Hospital Santa Casa de Misericórdia de Vitória, Espírito Santo, ES, Brasil.
Arq Gastroenterol. 2023 Oct-Dec;60(4):431-437. doi: 10.1590/S0004-2803.230402023-69.
Sarcopenia is a syndrome characterized by progressive and generalized loss of muscle mass and strength, observed to varying degrees in patients with various chronic conditions. In cirrhotic patients, it reflects protein-energy malnutrition due to metabolic protein imbalance and is associated with worsened prognosis and reduced post-liver transplantation survival.
To evaluate the epidemiological distribution of diminished hand grip (HG) strength in cirrhotic patients at an outpatient clinic of Santa Casa de Misericórdia in Vitória-ES, Brazil, seeking its association with liver function and cirrhosis complications.
Cross-sectional, epidemiological, and single-center study. A questionnaire was administered to patients and HG strength was measured using a dynamometer, with three interval measures taken for 3 seconds each.
The study's total population was 64 cirrhotic patients, with a mean age of 58 years and alcohol as the most prevalent etiology. Reduced HG strength was defined based on two reference values: using cutoff point 1, reduced HG strength was identified in 33 patients (51.6%); according to cutoff point 2, 23 (35.9%) had reduced HG strength. The study showed that, among the parameters observed, there was an association between the female gender and diminished HG strength in both cutoff points. Additionally, it was noted that patients with a score of 15 or more on the Model for End-Stage Liver Disease (MELD) had decreased HG strength at cutoff point 2. The study showed no association between decreased HG strength and the occurrence of cirrhosis complications in the population studied.
In our study, we obtained a diminished HG strength variation of 35-52%, which was related to higher MELD scores, suggesting an association with worse clinical outcomes. Therefore, the presence of reduced muscle strength in cirrhotic patients may be linked to prognostic factors and should be valued as clinical data in the management of these patients.
肌少症是一种以肌肉质量和力量进行性、广泛性下降为特征的综合征，在各种慢性疾病患者中都有不同程度的观察。在肝硬化患者中，它反映了由于代谢性蛋白质失衡导致的蛋白质能量营养不良，与预后恶化和肝移植后存活率降低有关。
评估巴西圣家慈善医院肝硬化患者门诊患者握力（HG）下降的流行病学分布情况，探讨其与肝功能和肝硬化并发症的关系。
这是一项横断面、流行病学、单中心研究。对患者进行问卷调查，并使用测力计测量 HG 强度，每个间隔测量 3 次，每次持续 3 秒。
该研究的总人群为 64 名肝硬化患者，平均年龄为 58 岁，酒精是最常见的病因。根据两个参考值定义了握力下降：使用截断值 1，33 名患者（51.6%）存在握力下降；根据截断值 2，23 名患者（35.9%）存在握力下降。研究表明，在所观察的参数中，在两个截断值下，女性性别与握力下降有关。此外，还注意到，模型终末期肝病评分（MELD）得分为 15 分或更高的患者在截断值 2 时握力下降。研究表明，握力下降与研究人群中肝硬化并发症的发生之间没有关联。
在我们的研究中，我们得到了 35-52%的握力下降变化，这与更高的 MELD 评分有关，表明与更差的临床结局有关。因此，肝硬化患者肌肉力量下降可能与预后因素有关，应作为这些患者管理的临床数据加以重视。
