• Jaya Benjamin, Varsha Shasthry, Chetan Ramesh Kaal, Lovkesh Anand, Ankit Bhardwaj, Vanshja Pandit, Ankur Arora, Sasidharan Rajesh, Viniyendra Pamecha, Vikas Jain, Guresh Kumar, Anthony Loria, Puneet Puri, Yogendra Kumar Joshi, and Shiv Kumar Sarin.
• Department of Clinical Nutrition, Institute of Liver and Biliary Sciences, New Delhi, India.
• Liver Int. 2017 Nov 1; 37 (11): 1668-1674.

BackgroundAlterations in body composition (BC) as loss of fat and muscle mass (sarcopenia) are associated with poor outcome in alcoholic cirrhosis (ALC). Prevalence of sarcopenia depends upon the method of assessment. Computed Tomography (CT) is a gold standard tool for assessing BC.AimTo characterize BC and define sarcopenia in ALC patients using CT.MethodsSingle slice CT images at L3 vertebrae of healthy controls (HC) - organ transplant donors and ALC patients were analysed to give cross-sectional area of five skeletal muscles normalized for height -skeletal muscle index (SMI; cm2 /m2 ), area of subcutaneous (SAT;cm2 ) and visceral adipose tissue (VAT;cm2 ). Cut-offs for defining sarcopenia was established at 2SD below the mean of HC. HC were compared with Child A-compensated (C) and Child B+C-decompensated (DC) patients.ResultsCut-offs of SMI derived from HC (n = 275; M: 50%; age 32.2 ± 9.8 years; BMI 24.2 ± 3.2 Kg/m2 ) were 36.54 in males and 30.21 in females. Sarcopenia was found in 12.8% of ALC patients [n = 148; C (31.8%): DC (68.2%); M: 100%; age 46.6 ± 9.7 years; BMI 24.5 ± 4.4]. Compared to HC, compensated patients had higher adiposity and comparable muscularity; decompensated patients had significantly lower muscle and also fat mass compared to both HC and compensated patients. HC vs C vs DC: SAT (140 ± 82 vs 177.3 ± 11 vs 112 ± 8.2); VAT (96.5 ± 6.5 vs 154.9 ± 8.7 vs 87.5 ± 6.5) and SMI (52.1 ± 0.9 vs 49.6 ± 1.2 vs 46 ± 0.9).ConclusionsCompensated ALC have increased adiposity and relatively preserved muscularity but decompensation leads to loss of both muscle and fat mass. Prevalence of sarcopenia, based on derived ethnic cut-offs was 12.8%.© 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

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