Department of Health and Rehabilitation Sciences, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Alkharj, Saudi Arabia.
Department of Physical Therapy, Kasr Al-Aini Hospital, Cairo University, Giza, Egypt.
Dis Markers. 2021 Feb 4;2021:8866093. doi: 10.1155/2021/8866093. eCollection 2021.
Sarcopenia is the most common feature of hepatic cirrhosis characterized by progressive loss of muscle mass and function and increases permanently the mortality and morbidity rates among those patients. The incidence of sarcopenia in cirrhotic patients ranged 40-70% associating with impaired quality of life and augmented rates of infection. Based on these issues, this review is aimed at determining the prevalence and main causes of sarcopenia among cirrhotic patients and recognizing the recent diagnostic and physical treatment modalities that prevent risk factors for sarcopenia in those patients. No ideal modality is currently demonstrated for diagnosing sarcopenia in hepatic diseases, particularly cirrhosis; however, recent studies reported different diagnostic modalities for muscle function in different individuals including handgrip strength, skeletal muscle index, six-min walk test, liver frailty index, short physical performance battery, and radiological assessments for quadriceps and psoas muscles. Exercise training and therapeutic nutrition are strongly recommended for controlling sarcopenia in cirrhotic patients. The exercise program is designed and carried out on a frequent basis within an extensive scheduled time aimed at improving functional performance, aerobic capacity, and healthy conditions. Finally, a combination of exercise training and therapeutic nutrition is powerfully recommended to control sarcopenia in cirrhosis.
肌肉减少症是肝硬化最常见的特征，其表现为肌肉质量和功能进行性丧失，并永久性地增加这些患者的死亡率和发病率。肝硬化患者中肌肉减少症的发生率为 40-70%，与生活质量受损和感染率增加有关。基于这些问题，本综述旨在确定肝硬化患者中肌肉减少症的患病率和主要原因，并认识到最近用于预防这些患者肌肉减少症风险因素的诊断和物理治疗方法。目前尚无用于诊断肝脏疾病（尤其是肝硬化）中肌肉减少症的理想方法；然而，最近的研究报告了针对不同个体肌肉功能的不同诊断方法，包括握力、骨骼肌指数、六分钟步行试验、肝脏脆弱指数、简短体能测试、股四头肌和腰大肌的影像学评估。运动训练和治疗性营养强烈推荐用于控制肝硬化患者的肌肉减少症。运动方案是在广泛的预定时间内频繁设计和进行的，旨在改善功能表现、有氧能力和健康状况。最后，强烈推荐将运动训练和治疗性营养相结合，以控制肝硬化中的肌肉减少症。
