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Loss of skeletal muscle mass affects the incidence of minimal hepatic encephalopathy: a case control study
Masakuni Tateyama1, Hideaki Naoe1, Motohiko Tanaka2
1Department of Gastroenterology and Hepatology, Graduate School of Medical Sciences, Kumamoto University, Honjo 1-1-1, Chuo-ku, Kumamoto, 860-8556, Japan.
Background:
Sarcopenia is a syndrome characterized by progressive and systemic decreases in skeletal muscle mass and muscle strength. The influence or prognosis of various liver diseases in this condition have been widely investigated, but little is known about whether sarcopenia and/or muscle mass loss are related to minimal hepatic encephalopathy (MHE).
Methods:
To clarify the relationship between MHE and sarcopenia and/or muscle mass loss in patients with liver cirrhosis.
Methods:
Ninety-nine patients with liver cirrhosis were enrolled. MHE was diagnosed by a neuropsychiatric test. Skeletal mass index (SMI) and Psoas muscle index (PMI) were calculated by dividing skeletal muscle area and psoas muscle area at the third lumbar vertebra by the square of height in meters, respectively, to evaluate muscle volume.
Results:
This study enrolled 99 patients (61 males, 38 females). MHE was detected in 48 cases (48.5%) and sarcopenia in 6 cases (6.1%). Patients were divided into two groups, with or without MHE. Comparing groups, no significant differences were seen in serum ammonia concentration or rate of sarcopenia. SMI was smaller in patients with MHE (46.4 cm2/m2) than in those without (51.2 cm2/m2, P = 0.027). Similarly, PMI was smaller in patients with MHE (4.24 cm2/m2) than in those without (5.53 cm2/m2, P = 0.003). Skeletal muscle volume, which is represented by SMI or PMI was a predictive factor related to MHE (SMI ≥ 50 cm2/m2; odds ratio 0.300, P = 0.002, PMI ≥ 4.3 cm2/m2; odds ratio 0.192, P = 0.001).
Conclusions:
Muscle mass loss was related to minimal hepatic encephalopathy, although sarcopenia was not. Measurement of muscle mass loss might be useful to predict MHE.
Insights
Muscle mass loss, not sarcopenia, is linked to minimal hepatic encephalopathy (MHE) in liver cirrhosis patients. Measuring muscle mass may help predict MHE development.
Area of Science:
- Hepatology
- Neurology
- Geriatrics
Background:
- Sarcopenia, a decline in muscle mass and strength, is common.
- The relationship between sarcopenia and minimal hepatic encephalopathy (MHE) in liver cirrhosis is unclear.
- Liver disease impacts muscle health, but MHE's specific association with muscle loss needs investigation.
Purpose of the Study:
- To investigate the association between minimal hepatic encephalopathy (MHE) and sarcopenia or muscle mass loss in liver cirrhosis patients.
- To determine if muscle volume is a predictor of MHE in this population.
Main Methods:
- Ninety-nine liver cirrhosis patients were assessed for MHE using neuropsychiatric tests.
- Muscle volume was quantified using skeletal mass index (SMI) and psoas muscle index (PMI).
- Patients were categorized into groups with and without MHE for comparative analysis.
Main Results:
- Minimal hepatic encephalopathy (MHE) was present in 48.5% of patients; sarcopenia in 6.1%.
- Patients with MHE showed significantly lower SMI (46.4 cm²/m²) and PMI (4.24 cm²/m²) compared to those without MHE.
- Reduced skeletal muscle volume (SMI < 50 cm²/m² or PMI < 4.3 cm²/m²) was a significant predictor of MHE.
Conclusions:
- Muscle mass loss, indicated by lower SMI and PMI, is associated with minimal hepatic encephalopathy (MHE) in liver cirrhosis.
- Sarcopenia itself was not directly linked to MHE in this study.
- Quantifying muscle mass loss may serve as a valuable tool for predicting MHE in liver cirrhosis patients.
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