A prospective analysis of factors associated with decreased physical activity in patients with cirrhosis undergoing transplant evaluation.
BACKGROUND
Physical activity (PA) has been associated with improved recovery time after transplantation. Handgrip strength has been related to post-transplant outcomes.


OBJECTIVE
To evaluate predictors of PA and grip strength in patients with cirrhosis undergoing liver transplant evaluation.


METHODS
Single-center, prospective analysis.


RESULTS
One hundred patients were evaluated (54% male, mean age 53 ± 9). Common etiologies of liver disease were non-alcoholic steatohepatitis (27%), hepatitis C (22%) and alcoholic liver disease (21%). Mean model of end-stage liver disease (MELD) score was 13.5. Forty-one percent had a history of smoking. Ninety-three patients completed the International Physical Activity Questionnaire (IPAQ). The median total PA score was 33 metabolic equivalent (MET)-min/wk. The mean total grip strength was 62.1 ± 22 lb. Total grip strength was found to be an independent predictor of low-moderate PA (OR 4.7, 95% CI 1.4-16.2, p = 0.038), and smoking was the only significant factor associated with reduced grip strength (OR 3.4, 95% CI 1.4-8, p = 0.005).


CONCLUSIONS
Patients with end-stage liver disease undergoing liver transplant evaluation have reduced total PA by IPAQ. Total grip strength was found to be a significant predictor of low-moderate PA in patients with cirrhosis. Smoking is a risk factor for reduced grip strength, an important indicator of muscle wasting in cirrhotics.
Department of Internal Medicine, Gastroenterology and Hepatology, University of Kentucky, College of Medicine, Lexington, KY, USA.
Anna Christina
AC
Dela Cruz
Department of Surgery - Transplant Division, University of Kentucky, College of Medicine, Lexington, KY, USA.
Valery
V
Vilchez
Department of Surgery - Transplant Division, University of Kentucky, College of Medicine, Lexington, KY, USA.
Sooyeon
S
Kim
Center for Muscle Biology, University of Kentucky, College of Medicine, Lexington, KY, USA.
Benjamin
B
Barnes
Department of Surgery - Transplant Division, University of Kentucky, College of Medicine, Lexington, KY, USA.
Abhishek
A
Ravinuthala
Department of Surgery - Transplant Division, University of Kentucky, College of Medicine, Lexington, KY, USA.
Anthony
A
Zanni
Department of Radiology, University of Kentucky, College of Medicine, Lexington, KY, USA.
Roberto
R
Galuppo
Department of Internal Medicine, Gastroenterology and Hepatology, University of Kentucky, College of Medicine, Lexington, KY, USA.
Achuthan
A
Sourianarayanane
Department of Internal Medicine, Gastroenterology and Hepatology, University of Kentucky, College of Medicine, Lexington, KY, USA.
Trushar
T
Patel
Department of Surgery - Transplant Division, University of Kentucky, College of Medicine, Lexington, KY, USA.
Erin
E
Maynard
Department of Surgery - Transplant Division, University of Kentucky, College of Medicine, Lexington, KY, USA.
Malay B
MB
Shah
Department of Surgery - Transplant Division, University of Kentucky, College of Medicine, Lexington, KY, USA.
Michael F
MF
Daily
Center for Muscle Biology, University of Kentucky, College of Medicine, Lexington, KY, USA.|Department of Rehabilitation Sciences, University of Kentucky, College of Health Sciences, Lexington, KY, USA.
Timothy
T
Uhl
Center for Muscle Biology, University of Kentucky, College of Medicine, Lexington, KY, USA.
Karyn
K
Esser
Department of Surgery - Transplant Division, University of Kentucky, College of Medicine, Lexington, KY, USA.
Roberto
R
Gedaly
D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D058625:End Stage Liver Disease / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D018737:Hand Strength; D006801:Humans; D008103:Liver Cirrhosis / Q000601:surgery*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index
cirrhosis; grip strength; liver transplantation; physical activity