Z Gastroenterol 2020; 58(05): e101
DOI: 10.1055/s-0040-1712318
Hepatologie

Sarcopenia and liver cirrhosis- Comparison of the European Working group on Sarcopenia criteria 2010 and 2019

J Traub
1   University Hospital Graz, Graz, Austria
,
M Eibisberger
2   Medical University of Graz, Department of Neuroradiology, Vascular and Interventional Radiology, Graz, Austria
,
I Bergheim
3   RF Molecular Nutritional Science, University Vienna, Department of Nutritional Sciences, Vienna, Austria
,
V Stadlbauer
4   Medical University of Graz, Department of Internal Medicine Division of Gastroenterology und Hepatology,Graz, Austria
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Background and Aims Sarcopenia occurs in 30-70 % of cirrhotic patients. However, criteria for the diagnosis of sarcopenia are not universally accepted and several different definitions coexist. In 2010, the European Working Group on Sarcopenia in Older People provided consensus definition criteria for the diagnosis of sarcopenia using muscle mass, strength and performance. In 2019, a revised definition was published. It is yet unclear how these modified criteria influence the rate of diagnosis in high risk populations, such as liver cirrhosis.

Method We therefore assessed if the new diagnostic criteria for sarcopenia impact on sarcopenia prevalence in liver cirrhosis. Within 2 years 114 cirrhotic patients were prospectively enrolled in the study. Sarcopenia was determined by muscle strength (handgrip strength), muscle mass (lumbal muscle index) and muscle performance (gait speed). We assessed the absence of sarcopenia or the presence of pre-sarcopenia or sarcopenia using both 2010 and 2019 definitions.

Results Based on the 2010 definition, 38/114 (33.3 %) patients had no sarcopenia, 35/114 (30.7 %) suffered from pre-sarcopenia and 41/114 (36 %) from sarcopenia. With the 2019 definition, significantly more patients 91/114 (79.8 %) were diagnosed as non-sarcopenic, whereas only 4/114 (3.5 %) were diagnosed as pre-sarcopenia and 19/114 (16.7 %) as sarcopenic (p  <  0.0001). Indeed, when applying the 2010 definition, significantly more men were diagnosed as pre-sarcopenic (80 % of 35, p = 0.042) and sarcopenic (87.8 % of 41, p = 0.003) compared to the non-sarcopenic group. Using the 2019 definition, the rate of pre-sarcopenia was significantly lower (30.7 % vs. 3.5 %) due to the different starting points (2010 muscle mass, 2019 muscle strength) and cut-off values (muscle strength).

Conclusion The change of the starting point of diagnostic criteria for sarcopenia drastically influences the rate of pre-sarcopenia and sarcopenia in cirrhotics. To evaluate, which diagnostic criteria should be chosen to diagnose sarcopenia in liver cirrhosis patients, prospective studies are needed.



Publication History

Article published online:
26 May 2020

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