Continued muscle loss increases mortality in cirrhosis: Impact of aetiology of liver disease

• Published in: Liver international 2020-05, Vol.40 (5), p.1178-1188
• Main Authors: Welch, Nicole, Dasarathy, Jaividhya, Runkana, Ashok, Penumatsa, Revathi, Bellar, Annette, Reen, Jaspreet, Rotroff, Daniel, McCullough, Arthur J., Dasarathy, Srinivasan
• Format: Article
• Language: English
• Subjects: Abdominal wall; alcoholic cirrhosis; Cirrhosis; Computed tomography; Etiology; Fatty liver; fatty liver disease; Health risks; Hepatitis; Liver; Liver cirrhosis; Liver diseases; mortality; Muscles; rate of muscle loss; Risk analysis; Risk factors; Sarcopenia; Skeletal muscle; Spine; Survival; Vertebrae
• ISSN: 1478-3223; 1478-3231
• DOI: 10.1111/liv.14358

Background and Aims Sarcopenia or skeletal muscle loss adversely affects outcomes in cirrhosis. The impact of aetiology of liver disease on the severity or the rate of muscle loss is not known. Methods Consecutive, well‐characterized adult patients with cirrhosis due to viral hepatitis (VH), alcoholic liver disease (ALD) or non‐alcoholic fatty liver disease (NAFLD) and non‐diseased controls with at least two temporally distinct abdominal CT (computed tomography) scans were evaluated. Psoas, paraspinal and abdominal wall muscle areas at the L3 vertebra level were quantified on the CT scans. Standardized rate of change in muscle area was expressed as change in area/100 days. Univariate and multivariable analyses were performed to identify contributors to rate of muscle loss and survival. Results Among 83 cirrhotics (NAFLD n = 26, ALD n = 39, VH n = 18), there were 20 (24.1%) deaths over 62.7 ± 41.3 months. The mean percentage change in psoas area was −0.03 ± 0.05/100d in controls and −3.52 ± 0.45/100d in cirrhosis (P