Hemoglobin levels as a surrogate marker of sarcopenia in patients with liver cirrhosis

Akihiko Shibamoto; Tadashi Namisaki; Junya Suzuki; Takahiro Kubo; Satoshi Iwai; Fumimasa Tomooka; Soichi Takeda; Yuki Fujimoto; Masahide Enomoto; Koji Murata; Takashi Inoue; Yuki Tsuji; Yukihisa Fujinaga; Norihisa Nishimura; Koh Kitagawa; Hiroaki Takaya; Kosuke Kaji; Hideto Kawaratani; Takemi Akahane; Akira Mitoro; Hitoshi Yoshiji

doi:10.1111/hepr.13904

Hemoglobin levels as a surrogate marker of sarcopenia in patients with liver cirrhosis

Hepatol Res. 2023 Aug;53(8):713-722. doi: 10.1111/hepr.13904. Epub 2023 Apr 28.

Authors

Akihiko Shibamoto¹, Tadashi Namisaki¹, Junya Suzuki¹, Takahiro Kubo¹, Satoshi Iwai¹, Fumimasa Tomooka¹, Soichi Takeda¹, Yuki Fujimoto¹, Masahide Enomoto¹, Koji Murata¹, Takashi Inoue², Yuki Tsuji¹, Yukihisa Fujinaga¹, Norihisa Nishimura¹, Koh Kitagawa¹, Hiroaki Takaya¹, Kosuke Kaji¹, Hideto Kawaratani¹, Takemi Akahane¹, Akira Mitoro¹, Hitoshi Yoshiji¹

Affiliations

¹ Department of Gastroenterology, Nara Medical University, Kashihara, Japan.
² Department of Evidence-Based Medicine, Nara Medical University, Kashihara, Japan.

PMID: 37050844
DOI: 10.1111/hepr.13904

Abstract

Aim: This study aimed to elucidate a surrogate marker of sarcopenia in patients with liver cirrhosis (LC).

Methods: A total of 424 patients were assessed for handgrip strength (HGS) and skeletal muscle index (SMI). They were divided into two groups: sarcopenia (Group S; n = 80) and nonsarcopenia (Group NS; n = 344).

Results: Group S showed significantly lower HGS, SMI, and hemoglobin (Hb) levels in males and female patients, and lower serum levels of albumin, cholinesterase, and zinc (all p < 0.001), along with significantly higher serum levels of procollagen type III-N-peptide and type IV collagen 7S-domain (p < 0.001 and p < 0.0017) than Group NS. The risk factors for sarcopenia were age 65 years or older, female gender, Child-Pugh class C, and Hb levels <10.9 g/dL in women and <12.4 g/dL in men (p = 0.012, p < 0.001, p = 0.031, and p < 0.001, respectively). Significant positive correlations were found between the Hb level and the SMI and HGS (r = 0.4, p < 0.001 and r = 0.4, p < 0.001, respectively). Sarcopenia, low HGS, and low SMI were significantly associated with overall survival in patients with LC (all p < 0.001). The predictive accuracy of Hb levels for predicting sarcopenia was significantly higher than for predicting SMI and tended to be higher than for predicting HGS (p = 0.014 and p = 0.059, respectively).

Conclusion: Hemoglobin levels are predictive of sarcopenia in patients with LC and warrants further investigation as a biomarker for sarcopenia in LC.

Keywords: handgrip strength; hemoglobin; liver cirrhosis; sarcopenia.