Impact of electrical muscle stimulation on serum myostatin level and maintenance of skeletal muscle mass in patients undergoing living‐donor liver transplantation: Single‐center controlled trial

Author:

Tsutsui Yuriko1,Itoh Shinji1ORCID,Toshima Takeo1ORCID,Yoshio Sachiyo2ORCID,Yoshiya Shohei1ORCID,Izumi Takuma1,Iseda Norifumi1,Toshida Katsuya1,Nakayama Yuki1,Ishikawa Takuma1,Kosai‐Fujimoto Yukiko1,Takeishi Kazuki1,Yoshizumi Tomoharu1

Affiliation:

1. Department of Surgery and Science Graduate School of Medical Sciences Kyushu University Fukuoka Japan

2. Department of Liver Diseases The Research Center of Hepatitis and Immunology National Center for Global Health and Medicine Chiba Japan

Abstract

AbstractAimSarcopenia is reportedly associated with a poor prognosis in patients who undergo living‐donor liver transplantation (LDLT), most of whom are not able to tolerate muscle strengthening exercise training. Myostatin is one of the myokines and a negative regulator of skeletal muscle growth. The clinical feasibility of an electrical muscle stimulation (EMS) system, which exercises muscle automatically by direct electrical stimulation, has been reported. In this study, we aimed to determine the effect of perioperative application of SIXPAD, which is a type of EMS system, with reference to the serum myostatin and sarcopenia in LDLT patients.MethodThirty patients scheduled for LDLT were divided into a SIXPAD group (n = 16) and a control group (n = 14). In the SIXPAD group, EMS was applied to the thighs twice daily. The serum myostatin was measured in samples obtained before use of SIXPAD and immediately before LDLT. The psoas muscle index (PMI) at the level of the third lumbar vertebra and the quadriceps muscle area were compared on computed tomography images before use of SIXPAD and 1 month after LDLT.ResultsThe preoperative serum myostatin was found to be higher in LDLT patients than in healthy volunteers and EMS significantly reduced the serum myostatin. Electrical muscle stimulation prevented a postoperative reduction not only in the area of the quadriceps muscles but also in the PMI despite direct stimulation of the thigh muscles.ConclusionStimulation of muscles by EMS decreases the serum myostatin and helps to maintain skeletal muscle in patients who have undergone LDLT.

Funder

Japan Agency for Medical Research and Development

Ministry of Health, Labour and Welfare

Publisher

Wiley

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