Sarcopenia in cirrhosis: epidemiology, diagnosis, management and prognosis

Author:

Liu Yi1,Ji Fanpu1234,Nguyen Mindie H.56

Affiliation:

1. Department of Infectious Diseases, the Second Affiliated Hospital of Xi’an Jiaotong University

2. National & Local Joint Engineering Research Center of Biodiagnosis and Biotherapy, the Second Affiliated Hospital of Xi’an Jiaotong University

3. Shaanxi Clinical Research Center of Infectious Diseases

4. Key Laboratory of Environment and Genes Related to Diseases, Xi’an Jiaotong University, Ministry of Education of China, Xi’an, PRC

5. Division of Gastroenterology and Hepatology

6. Department of Epidemiology and Population Health, Stanford University Medical Center, Palo Alto, California, USA

Abstract

Purpose of review With the development of many international guidelines, research on sarcopenia has increased rapidly, showing that sarcopenia is predictive of adverse outcomes, including increased mortality and impaired mobility, in patients with cirrhosis. The purpose of this article is to review the current evidence concerning the epidemiology, diagnosis, management and predictive value of sarcopenia on the prognosis of patients with cirrhosis. Recent findings Sarcopenia is a frequent and lethal complication of cirrhosis. Currently, abdominal computed tomography imaging is the most commonly used method to diagnose sarcopenia. In clinical practice, assessing muscle strength and physical performance, such as by measuring handgrip strength and gait speed, is of increasing interest. In addition to the necessary pharmacological therapy, adequate intake of protein, energy and micronutrients, as well as regular moderate-intensity exercise, can help to minimize sarcopenia. Sarcopenia has been shown to be a strong predictor of prognosis in patients with severe liver disease. Summary A global consensus is needed on the definition and operational parameters for the diagnosis of sarcopenia. Further research should focus on developing standardized screening, management and treatment protocols for sarcopenia. Adding sarcopenia to existing models may better exploit the effect of sarcopenia on prognosis in patients with cirrhosis, which should be investigated further.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Gastroenterology

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