Abstract
Skeletal muscle is the largest organ in the body, and skeletal muscle atrophy results from a shift in the balance of protein synthesis and degradation toward protein breakdown. Primary sarcopenia is defined as a loss of skeletal muscle mass and strength or physical function due to aging, and secondary sarcopenia is defined as a loss of skeletal muscle mass and strength or physical function due to underlying diseases. Liver cirrhosis (LC) is one of the representative diseases which can be complicated with secondary sarcopenia. Muscle mass loss becomes more pronounced with worsening liver reserve in LC patients. While frailty encompasses a state of increased vulnerability to environmental factors, there is also the reversibility of returning to a healthy state with appropriate intervention. Several assessment criteria for sarcopenia and frailty were proposed in recent years. In 2016, the Japan Society of Hepatology created assessment criteria for sarcopenia in liver disease. In Japan, health checkups for frailty in the elderly aged 75 years or more started in April 2020. Both sarcopenia and frailty can be adverse predictors for cirrhotic patients. In this review article, we will summarize the current knowledge of sarcopenia and frailty in LC patients.
Highlights
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Primary sarcopenia is defined as a loss of skeletal muscle mass and strength or physical function due to aging, and secondary sarcopenia is defined as a loss of skeletal muscle mass and strength or physical function due to underlying diseases [7]
These results suggest that muscle strength is more closely related to physical function than muscle mass, and that there is no difference in mental function
Summary
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. It was recognized that sarcopenia is a poor prognostic factor in liver disease, but the definition of sarcopenia itself and the reference values for muscle mass and other parameters used for the assessment of sarcopenia varied even among reports in Japan, causing some confusion in a sense. (1) elimination of age limit (because secondary sarcopenia may occur due to the pathology of liver disease unrelated to age), (2) elimination of walking speed (WS) because of the complexity of the measurement of WS in daily clinical practice and (3) specification of reference values for muscle mass on computed tomography (CT) because CT is frequently used in CLD patients [30]. It includes the determination of sarcopenia in the flow chart for nutritional therapy, and provides a nutritional guidance policy for LC patients with or without (1) a serum albumin level of 3.5 g/dL or less, (2) a Child-Pugh classification of B or C or (3) sarcopenia
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