Physical inactivity and insufficient dietary intake are associated with the frequency of sarcopenia in patients with compensated viral liver cirrhosis

Abstract

Our results suggest that walking 5000 or more steps per day and maintaining a total energy intake of 30 kcal/IBW may serve as a reference for lifestyle guidelines for compensated cirrhotic patients.

Loss of skeletal muscle mass in patients with chronic liver disease is related to decrease in bone mineral density and exercise tolerance

“…Previously, we found that skeletal muscle mass and muscle strength assessed anthropometrically were significantly lower in patients with chronic liver disease than in healthy subjects . Moreover, the amount of exercise, expressed as active physical activity measured using an accelerometer, was significantly lower in cirrhotic patients with sarcopenia than in cirrhotic patients without sarcopenia . The results of these studies suggest that patients with chronic liver disease and loss of skeletal muscle have decreased exercise tolerance, possibly indicating that the reduction in physical activity may be a factor leading to the loss of skeletal muscle.…”

“…It has been shown that muscle mass tends to decrease owing to protein and energy malnutrition (PEM) and amino acid imbalance in patients with chronic liver disease . In 2013, we reported that approximately 40% of patients with chronic liver disease experience loss of skeletal muscle mass and grip strength and are at a high risk of developing sarcopenia . On the basis of these findings, we believe that patients with chronic liver disease tend to experience skeletal muscle mass loss and muscle weakness and are more likely to develop sarcopenia than healthy persons.…”

Testosterone therapy increases muscle mass in men with cirrhosis and low testosterone: A randomised controlled trial

“…These include malnutrition, portal hypertension, elevated inflammatory mediators, reduced insulin-like growth factor-1 (IGF-1), myostatin upregulation (32) and a shift to muscle protein breakdown for energy use as a result of reduced hepatic glycogen synthesis and storage (33)(34)(35)(36)(37).…”

Anthropometric measures associated with sarcopenia in outpatients with liver cirrhosis

“…Montano‐Loza et al stated that sarcopenia was associated with higher Child‐Pugh scores and complications compatible with severe liver disease. On the other hand, Hayashi et al reported a prevalence of 10% in patients with compensated cirrhosis because of viral hepatitis. As the majority of the sample evaluated in the present study did not have advanced liver disease, the prevalence found was similar to that observed in patients with low Child‐Pugh and MELD scores, showing that sarcopenia can be an early finding in outpatients with cirrhosis.…”

“…Protein catabolism and amino acid expenditure are high in liver cirrhosis, leading to loss of muscle mass and physical performance, thus increasing the risk for sarcopenia . Despite the possibility of liver transplantation, many patients with chronic liver insufficiency are not submitted to a definite treatment and develop sarcopenia, which can be associated with the risk of other complications such as hepatic encephalopathy, ascites and infections …”