Editorial| Volume 51, ISSUE 11, P1500-1501, November 2019

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Muscle abnormalities in cirrhosis: Calling for more strength in evaluation and prevention

  • Chiara Becchetti
    Hepatology, University Clinic for Visceral Surgery and Medicine, Inselspital, Bern, Switzerland

    Multivisceral Transplant Unit, Department of Surgery, Oncology and Gastroenterology, University of Padua, Italy
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  • Jaume Bosch
    Corresponding author at: Inselspital, Bern University, Bern, Switzerland.
    Hepatology, University Clinic for Visceral Surgery and Medicine, Inselspital, Bern, Switzerland

    Hospital Clinic-IDIBAPS and CIBERehd, University of Barcelona, Spain
    Search for articles by this author
Published:September 18, 2019DOI:
      During the last five years, particular attention has been given to skeletal muscle abnormalities in patients with cirrhosis, since these carry independent prognostic value on clinical outcome. Skeletal muscle abnormalities include sarcopenia, which is defined as a progressive and generalized loss of skeletal muscle mass, strength and function, and myosteatosis, which means excessive and pathological fat accumulation in muscles.
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        • Wilson D.
        • Jackson T.
        • Sapey E.
        • Lord J.M.
        Frailty and sarcopenia: the potential role of an aged immune system.
        Ageing Res Rev. 2017; 36: 1-10
        • Kim H.Y.
        • Jang J.W.
        Sarcopenia in the prognosis of cirrhosis: going beyond the MELD score.
        World J Gastroenterol. 2015; 21: 7637-7647
        • De Fre C.H.
        • De Fre M.A.
        • Kwanten W.J.
        • Op de Beeck B.J.
        • Van Gaal L.F.
        • Francque S.M.
        Sarcopenia in patients with non-alcoholic fatty liver disease: is it a clinically significant entity?.
        Obes Rev. 2019; 20: 353-363
        • Berzigotti A.
        • Albillos A.
        • Villanueva C.
        • Genesca J.
        • Ardevol A.
        • Augustin S.
        • et al.
        Effects of an intensive lifestyle intervention program on portal hypertension in patients with cirrhosis and obesity: the SportDiet study.
        Hepatology. 2017; 65: 1293-1305
        • Stirnimann G.
        • Ebadi M.
        • Tandon P.
        • Montano-Loza A.J.
        Should sarcopenia increase priority for transplant or is it a contraindication?.
        Curr Gastroenterol Rep. 2018; 20: 50
        • Tsien C.
        • Shah S.N.
        • McCullough A.J.
        • Dasarathy S.
        Reversal of sarcopenia predicts survival after a transjugular intrahepatic portosystemic stent.
        Eur J Gastroenterol Hepatol. 2013; 25: 85-93
        • Praktiknjo M.
        • Clees C.
        • Pigliacelli A.
        • Fischer S.
        • Jansen C.
        • Lehmann J.
        • et al.
        Sarcopenia is associated with development of acute-on-chronic liver failure in decompensated liver cirrhosis receiving transjugular intrahepatic portosystemic shunt.
        Clin Transl Gastroenterol. 2019; 10e00025
        • Lucidi C.
        • Ginanni Corradini S.
        • Abraldes J.G.
        • Merli M.
        • Tandon P.
        • Ferri F.
        • et al.
        Hepatic encephalopathy expands the predictivity of model for end-stage liver disease in liver transplant setting: evidence by means of 2 independent cohorts.
        Liver Transplant. 2016; 22: 1333-1342
        • European Association for the Study of the Liver
        Electronic address eee, European Association for the Study of the L. EASL clinical practice guidelines for the management of patients with decompensated cirrhosis.
        J Hepatol. 2018; 69: 406-460
        • Montano-Loza A.J.
        • Duarte-Rojo A.
        • Meza-Junco J.
        • Baracos V.E.
        • Sawyer M.B.
        • Pang J.X.
        • et al.
        Inclusion of sarcopenia within MELD (MELD-sarcopenia) and the prediction of mortality in patients with cirrhosis.
        Clin Transl Gastroenterol. 2015; 6: e102
        • van Vugt J.L.A.
        • Alferink L.J.M.
        • Buettner S.
        • Gaspersz M.P.
        • Bot D.
        • Darwish Murad S.
        • et al.
        A model including sarcopenia surpasses the MELD score in predicting waiting list mortality in cirrhotic liver transplant candidates: a competing risk analysis in a national cohort.
        J Hepatol. 2018; 68: 707-714
        • Carey E.J.
        • Lai J.C.
        • Wang C.W.
        • Dasarathy S.
        • Lobach I.
        • Montano-Loza A.J.
        • et al.
        A multicenter study to define sarcopenia in patients with end-stage liver disease.
        Liver Transplant. 2017; 23: 625-633
        • Lai J.C.
        • Covinsky K.E.
        • Dodge J.L.
        • Boscardin W.J.
        • Segev D.L.
        • Roberts J.P.
        • et al.
        Development of a novel frailty index to predict mortality in patients with end-stage liver disease.
        Hepatology. 2017; 66: 564-574