Association between Sarcopenia and Depression in Patients with Chronic Liver Diseases

Abstract

Association between sarcopenia, as evaluated by grip strength (GS) and skeletal muscle mass (SMM), and depression, as evaluated by Beck Depression Inventory-2nd edition (BDI-II) in chronic liver diseases (CLDs, n = 414, average age = 61.5 years), was investigated. Study subjects were classified into four groups: Group A (n = 60), lower GS and lower SMM (sarcopenia); group B (n = 44), lower GS and higher SMM; group C (n = 100), higher GS and lower SMM; group D (n = 210), higher GS and higher SMM. Factors associated with BDI-II score ≥11 were examined. BDI-II score 0–10 (normal) was found in 284 (68.6%), 11–16 (minimal) in 76 (18.4%), 17–20 (mild) in 24 (5.8%), 21–30 (moderate) in 15 (3.6%), and ≥31 (severe) in 15 (3.6%). The average ± standard deviation BDI-II score in liver cirrhosis (LC) patients (10.2 ± 9.6, n = 152) was significantly higher than that in non-LC patients (7.4 ± 7.2, n = 262) (p = 0.0058). Univariate analysis identified three factors to be significantly associated with BDI-I score ≥11: Our classification (groups of A, B, C, and D) (p = 0.0259), serum albumin (p = 0.0445), and the presence of LC (p = 0.0157). Multivariate analysis revealed that only group A (p = 0.0074, group D as a reference) was significant. In conclusion, sarcopenia can be an independent predictor for depression in CLDs.

Evaluation of Muscle Cramp Associated with Liver Cirrhosis with a Focus on the Liver Function and Nutritional Status

“…Secondary sarcopenia is classified into three subcategories: activity-related, disease-related, and nutritionrelated sarcopenia (19). Among these subcategories, sarcopenia is easily induced by complicated processes, such as protein-energy malnutrition, increased basal metabolism, the presence of a portal circulatory shunt (21), as well as elevated serum myostatin levels (which occur secondary to decreased ammonia clearance and inhibit muscle growth) (22,23), and a decreased cognitive function (24), all of which may occur in patients with liver cirrhosis. Sarcopenia, is highly prevalent in patients with liver cirrhosis, with reported rates ranging from 40% to 70%.…”

Close Correlation between Frailty and Depressive State in Chronic Liver Diseases

“…The concept of overlap in frailty and depression is not so amazing provided that the frailty phenotype and depression share the criteria of exhaustion from a measure of depression at the outset [ 35 , 36 ]. In our previous report, we demonstrated that sarcopenia as evaluated by muscle muss decline and muscle strength decline in CLDs was closely associated with depression [ 24 ]. However, relevant data between depression and frailty in CLD patients are currently scarce.…”

“…In our previous study, we stated that reasons for the high prevalence of CLD patients with depressive state include the long-term suffering caused by CLD itself, social pressure for working and economic pressure for medical therapies [ 24 ]. On the other hand, the proportion of depressive state in prefrail patients accounted for 30.77% in our data.…”

“…A total of 340 CLD patients with data for frailty and the BDI-II score evaluable who admitted to our hospital between July 2015 and March 2020 were analyzed. LC was decided as described elsewhere [ 24 ]. Frailty was defined as a clinical syndrome in which 3 or more of the following criteria were met (frailty score 3, 4 or 5): unintentional body weight (BW) loss (2, 3 kg or more BW loss within the past 6 months), self-reported exhaustion, muscle weakness (grip strength (GS): <26 kg in men and <18 kg in women), slow walking speed (WS, <1.0 m/s) and low physical activity (doing light exercise or not), while prefrail was defined as patients with one or two above mentioned phenotype (frailty score 1 or 2).…”

Effect of levocarnitine administration in patients with chronic liver disease

“…Variables that affect sarcopenia were selected. Clinical features of CLD patients with sarcopenia were elderly, low BMI, and low albumin, and SMI depended on sex ( 27 ). Values of P<0.05 were considered statistically significant.…”