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Sarcopenia predicts minimal hepatic encephalopathy in patients with liver cirrhosis
Author(s) -
Hanai Tatsunori,
Shiraki Makoto,
Watanabe Satoshi,
Kochi Takahiro,
Imai Kenji,
Suetsugu Atsushi,
Takai Koji,
Moriwaki Hisataka,
Shimizu Masahito
Publication year - 2017
Publication title -
hepatology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.123
H-Index - 75
eISSN - 1872-034X
pISSN - 1386-6346
DOI - 10.1111/hepr.12873
Subject(s) - sarcopenia , hepatic encephalopathy , medicine , gastroenterology , odds ratio , confidence interval , cirrhosis , bioelectrical impedance analysis , univariate analysis , hepatology , multivariate analysis , body mass index
Aim Minimal hepatic encephalopathy (MHE) and sarcopenia impair the health‐related quality of life and prognosis of patients with liver cirrhosis; however, the relationship between MHE and sarcopenia remains unclear. The aim of this study was to investigate their relationship and to identify the predictors of MHE in cirrhotic patients. Methods This retrospective study evaluated 120 cirrhotic patients who were tested for MHE and sarcopenia. Minimal hepatic encephalopathy was diagnosed by using the computer‐aided neuropsychiatric test. Sarcopenia was diagnosed based on the assessment criteria recommended by the Japan Society of Hepatology. Muscle mass and muscle strength were measured by using bio‐impedance analysis and digital grip strength dynamometer. Univariate and multivariate logistic regression analyses were carried out to identify the predictors of MHE. Results Of the 120 cirrhotic patients, 28 (23%) and 32 (27%) were diagnosed with MHE and sarcopenia, respectively. The prevalence of MHE was higher in patients with sarcopenia than in those without sarcopenia ( P = 0.01). By the univariate analysis, MHE was significantly complicated with sarcopenia ( P < 0.01). In the multivariate analysis, sarcopenia (odds ratio = 3.31, 95% confidence interval = 1.19–9.42; P = 0.02) and serum branched‐chain amino acids levels <327 nmol/mL (odds ratio = 2.98, 95% confidence interval = 1.08–8.34; P = 0.03) were found to be associated with MHE. Conclusions Sarcopenia and serum branched‐chain amino acids levels were predictors of MHE. The amelioration of sarcopenia and/or amino acids imbalance may improve MHE in patients with liver cirrhosis.