title: The Role of Sarcopenia and Frailty in Hepatic Encephalopathy Management.
abstract: Normal regulation of total body and circulating ammonia requires a delicate interplay in ammonia formation and breakdown between several organ systems. In the setting of cirrhosis and portal hypertension, the decreased hepatic clearance of ammonia leads to significant dependence on skeletal muscle for ammonia detoxification; however, cirrhosis is also associated with muscle depletion and decreased functional muscle mass. Thus, patients with diminished muscle mass and sarcopenia may have a decreased ability to compensate for hepatic insufficiency and a higher likelihood of developing physiologically significant hyperammonemia and hepatic encephalopathy.
authors.affiliation: Division of Digestive and Liver Diseases, Department of Medicine, Center for Liver Disease and Transplantation, Columbia University College of Physicians and Surgeons, 622 West 168th Street, PH 14-105, New York, NY 10032, USA.
authors.forename: Catherine
authors.initials: C
authors.lastname: Lucero
authors.affiliation: Division of Digestive and Liver Diseases, Department of Medicine, Center for Liver Disease and Transplantation, Columbia University College of Physicians and Surgeons, 622 West 168th Street, PH 14-105, New York, NY 10032, USA. Electronic address: ev77@columbia.edu.
authors.forename: Elizabeth C
authors.initials: EC
authors.lastname: Verna
mesh_terms: D000641:Ammonia / Q000378:metabolism; D006501:Hepatic Encephalopathy / Q000209:etiology* / Q000378:metabolism / Q000628:therapy; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications* / Q000401:mortality / Q000601:surgery; D016031:Liver Transplantation; D055948:Sarcopenia / Q000209:etiology* / Q000378:metabolism / Q000628:therapy*
chemical_list: D000641:Ammonia
keywords: Frailty; Hepatic encephalopathy; Sarcopenia