Impacts of muscle mass dynamics on prognosis of outpatients with cirrhosis

Abstract

Number of figures and tables: 3 tables, 4 figures, and 7 supplementary tables and figures. Clinical Trial RegistrationThis clinical trial was registered in the ClinicalTrials.gov (NCT04414956). Ethics ApprovalThis prospective study conformed to the ethical guidelines of the 1975 Declaration of Helsinki and was approved by the institutional review board at the Korea University Ansan Hospital (IRB No: 2016AS0064).

Correspondence on Letter regarding “Impacts of muscle mass dynamics on prognosis of outpatients with cirrhosis”

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We sincerely appreciate the letter from Dr. Song, Chang, and Yang 1 for contemplating our recent paper on the prognostic impact of muscle mass change in outpatients with cirrhosis, published in Clinical and Molecular Hepatology. 2 We agree that sex and lifestyle influence muscle mass and that myosteatosis is an important prognostic marker in patients with cirrhosis.Many diagnostic criteria for sarcopenia have been established based on sex-specific differences, and this study was conducted by adopting one of them. However, the change in muscle mass may differ from the muscle mass itself.

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Interaction between sarcopenia and nonalcoholic fatty liver disease

“…Both sarcopenia and myosteatosis have been linked to advanced fibrosis and cirrhosis. 22,34,[119][120][121][122] However, the relatively low skeletal muscle mass observed in NAFLD patients may derive from increased body fat percentage. 15,111 Muscle wasting is often seen in patients with advanced fibrosis, implicating reverse causality between low skeletal muscle mass and NAFLD severity.…”

Letter regarding “Impacts of muscle mass dynamics on prognosis of outpatients with cirrhosis”

“…Secondly, the lifestyle of cirrhotic patients should be considered. In the study of Kim et al, 11 alcohol-related liver disease accounts for 21.0% of all patients and is the second most etiology.…”

“…However, there are few studies on the association between changes in sarcopenia and the prognosis of cirrhosis. Thus, we read with great interest the article of Kim et al [ 11 ], which described that the change in muscle mass was a good predictor of the development of cirrhotic complications independent of liver function. However, it is still necessary to consider some of the issues that were not mentioned by Kim et al [ 11 ].…”

“…Thus, we read with great interest the article of Kim et al [ 11 ], which described that the change in muscle mass was a good predictor of the development of cirrhotic complications independent of liver function. However, it is still necessary to consider some of the issues that were not mentioned by Kim et al [ 11 ].…”