Open AccessRelationship between sarcopenia/myosteatosis and frailty in hospitalized patients with cirrhosis: a sex-stratified analysis
Author(s) -
Hongjuan Feng,
Xiaoyu Wang,
Leilei Mao,
Zihan Yu,
Binxin Cui,
Lin Lin,
Yangyang Hui,
Xingliang Zhao,
Xin Xu,
Xiaofei Fan,
Bangmao Wang,
Qing Yu,
Kui Jiang,
Chao Sun
Publication year - 2021
Publication title -
therapeutic advances in chronic disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.027
H-Index - 35
eISSN - 2040-6231
pISSN - 2040-6223
DOI - 10.1177/20406223211026996
Subject(s) - sarcopenia , medicine , cirrhosis , bayesian multivariate linear regression , body mass index , multivariate analysis , proportional hazards model , gastroenterology , linear regression , machine learning , computer science
Background: Previous studies have shown that sarcopenia appears to be a significant contributor to physical frailty among outpatients with cirrhosis. However, the evidence is scant regarding the relationship between sarcopenia and multi-dimensional frailty among inpatients. We aimed to investigate the potential contribution of sarcopenia to frailty in hospitalized patients with cirrhosis in a sex-dependent manner.Methods: This cohort enrolled consecutive cirrhotics. Muscle quantity and quality were assessed using the computed tomography-based skeletal muscle index (SMI) and intramuscular adipose tissue content, respectively. Frailty phenotype was clarified by a self-reported Frailty Index. Multiple linear regression determined the association between sarcopenia and frailty phenotype.Results: A total of 202 cirrhotic patients with 48.5% male were included. The median Frailty Index was 0.13, rendering 17.3% subjects as frail. Among the 16 frail men, 68.8% had sarcopenia and 62.5% exhibited myosteatosis. In contrast, among the 19 frail women, 26.3% had sarcopenia and 15.8% exhibited myosteatosis. Frail patients had a significantly lower median SMI (42.80 cm 2 /m 2 ) compared with those with pre-frailty (48.23 cm 2 /m 2 ) and with robust status (50.82 cm 2 /m 2 ) in the male but not the female group. In male patients, multivariate linear regression implicated age (β = 0.330, p < 0.001), SMI (β = −0.260, p < 0.001), albumin (β = −0.245, p = 0.005), and sodium (β = −0.179, p = 0.037) as independent risk factors for frailty.Conclusion: Sarcopenia is associated with multi-dimensional frailty in male patients with cirrhosis. It is tempting to incorporate sex-specific intervention with the purpose of mitigating frailty among inpatients.