SARC-F combined with a simple tool for assessment of muscle abnormalities in outpatients with chronic liver disease.

Abstract

AimAn easily performed method for examination of muscle abnormalities is anticipated. We aimed to elucidate the clinical usefulness of simple assessments for muscle abnormality including a simple five‐item questionnaire (SARC‐F) in chronic liver disease patients.MethodsFrom February to July 2019, 383 outpatients (median age 71 years, 259 men; chronic hepatitis (CH) : liver cirrhosis Child–Pugh A : liver cirrhosis Child–Pugh B : liver cirrhosis Child–Pugh C = 157:176:39:11) who underwent a computed tomography examination were enrolled. SARC‐F, previously reported cut‐off values for muscle strength decline (MSD; handgrip), pre‐muscle volume loss (pre‐MVL), calf circumference and finger‐circle test results were used, and these results were analyzed retrospectively.ResultsA high SARC‐F score (≥4) was observed in 25 patients, and a low score (<4) in 358 patients. The frequency of high SARC‐F increased significantly with progression of chronic liver disease (chronic hepatitis : liver cirrhosis Child–Pugh A : liver cirrhosis Child–Pugh B/C = 2.5%:8.0%:14.0%, P=0.010). MSD frequency was 22.4% in men and 41.1% in women. Muscle volume loss and pre‐MVL were noted in 22% and 30.5%, respectively, of the male patients, and 9.7% and 32.3%, respectively, of the female patients. In cases with high SARC‐F and MSD, calf circumference and finger‐circle abnormalities were found in 56% and 40.0% of patients, respectively, whereas those values for patients with low SARC‐F and MSD were 14.5% and 10.6%, respectively (P < 0.001, for each; positive/negative predictive values: 0.560/0.855 and 0.400/0.894, respectively). Each SARC‐F item showed a good area under the curve for MSD, but not pre‐MVL.ConclusionSARC‐F score in combination with MSD and calf circumference or finger‐circle test results may be an easy and simple method for surveillance of chronic liver disease patients with a high risk of sarcopenia and decline of quality of life.