Sarcopenia and Myosteatosis in Cirrhotic Patients: A Cross-Sectional Study

Abstract

Background: Liver cirrhosis is an important cause of morbidity and mortality especially if associated with malnutrition and sarcopenia. The accumulation of intramuscular fat, known as myosteatosis, generates an early changes in muscle architecture, quality and function and has also been considered a concept of sarcopenia by some authors. Sarcopenia implies an increase in hospital admissions and worse outcomes after liver transplants. Identifying sarcopenia early helps prevent these outcomes. Myosteatosis has been increasingly studied and its clinical significance in liver cirrhosis is still unclear. Objective: To know the prevalence of sarcopenia and myosteatosis in cirrhotic patients. Methods: Observational, cross-sectional study performed in a tertiary gastroenterology hospital from October 2018 to October 2020 in outpatients with liver cirrhosis to identify the presence of sarcopenia and myosteatosis and correlate with variables capable of predicting these situations. The patients were submitted to a number of tests including muscle strength, computed tomography analysis with evaluation of skeletal muscle index (SMI) and muscle attenuation coefficient (HU) at the level of the third lumbar vertebra (L3) and a 6-minute walk test for sarcopenia evaluation. Results: A total of 62 patients were studied, half of them male. Most participants were classified as CHILD-PUGH A (70.9%) and mean SMI of 25.78 kg/m 2 . The median MELD score was 11.5 points. The average force measured with a dynamometer was 27.59 kgf and for this exam, eight patients had demonstrated reduced muscle strength. The distance covered in six minutes in the patients walk test was on average 418.34 m ± 59.21. The average SMI assessed by CT at the level