Efficacy of branched-chain amino acid supplementation and walking exercise for preventing sarcopenia in patients with liver cirrhosis

Hiraoka, Atsushi; Michitaka, Kojiro; Kiguchi, Daisuke; Izumoto, Hirofumi; Ueki, Hidetaro; Kaneto, Miho; Kitahata, Shogo; Aibiki, Toshihiko; Okudaira, Taeko; Tomida, Hideomi; Miyamoto, Yuji; Yamago, Hiroka; Suga, Yasuhiro; Iwasaki, Ryuichiro; Mori, Kenichiro; Miyata, Hideki; Tsubouchi, Eiji; Kishida, Masato; Nakamura, Tomoyuki; Kohgami, Shigeru; Hirooka, Masashi; Terada, Yoshio; Abe, Masanori; Matsuura, Bunzo; Hiasa, Yoichi

doi:10.1097/meg.0000000000000986

Cited by 123 publications

(107 citation statements)

References 19 publications

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“…In the present analysis, a finger‐circle test result other than Bigger in male patients and Smaller in female patients predicted early occurrence of MA. Daily physical activity has been reported to be lower in CLD patients as compared with healthy subjects . To confirm the relationships among total muscle volume or area of L3, maximum calf circumference, and level of daily physical activity, an additional study is necessary.…”

Section: Discussionmentioning

confidence: 99%

Easy surveillance of muscle volume decline in chronic liver disease patients using finger‐circle (yubi‐wakka) test

Hiraoka

Izumoto

Ueki

et al. 2019

J cachexia sarcopenia muscle

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Background Muscle atrophy (MA) and muscle strength decline are important clinical features in chronic liver disease (CLD) patients. An easy to perform MA screening method without need for special equipment would be helpful. We evaluated the usefulness of the previously reported finger‐circle test as screening for MA in CLD patients. Methods We retrospectively enrolled 358 Japanese CLD outpatients (70.8 ± 10.2 years, male/female = 234/124) who had undergone a computed tomography examination from December 2017 to March 2018, of whom 137 had chronic hepatitis, 169 had liver cirrhosis Child–Pugh A, and 52 had liver cirrhosis Child–Pugh B/C. Bilateral psoas muscle area at the middle of the third lumber vertebra (L3) was evaluated with computed tomography findings, which was performed as a screening of hepatocellular carcinoma, using a previously reported parameter for MA [psoas index (PI): total psoas muscle area (cm 2 )/height (m) 2 ] [mean PI ± standard deviation (SD) of male patients: 6.50 ± 1.13 cm 2 /m 2 and those of female patients: 4.30 ± 0.90 cm 2 /m 2 ]. We then evaluated the correlation between MA and finger‐circle test results in these patients. Results The mean PI values for finger‐circle test results Bigger, Just‐fits, and Smaller were 5.64 ± 1.34, 5.00 ± 1.25, and 4.83 ± 1.46 cm 2 /m 2 , respectively, in male patients ( P < 0.001) and 4.31 ± 1.06, 3.93 ± 0.97, and 3.42 ± 0.94 cm 2 /m 2 , respectively, in female patients ( P = 0.001). We found that a finger‐circle test result in male patients other than Bigger (Just‐fits and Smaller) predicted a decline in psoas muscle area of L3 to PI 5.25 cm 2 /m 2 (sensitivity/specificity 0.619/0.667, area under the curve 0.654, 95% confidence interval 0.583–0.724), which was approximately mean minus 1 SD (5.37 cm 2 /m 2 ). On the other hand, a Smaller test result in female patients predicted a decline in psoas muscle area of L3 to PI 3.33 cm 2 /m 2 (sensitivity/specificity 0.740/0.583, area under the curve 0.698, 95% confidence interval 0.583–0.813), approximately mean minus 1 SD (3.40 cm 2 /m 2 ). Conclusions The finger‐circle test is an easy to perform and effective screening method for predicting earlier stage of MA in CLD patients without the need for special equipment.

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Section: Discussionmentioning

confidence: 99%

Easy surveillance of muscle volume decline in chronic liver disease patients using finger‐circle (yubi‐wakka) test

Hiraoka

Izumoto

Ueki

et al. 2019

J cachexia sarcopenia muscle

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“…Therefore, these patients should undergo intensive exercise and receive nutritional support. It was reported that walking exercise and branched chain amino acid supplementation contributed to improvement of skeletal muscle volume and strength in liver cirrhosis patients . The degree of skeletal muscle attenuation may have utility in identifying patients with muscle wasting and impaired nutritional status who may benefit from intensive nutritional and exercise support.…”

Section: Discussionmentioning

confidence: 99%

Impact of myosteatosis on skeletal muscle volume loss in patients with chronic liver disease

Tachi

Kozuka

Hirai

et al. 2018

J of Gastro and Hepatol

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“…On the other hand, prevention of progression of MVL and muscle function decline is important in the early stages of CLD. A few reports for intervention with nutritional guidance and exercise for improvement of muscle strength or prevention of decline and MVL have been reported . To improve the prognosis and quality of life in CLD patients with and without HCC, establishment of nutritional and exercise programs is needed.…”

Section: Discussionmentioning

confidence: 99%

Impact of muscle volume and muscle function decline in patients undergoing surgical resection for hepatocellular carcinoma

Hiraoka

Otsuka

Kawasaki

et al. 2018

J of Gastro and Hepatol

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Efficacy of branched-chain amino acid supplementation and walking exercise for preventing sarcopenia in patients with liver cirrhosis

Abstract: BCAA supplementation and walking exercise were found to be effective and easily implemented for improving muscle volume and strength in liver cirrhosis patients.

Cited by 123 publications

References 19 publications

Easy surveillance of muscle volume decline in chronic liver disease patients using finger‐circle (yubi‐wakka) test

Easy surveillance of muscle volume decline in chronic liver disease patients using finger‐circle (yubi‐wakka) test

Impact of myosteatosis on skeletal muscle volume loss in patients with chronic liver disease

Impact of muscle volume and muscle function decline in patients undergoing surgical resection for hepatocellular carcinoma

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