Relationship between sarcopenia/myosteatosis and frailty in hospitalized patients with cirrhosis: a sex-stratified analysis

Author:

Feng Hongjuan1,Wang Xiaoyu23,Mao Lihong23,Yu Zihan23,Cui Binxin4,Lin Lin4,Hui Yangyang23,Zhao Xingliang23,Xu Xin23,Fan Xiaofei23,Wang Bangmao23,Yu Qingxiang23,Jiang Kui53,Sun Chao5ORCID

Affiliation:

1. Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, China Department of Nutriology, Tianjin Third Central Hospital, Tianjin, China

2. Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, China

3. Tianjin Institute of Digestive Disease, Tianjin Medical University General Hospital, Tianjin, China

4. Department of Gastroenterology, Tianjin Medical University General Hospital Airport Hospital, Tianjin, China

5. Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Anshan Road 154, Heping District, Tianjin, 300052, China

Abstract

Background: Previous studies have shown that sarcopenia appears to be a significant contributor to physical frailty among outpatients with cirrhosis. However, the evidence is scant regarding the relationship between sarcopenia and multi-dimensional frailty among inpatients. We aimed to investigate the potential contribution of sarcopenia to frailty in hospitalized patients with cirrhosis in a sex-dependent manner. Methods: This cohort enrolled consecutive cirrhotics. Muscle quantity and quality were assessed using the computed tomography-based skeletal muscle index (SMI) and intramuscular adipose tissue content, respectively. Frailty phenotype was clarified by a self-reported Frailty Index. Multiple linear regression determined the association between sarcopenia and frailty phenotype. Results: A total of 202 cirrhotic patients with 48.5% male were included. The median Frailty Index was 0.13, rendering 17.3% subjects as frail. Among the 16 frail men, 68.8% had sarcopenia and 62.5% exhibited myosteatosis. In contrast, among the 19 frail women, 26.3% had sarcopenia and 15.8% exhibited myosteatosis. Frail patients had a significantly lower median SMI (42.80 cm2/m2) compared with those with pre-frailty (48.23 cm2/m2) and with robust status (50.82 cm2/m2) in the male but not the female group. In male patients, multivariate linear regression implicated age (β  = 0.330, p < 0.001), SMI (β  = −0.260, p < 0.001), albumin (β  = −0.245, p = 0.005), and sodium (β  = −0.179, p = 0.037) as independent risk factors for frailty. Conclusion: Sarcopenia is associated with multi-dimensional frailty in male patients with cirrhosis. It is tempting to incorporate sex-specific intervention with the purpose of mitigating frailty among inpatients.

Publisher

SAGE Publications

Subject

Medicine (miscellaneous)

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