IDDF2019-ABS-0305 Psoas muscle thickness as measure for sarcopenia and prognosis in liver cirrhosis

Abstract

Background Malnutrition is an overlooked complication of liver cirrhosis. Sarcopenia, a marker of malnutrition, is an independent prognostic factor for mortality in liver cirrhosis.We aimed to evaluate psoas muscle thickness divided by height (PMTH) as a measure for the degree of sarcopenia and determine its correlation with the clinical outcomes. Methods Sixty-five liver cirrhosis patients with available abdominal CT scan were reviewed in this retrospective cohort study. PMTH were measured and correlated with clinical parameters and outcomes. The diagnostic performance for predicting long-term mortality of PMTH, Child-Pugh, MELD and MELD-Na score was determined by calculating the area under the receiver-operating curve (AUROC) and cut-off values were derived. Event rate of specific complications was analyzed using the cut-off. Kaplan Meier with a log-rank test was used to compare survival rates in the low PMTH vs. high PMTH group. Cox regression analysis was used to determine the variables predictive of mortality. Results There was no significant difference among the PMTH values between cirrhotic patients without HCCA and with HCCA (p=0.652). BMI showed a significant correlation to PMTH with p=0.001 (r=0.415). A weak negative correlation was noted between liver-related complications and PMTH. The best cut-off value of PMTH to predict 6-month mortality was derived at 13.45 mm/m. Low PMTH was significantly predictive of the occurrence of SBP with p=0.032. The performance of PMTH in 6-month mortality was not significant (p= 0.517). Kaplan Meier graph revealed that high PMTH group had a higher survival rate (figure 1). The univariate Cox-regression analysis demonstrated that age and lower serum Na were significantly associated with mortality (p=0.005 and p=0.045).

Low Psoas-Muscle index is associated with decreased survival in hepatocellular carcinoma treated with transarterial chemoembolization

“…Recently, several studies reported single muscle, rather than total skeletal muscle, mass for sarcopenia assessment [ 11 , 21 ]. The most commonly used individual muscle for sarcopenia diagnosis is the psoas muscle.…”

“…A single-muscle approach to be used clinically for the diagnosis of sarcopenia is a recent trend in the literature on CT-defined muscle quantification [ 10 ] Currently, the psoas muscle is one of the most common muscles for the diagnosis of sarcopenia [ 11 ]. However, whether psoas muscle also predict survival is not known.…”

Sarcopenia Among Older People in the Philippines: A Scoping Review

“…Sarcopenic COPD patients reduced peak inspiratory flow, peak expiratory flow, and CAT score compared to non-sarcopenic COPD patients (Chua et al, 2019). No significant difference in the PMTH values between cirrhotic patients without HCCA and those with HCCA (Tan et al, 2019). Sarcopenic COPD patients' diagnosis was associated with osteoporosis; they also have lower HGS compared to nonsarcopenic COPD patients (Chua & Tee, 2020).…”