title: Impact of muscle wasting on survival in patients with liver cirrhosis.
abstract: Muscle wasting is defined as the progressive and generalized loss of muscle mass. Muscle depletion is a common feature of chronic liver disease found in approximately 40% of patients with cirrhosis. Its etiology is multifactorial subsequent to liver failure and its prevalence increases along with disease severity. Cross-sectional analytic morphometry using computed tomography (CT) scan or magnetic resonance imaging are considered by consensus the gold standards to assess muscle size in cirrhosis for research purposes because they are not biased by fluid accumulation. Several studies have assessed the impact of muscle wasting on overall survival of patients in the waiting list for liver transplantation and there is a general agreement that decreased muscle size assessed by CT scan is an independent predictor for mortality in cirrhosis. It has been proposed that the addition of cross-sectional muscle area into the Model for End-stage Liver Disease can increase its prognostic performance. Nevertheless, the use of CT scan in assessing muscle size is inappropriate for routine clinical practice and an alternative cost-effective, easy to use and accurate tool should be developed. In conclusion, muscle wasting has a detrimental impact on survival of patients with cirrhosis and, thus, it remains to be elucidated if nutritional interventions and exercise could improve muscle wasting and, subsequently, survival in this setting.
authors.affiliation: Maria Kalafateli, Christos Konstantakis, Konstantinos Thomopoulos, Christos Triantos, Department of Gastroenterology, University Hospital of Patras, 26504 Patras, Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Kalafateli
authors.affiliation: Maria Kalafateli, Christos Konstantakis, Konstantinos Thomopoulos, Christos Triantos, Department of Gastroenterology, University Hospital of Patras, 26504 Patras, Greece.
authors.forename: Christos
authors.initials: C
authors.lastname: Konstantakis
authors.affiliation: Maria Kalafateli, Christos Konstantakis, Konstantinos Thomopoulos, Christos Triantos, Department of Gastroenterology, University Hospital of Patras, 26504 Patras, Greece.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Thomopoulos
authors.affiliation: Maria Kalafateli, Christos Konstantakis, Konstantinos Thomopoulos, Christos Triantos, Department of Gastroenterology, University Hospital of Patras, 26504 Patras, Greece.
authors.forename: Christos
authors.initials: C
authors.lastname: Triantos
mesh_terms: D003952:Diagnostic Imaging / Q000379:methods; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications / Q000175:diagnosis / Q000401:mortality* / Q000601:surgery; D016031:Liver Transplantation; D018482:Muscle, Skeletal / Q000473:pathology*; D009752:Nutritional Status; D011237:Predictive Value of Tests; D011379:Prognosis; D012307:Risk Factors; D055948:Sarcopenia / Q000175:diagnosis / Q000209:etiology / Q000401:mortality*; D014850:Waiting Lists / Q000401:mortality
keywords: Cirrhosis; Malnutrition; Muscle wasting; Sarcopenia; Survival