-3.50] days; P = 0.03). Sarcopenia was prevalent in 40% of children with ESLD awaiting LT, and lower tPMA z score was associated with deficient anthropometrics and need for nutritional support before LT. Post-LT PICU duration was increased in children with sarcopenia, reflecting adverse outcomes associated with muscle loss. Further studies are needed to elucidate the underlying mechanisms of sarcopenia in children with ESLD. Sarcopenia predicts morbidity and mortality in adults with end-stage liver disease (ESLD) and is determined by total psoas muscle area (tPMA) measurement from computed tomography (CT) imaging. Recently developed pediatric age- and sex-specific tPMA growth curves provide the opportunity to ascertain prevalence and impact of sarcopenia in children awaiting liver transplantation (LT). This retrospective single-center study evaluated sarcopenia in children between 1 and 16 years with ESLD and a clinically indicated abdominal CT less than 3 months before first isolated LT. Sarcopenia was defined as tPMA z score less than -2 measured at the intervertebral L4-5 level. Patient demographic, biochemical, and outcome data were recorded. tPMA was compared with other measures of nutritional status using univariate and multivariate logistic analyses. Outcome measures included 1-year morbidity events and mortality after LT. CT images from 25 (64% female) children with median age of 5.50 (interquartile range [IQR], 3.75-11.33) years were reviewed. Ten children (40%) had a tPMA z score less than -2. Sarcopenia was associated with lower z scores for weight (odds ratio [OR], 0.38; P = 0.02), height (OR, 0.32; P = 0.03), and nutritional support before LT (OR, 12.93; P = 0.01). Sarcopenic children had a longer duration of pediatric intensive care unit (PICU) stay (3.50 [IQR, 3.00-6.00] versus 2.00 [IQR, 2.00-3.50] days; P = 0.03). Sarcopenia was prevalent in 40% of children with ESLD awaiting LT, and lower tPMA z score was associated with deficient anthropometrics and need for nutritional support before LT. Post-LT PICU duration was increased in children with sarcopenia, reflecting adverse outcomes associated with muscle loss. Further studies are needed to elucidate the underlying mechanisms of sarcopenia in children with ESLD. Sarcopenia predicts morbidity and mortality in adults with end‐stage liver disease (ESLD) and is determined by total psoas muscle area (tPMA) measurement from computed tomography (CT) imaging. Recently developed pediatric age‐ and sex‐specific tPMA growth curves provide the opportunity to ascertain prevalence and impact of sarcopenia in children awaiting liver transplantation (LT). This retrospective single‐center study evaluated sarcopenia in children between 1 and 16 years with ESLD and a clinically indicated abdominal CT less than 3 months before first isolated LT. Sarcopenia was defined as tPMA z score less than −2 measured at the intervertebral L4‐5 level. Patient demographic, biochemical, and outcome data were recorded. tPMA was compared with other measures of nutritional status using univariate and multivariate logistic analyses. Outcome measures included 1‐year morbidity events and mortality after LT. CT images from 25 (64% female) children with median age of 5.50 (interquartile range [IQR], 3.75‐11.33) years were reviewed. Ten children (40%) had a tPMA z score less than −2. Sarcopenia was associated with lower z scores for weight (odds ratio [OR], 0.38; P = 0.02), height (OR, 0.32; P = 0.03), and nutritional support before LT (OR, 12.93; P = 0.01). Sarcopenic children had a longer duration of pediatric intensive care unit (PICU) stay (3.50 [IQR, 3.00‐6.00] versus 2.00 [IQR, 2.00‐3.50] days; P = 0.03). Sarcopenia was prevalent in 40% of children with ESLD awaiting LT, and lower tPMA z score was associated with deficient anthropometrics and need for nutritional support before LT. Post‐LT PICU duration was increased in children with sarcopenia, reflecting adverse outcomes associated with muscle loss. Further studies are needed to elucidate the underlying mechanisms of sarcopenia in children with ESLD. Sarcopenia predicts morbidity and mortality in adults with end‐stage liver disease (ESLD) and is determined by total psoas muscle area (tPMA) measurement from computed tomography (CT) imaging. Recently developed pediatric age‐ and sex‐specific tPMA growth curves provide the opportunity to ascertain prevalence and impact of sarcopenia in children awaiting liver transplantation (LT). This retrospective single‐center study evaluated sarcopenia in children between 1 and 16 years with ESLD and a clinically indicated abdominal CT less than 3 months before first isolated LT. Sarcopenia was defined as tPMA z score less than −2 measured at the intervertebral L4‐5 level. Patient demographic, biochemical, and outcome data were recorded. tPMA was compared with other measures of nutritional status using univariate and multivariate logistic analyses. Outcome measures included 1‐year morbidity events and mortality after LT. CT images from 25 (64% female) children with median age of 5.50 (interquartile range [IQR], 3.75‐11.33) years were reviewed. Ten children (40%) had a tPMA z score less than −2. Sarcopenia was associated with lower z scores for weight (odds ratio [OR], 0.38; P = 0.02), height (OR, 0.32; P = 0.03), and nutritional support before LT (OR, 12.93; P = 0.01). Sarcopenic children had a longer duration of pediatric intensive care unit (PICU) stay (3.50 [IQR, 3.00‐6.00] versus 2.00 [IQR, 2.00‐3.50] days; P = 0.03). Sarcopenia was prevalent in 40% of children with ESLD awaiting LT, and lower tPMA z score was associated with deficient anthropometrics and need for nutritional support before LT. Post‐LT PICU duration was increased in children with sarcopenia, reflecting adverse outcomes associated with muscle loss. Further studies are needed to elucidate the underlying mechanisms of sarcopenia in children with ESLD. |
