Sarcopenia and frailty in decompensated cirrhosis.
Body composition
Computed tomography
End-stage liver disease
Liver transplant
Muscle function
Muscle mass
Survival
Journal
Journal of hepatology
ISSN: 1600-0641
Titre abrégé: J Hepatol
Pays: Netherlands
ID NLM: 8503886
Informations de publication
Date de publication:
07 2021
07 2021
Historique:
received:
14
10
2020
revised:
13
01
2021
accepted:
13
01
2021
entrez:
27
5
2021
pubmed:
28
5
2021
medline:
8
2
2022
Statut:
ppublish
Résumé
In patients with decompensated cirrhosis, sarcopenia and frailty are prevalent. Although several definitions exist for these terms, in the field of hepatology, sarcopenia has commonly been defined as loss of muscle mass, and frailty has been broadly defined as the phenotypic manifestation of the loss of muscle function. Prompt recognition and accurate assessment of these conditions are critical as they are both strongly associated with morbidity, mortality, poor quality of life and worse post-liver transplant outcomes in patients with cirrhosis. In this review, we describe the complex pathophysiology that underlies the clinical phenotypes of sarcopenia and frailty, their association with decompensation, and provide an overview of tools to assess these conditions in patients with cirrhosis. When available, we highlight data focusing on patients with acutely decompensated cirrhosis, such as inpatients, as this is an area of unmet clinical need. Finally, we discuss management strategies to reverse and/or prevent the development of sarcopenia and frailty, which include adequate nutritional intake of calories and protein, as well as regular exercise of at least moderate intensity, with a mix of aerobic and resistance training. Key knowledge gaps in our understanding of sarcopenia and frailty in decompensated cirrhosis remain, including best methods to measure muscle mass and function in the inpatient setting, racial/ethnic variation in the development and presentation of sarcopenia and frailty, and optimal clinical metrics to assess response to therapeutic interventions that translate into a reduction in adverse outcomes associated with these conditions.
Identifiants
pubmed: 34039486
pii: S0168-8278(21)00037-4
doi: 10.1016/j.jhep.2021.01.025
pmc: PMC9125684
mid: NIHMS1804397
pii:
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
S147-S162Subventions
Organisme : NHLBI NIH HHS
ID : R56 HL141744
Pays : United States
Organisme : NIDDK NIH HHS
ID : U01 DK062470
Pays : United States
Organisme : NIDDK NIH HHS
ID : U01 DK061732
Pays : United States
Organisme : NIAAA NIH HHS
ID : R01 AA028190
Pays : United States
Organisme : NIAAA NIH HHS
ID : U01 AA026976
Pays : United States
Organisme : NIAAA NIH HHS
ID : P50 AA024333
Pays : United States
Organisme : AHRQ HHS
ID : R01 HS026937
Pays : United States
Organisme : NIGMS NIH HHS
ID : R01 GM119174
Pays : United States
Organisme : NIAMS NIH HHS
ID : R21 AR071046
Pays : United States
Organisme : NIDDK NIH HHS
ID : R01 DK083414
Pays : United States
Organisme : NIAAA NIH HHS
ID : U01 AA021890
Pays : United States
Organisme : NIDDK NIH HHS
ID : R01 DK113196
Pays : United States
Organisme : NIA NIH HHS
ID : R01 AG059183
Pays : United States
Informations de copyright
Copyright © 2021 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.
Déclaration de conflit d'intérêts
Conflict of interest The authors declare no conflicts of interest that pertain to this work. Please refer to the accompanying ICMJE disclosure forms for further details.
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