title: Sarcopenia and two types of presarcopenia in Japanese patients with chronic liver disease.
abstract: OBJECTIVE
  The frequency of sarcopenia, defined as loss of both muscle volume and strength, was analyzed in chronic liver disease (CLD).
  
  
  METHODS
  From April to September 2015, 807 Japanese CLD patients treated as outpatients were enrolled (67.1±10.0 years, men : women=466 : 341, hepatitis C virus : hepatitis B virus : hepatitis B and C virus : alcohol : other=511 : 134 : 3 : 45 : 114). Sarcopenia was diagnosed when the patient showed muscle volume loss and reduced handgrip strength, whereas those with only muscle volume loss were classified as 'v-presarcopenia' and those with only reduced handgrip strength were classified as 's-presarcopenia'. Muscle volume loss was determined using computed tomography findings and a previously reported index (psoas index), and cut-off values for reduced handgrip strength presented by the Asia Working Group for Sarcopenia (AWGS) (AWGS/grip criteria) and European Working Group on Sarcopenia in Older People (EWGSOP) (EWGSOP/grip criteria) (men; 26 and 30 kg, women; 18 and 20 kg, respectively) were used. Clinical features were analyzed for diagnoses of chronic hepatitis (CH, n=381), liver cirrhosis Child-Pugh A (n=330), and liver cirrhosis Child-Pugh B/C (n=96).
  
  
  RESULTS
  When the AWGS/grip criteria were used, the frequencies of sarcopenia, v-presarcopenia, and s-presarcopenia in CH were 3.9, 7.9, and 19.4%, whereas those in Child-Pugh A were 4.8, 17.6, and 21.8% and those in Child-Pugh B/C were 16.7, 11.5, and 39.6%, respectively. When the EWGSOP/grip criteria were used, these frequencies were 7.1, 4.7, and 33.1%, in CH, 11.8, 10.6, and 32.7%, in Child-Pugh A, and 21.9, 6.3, and 49.0%, in Child-Pugh B/C, respectively. The incidence rates of sarcopenia and both types of presarcopenia increased with progression of CLD.
  
  
  CONCLUSIONS
  Evaluation of handgrip strength and psoas index is an easy and effective method for the detection of sarcopenia and presarcopenia.
authors.affiliation: aGastroenterology Center, Ehime Prefectural Central Hospital, Matsuyama bDepartment of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon, Ehime, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Hiraoka
authors.forename: Kojiro
authors.initials: K
authors.lastname: Michitaka
authors.forename: Hidetaro
authors.initials: H
authors.lastname: Ueki
authors.forename: Miho
authors.initials: M
authors.lastname: Kaneto
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Aibiki
authors.forename: Tomonari
authors.initials: T
authors.lastname: Okudaira
authors.forename: Takamasa
authors.initials: T
authors.lastname: Kawakami
authors.forename: Hiroka
authors.initials: H
authors.lastname: Yamago
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Suga
authors.forename: Hideomi
authors.initials: H
authors.lastname: Tomida
authors.forename: Yuji
authors.initials: Y
authors.lastname: Miyamoto
authors.forename: Nobuaki
authors.initials: N
authors.lastname: Azemoto
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Mori
authors.forename: Hideki
authors.initials: H
authors.lastname: Miyata
authors.forename: Eiji
authors.initials: E
authors.lastname: Tsubouchi
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Ninomiya
authors.forename: Masashi
authors.initials: M
authors.lastname: Hirooka
authors.forename: Masanori
authors.initials: M
authors.lastname: Abe
authors.forename: Bunzo
authors.initials: B
authors.lastname: Matsuura
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Hiasa
mesh_terms: D000368:Aged; D018450:Disease Progression; D005260:Female; D018737:Hand Strength; D019694:Hepatitis B, Chronic / Q000175:diagnosis / Q000453:epidemiology*; D019698:Hepatitis C, Chronic / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008103:Liver Cirrhosis / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology; D008104:Liver Cirrhosis, Alcoholic / Q000175:diagnosis / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000000981:diagnostic imaging / Q000503:physiopathology; D011237:Predictive Value of Tests; D055948:Sarcopenia / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D013997:Time Factors; D014057:Tomography, X-Ray Computed