Author | Ng, Vicky L. Perez, Manuela Chavhan, Govind B. Johara, Fatema T. Woolfson, Jessica P. Lurz, Eberhard Kamath, Binita M. |
AuthorAffiliation | 2 University of Toronto Toronto Ontario Canada 3 Department of Diagnostic Imaging and Department of Medical Imaging the Hospital for Sick Children Toronto Ontario Canada 1 Division of Gastroenterology, Hepatology, and Nutrition the Hospital for Sick Children Toronto Ontario Canada 4 Transplant and Regenerative Medicine Centre the Hospital for Sick Children Toronto Ontario Canada |
AuthorAffiliation_xml | – name: 2 University of Toronto Toronto Ontario Canada – name: 4 Transplant and Regenerative Medicine Centre the Hospital for Sick Children Toronto Ontario Canada – name: 3 Department of Diagnostic Imaging and Department of Medical Imaging the Hospital for Sick Children Toronto Ontario Canada – name: 1 Division of Gastroenterology, Hepatology, and Nutrition the Hospital for Sick Children Toronto Ontario Canada |
Author_xml | – sequence: 1 givenname: Jessica P. surname: Woolfson fullname: Woolfson, Jessica P. organization: University of Toronto – sequence: 2 givenname: Manuela surname: Perez fullname: Perez, Manuela organization: the Hospital for Sick Children – sequence: 3 givenname: Govind B. surname: Chavhan fullname: Chavhan, Govind B. organization: the Hospital for Sick Children – sequence: 4 givenname: Fatema T. surname: Johara fullname: Johara, Fatema T. organization: University of Toronto – sequence: 5 givenname: Eberhard surname: Lurz fullname: Lurz, Eberhard organization: University of Toronto – sequence: 6 givenname: Binita M. surname: Kamath fullname: Kamath, Binita M. organization: the Hospital for Sick Children – sequence: 7 givenname: Vicky L. surname: Ng fullname: Ng, Vicky L. email: vicky.ng@sickkids.ca organization: the Hospital for Sick Children |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/33460522$$D View this record in MEDLINE/PubMed |
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ContentType | Journal Article |
Copyright | Copyright © 2021 The Authors. published by Wiley Periodicals LLC on behalf of American Association for the Study of Liver Diseases. Copyright © 2021 The Authors. Liver Transplantation published by Wiley Periodicals LLC on behalf of American Association for the Study of Liver Diseases. 2021. This article is published under http://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. |
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Notes | Jessica P. Woolfson participated in research design, data acquisition and analysis and interpretation, drafting and revising the article for important intellectual content, and final approval of the article. Manuela Perez and Govind B. Chavhan participated in data acquisition, drafting and revising the article for important intellectual content, and final approval of the article. Fatema Johara participated in data analysis and interpretation, drafting and revising the article for important intellectual content, and final approval of the article. Eberhard Lurz, Binita M. Kamath, and Vicky L. Ng participated in research design, data analysis and interpretation, drafting and revising the article for important intellectual content, and final approval of the article. These authors contributed equally to this work. Binita M. Kamath consults and has grants with Mirum and Albireo. Eberhard Lurz is on the speakers’ bureau for Nutricia. Vicky L. Ng consults for Albireo. This study was supported by the Clinical Hepatology Fellowship award from the Canadian Liver Foundation and the Canadian Association for the Study of the Liver (to Jessica P. Woolfson). ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
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Snippet | Sarcopenia predicts morbidity and mortality in adults with end‐stage liver disease (ESLD) and is determined by total psoas muscle area (tPMA) measurement from... Sarcopenia predicts morbidity and mortality in adults with end-stage liver disease (ESLD) and is determined by total psoas muscle area (tPMA) measurement from... |
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SubjectTerms | Adult Child Child, Preschool Children Computed tomography End Stage Liver Disease - complications End Stage Liver Disease - surgery Female Growth curves Humans Liver diseases Liver transplantation Liver Transplantation - adverse effects Male Morbidity Mortality Nutritional status Original Pediatrics Psoas muscle Retrospective Studies Sarcopenia Sarcopenia - complications Sarcopenia - diagnostic imaging Sarcopenia - epidemiology Transplants & implants Waiting Lists |
Title | Sarcopenia in Children With End‐Stage Liver Disease on the Transplant Waiting List |
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