Nazir Shamim, Abbas Zaigham, Amjad Shaima, Altaf Abeer, Qadeer Muhammad Ali, Maqbool Sania, Siyal Mehreen, Kumar Manesh
Department of Gastroenterology and Hepatology, Dr. Ziauddin Hospital Clifton Campus, Karachi, Pakistan.
Euroasian J Hepatogastroenterol. 2024 Jul-Dec;14(2):156-159. doi: 10.5005/jp-journals-10018-1442. Epub 2024 Dec 27.
Chronic liver disease (CLD) can have a significant impact on the nutritional status of patients. Malnutrition is an under-recognized condition in patients with cirrhosis. Malnutrition increases the incidence and severity of decompensation, increases the risk of infections, and increases mortality. The present study aimed to assess osteosarcopenia and frailty in patients with CLD.
This prospective cross-sectional study included 151 cases of CLD, aged between 18 and 85 years. Anthropometric measurements were performed. Sarcopenia was assessed by handgrip strength using a hand-held dynamometer. Bone mineral density was measured with the help of an office-based DEXA scan (Osteosys). Liver frailty was assessed through performance-based tests.
Out of 151 patients, 98 were male (69.5%); mean age was 51.8 ± 13.2. The presarcopenia was seen in 91 (60%) patients, and sarcopenia in 45(30%). Osteopenia was present in 75 (50%) and osteoporosis in 24 (16%). The patients with osteopenia and osteoporosis had a high liver frailty index (LFI) (-value < 0.001). A significant correlation between body mass index, waist circumference, LFI, calcium level, bilirubin and Child Pugh scores was seen with T and Z scores. Factors associated with low bone mineral density included increasing age and LFI, low calcium and higher PTH.
There is a high prevalence of pre-sarcopenia, sarcopenia, osteopenia, osteoporosis and high frailty in our patients with CLD. Early detection and timely intervention in these conditions are important to reduce the associated consequences. All patients with CLD should be assessed for osteosarcopenia and frailty, both at baseline and longitudinally.
Nazir S, Abbas Z, Amjad S, Prevalence of Osteosarcopenia and Frailty in Patients with Chronic Liver Disease. Euroasian J Hepato-Gastroenterol 2024;14(2):156-159.
慢性肝病（CLD）会对患者的营养状况产生重大影响。营养不良在肝硬化患者中是一种未得到充分认识的情况。营养不良会增加失代偿的发生率和严重程度，增加感染风险，并增加死亡率。本研究旨在评估CLD患者的骨少肌症和衰弱情况。
这项前瞻性横断面研究纳入了151例年龄在18至85岁之间的CLD患者。进行了人体测量。使用手持式测力计通过握力评估少肌症。借助基于办公室的双能X线吸收法扫描（Osteosys）测量骨密度。通过基于性能的测试评估肝脏衰弱情况。
151例患者中，98例为男性（69.5%）；平均年龄为51.8±13.2岁。91例（60%）患者存在少肌症前期，45例（30%）患者存在少肌症。75例（50%）患者存在骨质减少，24例（16%）患者存在骨质疏松。骨质减少和骨质疏松患者的肝脏衰弱指数（LFI）较高（P值<0.001）。体重指数、腰围、LFI、钙水平、胆红素和Child Pugh评分与T值和Z值之间存在显著相关性。与低骨密度相关的因素包括年龄增长和LFI、低钙和高甲状旁腺激素。
我们的CLD患者中少肌症前期、少肌症、骨质减少、骨质疏松和高衰弱的患病率很高。对这些情况进行早期检测和及时干预对于减少相关后果很重要。所有CLD患者在基线和纵向都应评估骨少肌症和衰弱情况。
Nazir S, Abbas Z, Amjad S, 慢性肝病患者骨少肌症和衰弱的患病率。《欧亚肝脏胃肠病学杂志》2024；14(2):156 - 159。
