Combined Albumin-Bilirubin Grade and Skeletal Muscle Mass as a Predictor in Liver Cirrhosis

Abstract

We aimed to compare the prognostic impact among albumin-bilirubin (ALBI) grade, the Child-Pugh classification and our proposed combined ALBI grade and skeletal muscle mass (SMM) grading system in patients with liver cirrhosis (LC) (n = 468, 254 males and 214 females) using the Akaike information criterion (AIC) and time-dependent receiver operating characteristics (ROC) curve analysis. SMM was tested using bioimpedance analysis. Male subjects with skeletal muscle mass index (SMI) <7.0 cm2/m2 and female subjects with SMI <5.7 cm2/m2 were defined as having low SMM. Patients with ALBI grade 1, 2 and 3 were given 1, 2 and 3 points. Patients with and without low SMM were given 1 and 0 point, respectively. The sum of the point of ALBI (1, 2, or 3) and SMM (0 or 1) was defined as the ALBI-SMM grade. The value obtained with the AIC for survival by the ALBI-SMM grade was the lowest among three assessment methods (AIC: 513.418 in ALBI grade, 533.584 in Child-Pugh classification and 493.72 in ALBI-SMM grade). In time-dependent ROC analysis, all area under the ROCs of the ALBI-SMM grade in each time point were the highest among three assessment methods. In conclusion, the ALBI-SMM grading system can be helpful for LC patients.

Calf Circumference as a Useful Predictor of Sarcopenia in Patients With Liver Diseases

“…In individuals with chronic liver damages (CLDs), metabolic or nutritional disorders including protein-energy-malnutrition or muscle abnormalities are frequently observed, which can be related to falls, poor quality of life or poor prognosis (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11). When the liver function deteriorates, the ability to detoxify harmful substances such as ammonia can decrease.…”

Walking Speed: Japanese Data in Chronic Liver Diseases

“…Because sarcopenia, as defined by muscle mass decline and muscle strength decline in patients with chronic liver diseases (CLDs), can be associated with falls, decreased quality of life, or poor prognosis, it has gained much interest among clinicians these days [1][2][3][4][5][6][7]. Sarcopenia, especially, can occur frequently in patients with liver cirrhosis (LC), and it can be a risk factor for the development of hepatic encephalopathy in LC patients [8,9].…”

Correlation between serum bilirubin levels and the severity as well as the prognosis of idiopathic pulmonary fibrosis

“… 6 , 19 In addition to studies indicating the potential benefits of raised serum bilirubin levels against oxidant stress, the protective effects of the serum bilirubin levels on various fibrosis-related diseases have been widely reported. 20 , 21 Accumulating evidence suggests that oxidative stress and fibrogenesis play significant roles in pathophysiology of IPF. 8 However, few studies have focused on the association between serum bilirubin concentrations and IPF.…”