Abstract

Purpose. To assess the severity of sarcopenia in liver cirrhosis patients by comparing them to control participants and determining its relation to conventional prognostic scores for liver cirrhosis, such as (CTP and MELD) scores.

Methods. This prospective observational study was conducted on 101 cirrhotic patients and 30 healthy participants aged (40–70 y.o.). Mid upper arm circumference (MUAC) and HGS were measured. BMI, Nutrition risk sore (NRS), Child-Pugh and MELD scores were calculated. CT L3 psoas volume, surface area and psoas muscle index (PMI) were measured. Ultrasonography was used to assess mid-upper arm and mid-thigh. Quadriceps muscle index (QMI) was calculated. It was determined how long the patient would be admitted to the hospital.

Results. According to the HGS cutoff established by the Foundation for the National Institutes of Health (FNIH), 87 percent of the patients were sarcopenic.  Psoas muscle index (PMI) was (4.6 for male, 3.19 cm/m

 for female) and Quadricepes muscle index (QMI) cutoff was (1.67 for male, 1.58 cm/m2 for female) based on the FNIH HGS cutoff. CT L3 Psoas and ultrasound parameters showed significant negative correlation with (Child and MELD) scores, duration of hospital stay and NRS. Also, they showed a significant positive correlation with HGS. We found a positive correlation between PMI and QMI with (p < 0.001). AUC in Roc analysis for QMI considering sarcopenia by PMI was 0.9.

Conclusion. Sarcopenia, as measured by CT psoas, ultrasonography, and HGS in cirrhotic patients, is an independent predictor of liver disease severity. USG and HGS are bedside methods that are as sensitive as CT for assessing sarcopenia.

Key words:

Sarcopenia, cirrhosis, CT L3 psoas, ultrasonography, HGS