Journal of Korean Medical Science

Korean Acad Medical Sciences (대한의학회)
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Presence of Sarcopenia and Its Rate of Change Are Independently Associated with Long-term Mortality in Patients with Liver Cirrhosis

  • Jeong, Jae Yoon (Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine) ;
  • Lim, Sanghyeok (Department of Radiology, Hanyang University Guri Hospital, Hanyang University College of Medicine) ;
  • Sohn, Joo Hyun (Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine) ;
  • Lee, Jae Gon (Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine) ;
  • Jun, Dae Won (Department of Internal Medicine, Hanyang University Hospital, Hanyang University College of Medicine) ;
  • Kim, Yongsoo (Department of Radiology, Hanyang University Guri Hospital, Hanyang University College of Medicine)
  • Received : 2018.03.09
  • Accepted : 2018.09.13
  • Published : 2018.12.10
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Abstract

Background: Sarcopenia is associated with a poor prognosis in patients with liver cirrhosis. However, it is not known whether the rate of skeletal muscle depletion is also associated with a poor prognosis. We investigated the prognostic impact of the rate of skeletal muscle depletion in patients with liver cirrhosis. Methods: We included retrospectively all patients with liver cirrhosis who underwent both multiple computed tomography scans and hepatic venous pressure gradient (HVPG) measurements. Results: A total of 131 patients with liver cirrhosis were enrolled. The mean age of the patients was 53.7 years and alcoholic liver disease was the most common cause (61.8%). Sixty-four patients (48.9%) were diagnosed with sarcopenia. The median changes in skeletal muscle area per year (${\Delta}SMA/y$) were -0.89%. During a median follow-up period of 46.2 months (range, 3.4-87.6), 45 patients (34.4%) died. In multivariate analyses, age, Child-Pugh score, HVPG, presence of sarcopenia and ${\Delta}SMA/y$ were independently associated with mortality. Cumulative mortality was significantly higher in patients with ${\Delta}SMA/y$ < -2.4% than those with ${\Delta}SMA/y{\geq}-2.4%$ (log-rank test, P < 0.001). Conclusion: Both the presence and rate of change of sarcopenia are independently associated with long-term mortality in patients with liver cirrhosis.

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References

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