Muscle atrophy as pre-sarcopenia in Japanese patients with chronic liver disease: computed tomography is useful for evaluation

• Published in: Journal of gastroenterology Vol. 50; no. 12; pp. 1206 - 1213
• Main Authors: Hiraoka, Atsushi, Aibiki, Toshihiko, Okudaira, Tomonari, Toshimori, Akiko, Kawamura, Tomoe, Nakahara, Hiromasa, Suga, Yoshifumi, Azemoto, Nobuaki, Miyata, Hideki, Miyamoto, Yasunao, Ninomiya, Tomoyuki, Hirooka, Masashi, Abe, Masanori, Matsuura, Bunzo, Hiasa, Yoichi, Michitaka, Kojiro
• Format: Journal Article
• Language: English
• Published: Tokyo Springer Japan 01.12.2015; Springer; Springer Nature B.V
• Subjects: Abdominal Surgery; Adult; Aged; Aged, 80 and over; Aging - pathology; Biliary Tract; Branched chain amino acids; Case-Control Studies; Chronic Disease; Colorectal Surgery; CT imaging; Diagnosis; Disease Progression; Female; Gastroenterology; Hepatitis C virus; Hepatitis, Chronic - complications; Hepatology; Humans; Liver cirrhosis; Liver Cirrhosis - complications; Liver Diseases - complications; Male; Medical colleges; Medicine; Medicine & Public Health; Middle Aged; Muscular Atrophy - diagnostic imaging; Muscular Atrophy - etiology; Original Article—Liver; Original —Liver, Pancreas, and Biliary Tract; Pancreas; Psoas Muscles - diagnostic imaging; Psoas Muscles - pathology; Sarcopenia; Sarcopenia - diagnostic imaging; Sarcopenia - etiology; Software; Surgical Oncology; Tomography, X-Ray Computed - methods; Young Adult; Sarcopenia; Muscle atrophy; Chronic liver disease; Liver cirrhosis; Chronic hepatitis
• ISSN: 0944-1174; 1435-5922
• DOI: 10.1007/s00535-015-1068-x

Background/Aim The definition of muscle atrophy (pre-sarcopenia) and its diagnostic criteria have not been well reported. To elucidate the frequency of pre-sarcopenia in chronic liver disease (CLD), we examined clinical features of Japanese CLD patients using abdominal computed tomography (CT) findings. Methods We enrolled 988 CLD (736 with naïve hepatocellular carcinoma) and 372 normal control subjects (NCs). The psoas muscle area index [PI, psoas muscle area at the mid-L3 level in CT (cm 2 )/height (m) 2 ] was calculated using personal computer software. The cut-off level for pre-sarcopenia was defined as less than two standard deviations (SDs) below the mean PI value in the NCs under 55 years old [males, 45.6 ± 5.7 years ( n  = 61), 4.24 cm 2 /m 2 ; females, 47.0 ± 6.1 years ( n  = 49), 2.50 cm 2 /m 2 ]. Elderly was defined as 65 years or older. Clinical features were retrospectively evaluated. Results In the CLD group (HCV:HBV:HBV and HCV:alcohol:non-HBV and HCV = 652:88:7:82:159), pre-sarcopenia was observed in 15.3 % of patients with chronic hepatitis (CH), 24.4 % of those with liver cirrhosis (LC) Child-Pugh A, 37.7 % of those with LC Child-Pugh B, and 37.1 % of those with LC Child-Pugh C. A comparison between NC and CH by age (<55, 55–64, 65–74, ≥75 years) showed that the frequency of pre-sarcopenia was higher in CH regardless of age (1.8 vs. 3.6 %, 3.2 vs. 15.9 %, 4.9 vs. 13.4 %, 14.3 vs. 20.2 %, respectively). PI values showed correlations with BMI ( r  = 0.361), age ( r  = −0.167), albumin ( r  = 0.115), and branched-chain amino acids ( r  = 0.199) ( P  < 0.01). Conclusion Retrospective evaluate for pre-sarcopenia was easy to perform with CT findings. Nutrition and exercise instruction should be considered for early stage and even non-elderly CLD as well as LC.