Abstract
Sarcopenia is an independent predictor of mortality in patients with liver cirrhosis. However, evidence has emerged that skeletal muscles mediate their protective effect against sarcopenia by secreting myokines. Therefore, we investigated whether irisin was associated with sarcopenia in patients with liver cirrhosis. This was an observational cross-sectional study of data collected from 187 cirrhotic patients. Sarcopenia was defined by computed tomography (CT) scans using specific cutoffs of the 3rd lumbar vertebra skeletal muscle index (L3 SMI). Morning irisin levels were obtained in all patients. Of the 187 patients, sarcopenia was noted in 73 (39%). Irisin concentrations were lower in sarcopenic patients (32.40 pg/ml [interquartile range (IQR): 18.70, 121.26], p < 0.001) than in nonsarcopenic patients. There was a weak correlation between L3 SMI and irisin levels (r = 0.516, p < 0.001). Multivariable regression analysis including L3 SMI, body mass index (BMI), very-low-density lipoprotein (VLDL)-cholesterol, aspartate aminotransferase (AST), adiponectin, and irisin levels showed that L3 SMI (odds ratio [OR] = 0.915, p = 0.023), adiponectin levels (OR = 1.074, p = 0.014), irisin levels (OR = 0.993, p < 0.001) and BMI (OR = 0.456, p = 0.004) were independently associated with sarcopenia. Irisin levels are associated with sarcopenia in patients with liver cirrhosis. This paper addresses a gap in the literature and facilitates the future transition into clinical treatment.
Highlights
Sarcopenia is an independent predictor of mortality in patients with liver cirrhosis
Based on the current guidelines, skeletal muscle index (SMI) is defined as skeletal muscle area (SMA)/height squared ( m2), where SMA is measured using computed tomography (CT), and sarcopenia in patients with liver cirrhosis is less than 52.4 cm2/m2 for men and less than 38.5 cm2/ m2 for w omen[3]
We found that body mass index (BMI) was significantly decreased in the sarcopenia group (p < 0.001), as were triglycerides (p < 0.05)
Summary
Based on the current guidelines, SMI is defined as skeletal muscle area (SMA)/height squared ( m2), where SMA is measured using computed tomography (CT), and sarcopenia in patients with liver cirrhosis is less than 52.4 cm2/m2 for men and less than 38.5 cm2/ m2 for w omen[3]. Routine biochemical parameters, including albumin, creatinine, prothrombin time, INR, alanine aminotransferase (ALT), AST, total bilirubin, platelet count, total cholesterol, triglycerides, VLDL, and glucose, were measured for all patients according to standard methods in a routine clinical laboratory. Variables Age (years) Gender, male:female HBV/HCV/PBC/others Child–Pugh classification BMI (kg/m2) L3 SMI (cm2/m2) Prothrombin time, INR Serum albumin (g/l) Total bilirubin (g/dl) ALT (IU/L) AST (IU/L) Platelet count (× 109/mm3) Total cholesterol (mg/dl) Triglycerides (mg/dl) VLDL-cholesterol (mg/dl) Glucose (mg/dl) Insulin (IU/ml) HOMA-IR IL-6 (pg/ml) TNF-α (pg/ml) Adiponectin (μg/ml) Irisin (pg/ml). Statistical analyses were performed using SPSS 18 (SPSS, Inc., Chicago, IL)
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