Journal
HEPATOLOGY RESEARCH
Volume 47, Issue 13, Pages 1359-1367Publisher
WILEY
DOI: 10.1111/hepr.12873
Keywords
cirrhosis; minimal hepatic encephalopathy; sarcopenia; skeletal muscle
Categories
Funding
- Ministry of Education, Science, Sports and Culture of Japan
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AimMinimal hepatic encephalopathy (MHE) and sarcopenia impair the health-related quality of life and prognosis of patients with liver cirrhosis; however, the relationship between MHE and sarcopenia remains unclear. The aim of this study was to investigate their relationship and to identify the predictors of MHE in cirrhotic patients. MethodsThis retrospective study evaluated 120 cirrhotic patients who were tested for MHE and sarcopenia. Minimal hepatic encephalopathy was diagnosed by using the computer-aided neuropsychiatric test. Sarcopenia was diagnosed based on the assessment criteria recommended by the Japan Society of Hepatology. Muscle mass and muscle strength were measured by using bio-impedance analysis and digital grip strength dynamometer. Univariate and multivariate logistic regression analyses were carried out to identify the predictors of MHE. ResultsOf the 120 cirrhotic patients, 28 (23%) and 32 (27%) were diagnosed with MHE and sarcopenia, respectively. The prevalence of MHE was higher in patients with sarcopenia than in those without sarcopenia (P=0.01). By the univariate analysis, MHE was significantly complicated with sarcopenia (P<0.01). In the multivariate analysis, sarcopenia (odds ratio=3.31, 95% confidence interval=1.19-9.42; P=0.02) and serum branched-chain amino acids levels <327 nmol/mL (odds ratio=2.98, 95% confidence interval=1.08-8.34; P=0.03) were found to be associated with MHE. ConclusionsSarcopenia and serum branched-chain amino acids levels were predictors of MHE. The amelioration of sarcopenia and/or amino acids imbalance may improve MHE in patients with liver cirrhosis.
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