Slow walking speed overlapped with low handgrip strength in chronic liver disease patients with hepatocellular carcinoma

• Published in: Hepatology research 2019-12, Vol.49 (12), p.1427-1440
• Main Authors: Nagamatsu, Ayu, Kawaguchi, Takumi, Hirota, Keisuke, Koya, Shunji, Tomita, Manabu, Hashida, Ryuki, Kida, Yohei, Narao, Hayato, Manako, Yuta, Tanaka, Daisuke, Koga, Noboru, Nakano, Dan, Niizeki, Takashi, Matsuse, Hiroo, Torimura, Takuji, Shiba, Naoto
• Format: Article
• Language: English
• Subjects: Body mass index; Cirrhosis; gait speed; handgrip strength; Hepatitis; Hepatocellular carcinoma; Hepatology; hepatoma; Liver cancer; Liver cirrhosis; Liver diseases; muscle function; Musculoskeletal system; Regression analysis; Sarcopenia; Skeletal muscle; Working groups
• ISSN: 1386-6346; 1872-034X
• DOI: 10.1111/hepr.13405

Aim Walking speed and grip strength are parameters of muscle function; however, evaluating walking speed is not always available in clinical practice. We aimed to investigate the impact of walking speed on the evaluation of muscle dysfunction in chronic liver disease (CLD) patients with hepatocellular carcinoma (HCC). Methods We enrolled 107 consecutive CLD patients with HCC in this study (age 76 years [range 60–92 years]; female/male 39/68; body mass index 22.9 [range 20.0–25.3]; chronic hepatitis/liver cirrhosis 25/82). Muscle dysfunction was evaluated using the Asian Working Group for Sarcopenia criteria (grip strength or walking speed) and the Japan Society of Hepatology criteria (grip strength). A correlation between walking speed and skeletal muscle index was evaluated. Independent factors for slow walking speed were evaluated using a logistic regression analysis. Results There was no significant correlation between walking speed and skeletal muscle index (r = 0.14, P = 0.16). For both the Asian Working Group for Sarcopenia and Japan Society of Hepatology criteria, 33.6% of all patients were classified as having muscle dysfunction. All patients with slow walking speed (4.7% of all patients) also showed low handgrip strength. The logistic regression analysis identified grip strength as an independent factor for slow walking speed (OR 0.65; 95% CI 0.432–0.838; P = 0.008). Conclusions No difference was seen in the prevalence of muscle dysfunction between the Asian Working Group for Sarcopenia and Japan Society of Hepatology criteria in CLD patients with HCC. Furthermore, all patients with slow walking speed also showed low handgrip strength. Thus, for the evaluation of muscle dysfunction, grip strength might be a suitable proxy for walking speed in CLD patients with HCC.