Background & objectives: Sarcopenia is one of the most common complication associated with mortality in cirrhotic patients. However, the lack of an objective and reliable method to quantify muscle mass has limited the general incorporation of sarcopenia into cirrhosis prognostic scores. In this article, we highlight crosssectional imaging-based estimation of skeletal muscle mass for diagnosing sarcopenia in cirrhotic patients and its effect on health related quality of life.
Methods: After getting ethical clearance and informed consent, all patients with cirrhosis were taken and assessed for sarcopenia using thigh muscle based index The average feather index was used in conjunction with BMI in determining the probability of sarcopenia. The CLDQ was used to assess the health related quality of life. The chi-square and Pearsons coefficient were used for analyzing correlation between sarcopenia and other variables.
Results & discussion: In our study, out of the 288 patients, sarcopenia was present in 132 patients (45.83%). Sarcopenia was present in 18.2% in CHILD A,42.4 % in CHID B and 90.5 % in CHILD C cirrhotics. Sarcopenia was highest in autoimmune hepatitis related cirrhosis (80%), followed by NASH (61.9%),followed by ethanol (42.4%), followed by HCV (28.5%) and HBV (16.6%). Sarcopenia had a moderate negative correlation with health related Quality of life as assessed by CLD Q particularly in relation with systemic symptoms and activity.
Conclusion: The factors like high MELD, CHILD C cirrhosis, NASH as etiology, were associated with higher prevalence of sarcopenia.NASH related cirrhotics have high prevalance of sarcopenia even in CHILD A patients. The patients with sarcopenia were having a low overall quality of life as per CLDQ,especially in specific aspects related to systemic symptoms and activity.
© Journal of the Association of Physicians of India 2011.