Development of a Risk-Estimation Model for Identifying Patients at Risk of Early Skeletal Muscle Mass Loss in Chronic...

Area of Science:

• Hepatology and Gastroenterology
• Geriatrics and Gerontology
• Clinical Nutrition and Metabolism

Background:

• Sarcopenia is linked to adverse outcomes in chronic liver disease (CLD).
• Current screening methods based on muscle strength may miss early skeletal muscle loss.
• Early detection of muscle loss is crucial for timely intervention in CLD patients.

Purpose of the Study:

• To develop a risk-estimation model for early skeletal muscle mass loss in CLD patients.
• To identify patients at risk before they meet diagnostic criteria for overt sarcopenia.
• To improve screening accuracy beyond simple muscle strength assessments.

Main Methods:

• Retrospective analysis of 1276 CLD patients with handgrip strength and skeletal muscle index (SMI) data.
• Development of the MYO-SCAN score using multivariable logistic regression.
• Inclusion of grip ratio, age, sex, albumin-bilirubin score, creatinine, BMI, and HCC status in the model.

Main Results:

• The MYO-SCAN score demonstrated strong discrimination for early muscle loss (AUC 0.847).
• Optimal cutoff of 0.435 achieved 77.7% sensitivity and 76.4% specificity.
• MYO-SCAN significantly outperformed grip ratio alone (AUC 0.847 vs. 0.614, p < 0.001).

Conclusions:

• The MYO-SCAN score facilitates early identification of skeletal muscle mass loss in CLD patients.
• This model can identify individuals potentially missed by grip-strength-based screening.
• MYO-SCAN offers a valuable tool for proactive management of sarcopenia in liver disease.