title: Sarcopenia in Patients with Chronic Liver Disease: Can It Be Altered by Diet and Exercise?
abstract: Sarcopenia, a loss of muscle mass, is being increasingly recognized to have a deleterious effect on outcomes in patients with chronic liver disease. Factors related to diet and the inflammatory nature of chronic liver disease contribute to the occurrence of sarcopenia in these patients. Sarcopenia adversely influences quality of life, performance, morbidity, success of transplantation, and even mortality. Specific deficiencies in macronutrients (protein, polyunsaturated fatty acids) and micronutrients (vitamins C, D, and E, carotenoids, and selenium) have been linked to sarcopenia. Lessons learned from nutritional therapy in geriatric patient populations may provide strategies to manage sarcopenia in patients with liver disease. Combining diet modification and nutrient supplementation with an organized program of exercise may help ameliorate or even reverse the effects of sarcopenia on an already complex disease process.
authors.affiliation: Department of Medicine, Duke University Medical Center, DUMS 03142, Orange Zone, Durham, NC, 27710, USA. matthew.kappus@duke.edu.
authors.forename: Matthew R
authors.initials: MR
authors.lastname: Kappus
authors.affiliation: Department of Medicine, Ochsner Clinic, New Orleans, LA, USA.
authors.forename: Mardeli Saire
authors.initials: MS
authors.lastname: Mendoza
authors.affiliation: Department of Medicine, College of Medicine, University of California-Irvine, Irvine, CA, USA.
authors.forename: Douglas
authors.initials: D
authors.lastname: Nguyen
authors.affiliation: Department of Medicine, University of California-Davis, Davis, CA, USA.
authors.forename: Valentina
authors.initials: V
authors.lastname: Medici
authors.affiliation: Department of Medicine, School of Medicine, University of Louisville, Louisville, KY, USA.
authors.forename: Stephen A
authors.initials: SA
authors.lastname: McClave
mesh_terms: D000975:Antioxidants / Q000627:therapeutic use; D002908:Chronic Disease; D003131:Combined Modality Therapy; D019587:Dietary Supplements; D015444:Exercise; D005231:Fatty Acids, Unsaturated / Q000627:therapeutic use; D006801:Humans; D008107:Liver Diseases / Q000150:complications*; D055948:Sarcopenia / Q000178:diet therapy / Q000209:etiology* / Q000628:therapy*; D014807:Vitamin D / Q000627:therapeutic use
chemical_list: D000975:Antioxidants; D005231:Fatty Acids, Unsaturated; D014807:Vitamin D
keywords: Cirrhosis; Liver disease; Malnutrition; Muscle wasting; Portal hypertension; Protein malnutrition; Sarcopenia