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Characterization of body composition and definition of sarcopenia in patients with alcoholic cirrhosis: A computed tomography based study
Author(s) -
Benjamin Jaya,
Shasthry Varsha,
Kaal Chetan Ramesh,
Anand Lovkesh,
Bhardwaj Ankit,
Pandit Vanshja,
Arora Ankur,
Rajesh Sasidharan,
Pamecha Viniyendra,
Jain Vikas,
Kumar Guresh,
Loria Anthony,
Puri Puneet,
Joshi Yogendra Kumar,
Sarin Shiv Kumar
Publication year - 2017
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/liv.13509
Subject(s) - sarcopenia , medicine , cirrhosis , alcoholic liver disease , adipose tissue , skeletal muscle , computed tomography , gastroenterology , nuclear medicine , surgery
Background Alterations in body composition ( BC ) as loss of fat and muscle mass (sarcopenia) are associated with poor outcome in alcoholic cirrhosis ( ALC ). Prevalence of sarcopenia depends upon the method of assessment. Computed Tomography ( CT ) is a gold standard tool for assessing BC . Aim To characterize BC and define sarcopenia in ALC patients using CT . Methods Single slice CT images at L3 vertebrae of healthy controls ( HC ) ‐ organ transplant donors and ALC patients were analysed to give cross‐sectional area of five skeletal muscles normalized for height ‐skeletal muscle index ( SMI ; cm 2 /m 2 ), area of subcutaneous ( SAT ;cm 2 ) and visceral adipose tissue ( VAT ;cm 2 ). Cut‐offs for defining sarcopenia was established at 2 SD below the mean of HC . HC were compared with Child A—compensated (C) and Child B+C—decompensated ( DC ) patients. Results Cut‐offs of SMI derived from HC (n = 275; M: 50%; age 32.2 ± 9.8 years; BMI 24.2 ± 3.2 Kg/m 2 ) were 36.54 in males and 30.21 in females. Sarcopenia was found in 12.8% of ALC patients [n = 148; C (31.8%): DC (68.2%); M: 100%; age 46.6 ± 9.7 years; BMI 24.5 ± 4.4]. Compared to HC , compensated patients had higher adiposity and comparable muscularity; decompensated patients had significantly lower muscle and also fat mass compared to both HC and compensated patients. HC vs C vs DC : SAT (140 ± 82 vs 177.3 ± 11 vs 112 ± 8.2); VAT (96.5 ± 6.5 vs 154.9 ± 8.7 vs 87.5 ± 6.5) and SMI (52.1 ± 0.9 vs 49.6 ± 1.2 vs 46 ± 0.9). Conclusions Compensated ALC have increased adiposity and relatively preserved muscularity but decompensation leads to loss of both muscle and fat mass. Prevalence of sarcopenia, based on derived ethnic cut‐offs was 12.8%.