Abstract
Sarcopenia is an important prognostic factor in patients with gastrointestinal and chronic liver diseases. Computed tomography and bioelectrical impedance analysis are the gold standards for measuring skeletal muscle mass for the diagnosis of decreased muscle mass, but there are some institutions where BIA and CT cannot be carried out. We evaluated the utility of simplified methods for measuring muscle mass; the psoas muscle mass index (PMI) method, simple PMI method, and arm muscle area (AMA) method. This retrospective study included 331 patients with gastrointestinal diseases and 81 patients with chronic liver diseases who were admitted from June 2018 to December 2019 at Municipal Hospital of Kofu. The skeletal muscle mass was measured using the PMI via the volume analyzer SYNAPSE VINCENT ver3.0, simple PMI based on CT imaging, and AMA method. Positive correlations were found between muscle mass measured by PMI and simple PMI, PMI and AMA, and simple PMI and AMA in patients with gastrointestinal diseases (correlation coefficients = 0.76, 0.57, 0.47, respectively, p < 0.001). Positive correlations were observed between muscle mass measured by PMI and simple PMI, PMI and AMA, and simple PMI and AMA in chronic liver diseases (correlation coefficients = 0.77, 0.53, 0.45, respectively, p < 0.001). Measurement of muscle mass by the AMA method showed some correlation with the PMI method. Measurement of muscle mass by the simple PMI method showed correlation with the PMI method. These simplified methods can be alternative methods of evaluating muscle mass in patients with gastrointestinal and chronic liver disease.
Highlights
Sarcopenia is an important prognostic factor in patients with gastrointestinal and chronic liver diseases
SYNAPSE Vincent volume analyzer version 3.0 was used in the psoas muscle mass index (PMI) method as the sum of the areas of the iliopsoas muscles on both sides at the level of the L3 vertebral body divided by the square of the height
The frequency of myopenia was significantly higher in patients with malignant tumors than in those without (24 vs. 5.7% by PMI, p < 0.001, 37 vs. 25% by simple PMI, p = 0.017, 49 vs. 26% by arm muscle area (AMA), p < 0.001)
Summary
Sarcopenia is an important prognostic factor in patients with gastrointestinal and chronic liver diseases. We evaluated the utility of simplified methods for measuring muscle mass; the psoas muscle mass index (PMI) method, simple PMI method, and arm muscle area (AMA) method This retrospective study included 331 patients with gastrointestinal diseases and 81 patients with chronic liver diseases who were admitted from June 2018 to December 2019 at Municipal Hospital of Kofu. Measurement of muscle mass by the simple PMI method showed correlation with the PMI method These simplified methods can be alternative methods of evaluating muscle mass in patients with gastrointestinal and chronic liver disease. In the JSH criteria, patients with chronic liver disease are diagnosed with sarcopenia if they have “decreased grip strength” and “decreased muscle mass” (as determined by computed tomography (CT) or bioelectrical impedance analysis (BIA)-guided skeletal muscle mass index). The utility of the AMA method and the simple PMI method as simplified methods was verified
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