• Atsushi Hiraoka, Kojiro Michitaka, Hidetaro Ueki, Miho Kaneto, Toshihiko Aibiki, Tomonari Okudaira, Takamasa Kawakami, Hiroka Yamago, Yoshifumi Suga, Hideomi Tomida, Yuji Miyamoto, Nobuaki Azemoto, Kenichiro Mori, Hideki Miyata, Eiji Tsubouchi, Tomoyuki Ninomiya, Masashi Hirooka, Masanori Abe, Bunzo Matsuura, and Yoichi Hiasa.
• aGastroenterology Center, Ehime Prefectural Central Hospital, Matsuyama bDepartment of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon, Ehime, Japan.
• Eur J Gastroenterol Hepatol. 2016 Aug 1; 28 (8): 940-7.

Background/AimThe frequency of sarcopenia, defined as loss of both muscle volume and strength, was analyzed in chronic liver disease (CLD).Methods And MaterialsFrom April to September 2015, 807 Japanese CLD patients treated as outpatients were enrolled (67.1±10.0 years, men : women=466 : 341, hepatitis C virus : hepatitis B virus : hepatitis B and C virus : alcohol : other=511 : 134 : 3 : 45 : 114). Sarcopenia was diagnosed when the patient showed muscle volume loss and reduced handgrip strength, whereas those with only muscle volume loss were classified as 'v-presarcopenia' and those with only reduced handgrip strength were classified as 's-presarcopenia'. Muscle volume loss was determined using computed tomography findings and a previously reported index (psoas index), and cut-off values for reduced handgrip strength presented by the Asia Working Group for Sarcopenia (AWGS) (AWGS/grip criteria) and European Working Group on Sarcopenia in Older People (EWGSOP) (EWGSOP/grip criteria) (men; 26 and 30 kg, women; 18 and 20 kg, respectively) were used. Clinical features were analyzed for diagnoses of chronic hepatitis (CH, n=381), liver cirrhosis Child-Pugh A (n=330), and liver cirrhosis Child-Pugh B/C (n=96).ResultsWhen the AWGS/grip criteria were used, the frequencies of sarcopenia, v-presarcopenia, and s-presarcopenia in CH were 3.9, 7.9, and 19.4%, whereas those in Child-Pugh A were 4.8, 17.6, and 21.8% and those in Child-Pugh B/C were 16.7, 11.5, and 39.6%, respectively. When the EWGSOP/grip criteria were used, these frequencies were 7.1, 4.7, and 33.1%, in CH, 11.8, 10.6, and 32.7%, in Child-Pugh A, and 21.9, 6.3, and 49.0%, in Child-Pugh B/C, respectively. The incidence rates of sarcopenia and both types of presarcopenia increased with progression of CLD.ConclusionEvaluation of handgrip strength and psoas index is an easy and effective method for the detection of sarcopenia and presarcopenia.

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