Sarcopenia in Liver Cirrhosis

Comprehensive Medical Information and Management Guidelines

40%-70%

Prevalence Rate

Primary symptom

Muscle weakness
Reversible With Treatment

Sarcopenia

Sarcopenia is a syndrome characterized by the progressive and generalized loss of skeletal muscle mass and strength. It increases the risk of adverse outcomes such as frailty, falls, fractures, physical disability, poor quality of life, and even mortality. The primary symptom is muscle weakness.

Sarcopenia is a common complication in patients with liver cirrhosis, with a prevalence ranging from 40% to 70%. It significantly impacts patient outcomes both before and after liver transplantation. The condition is multifactorial in origin, caused by an imbalance between protein synthesis and protein breakdown.

Reference: J Gastroenterol. 2019 Oct;54(10):845-859

Reversing Sarcopenia in Cirrhosis

Clinical guidelines recommend combining moderate physical exercise with adequate protein and energy intake to help
restore muscle mass and function

Nutritional interventions
Physical activity
Pharmacological therapy

Prevalence and Burden of Liver Cirrhosis in India

Liver cirrhosis is a major public health concern in India due to its high frequency and severe complications. In 2015, India accounted for 18.3% of the two million global liver disease-related deaths, highlighting the alarming burden of liver disease in the country.

Mortality due to chronic liver diseases (CLDs), including cirrhosis and its complications, is progressively increasing.

Leading Causes of CLD in India

  • Non-alcoholic fatty liver disease (NAFLD)
  • Alcoholic liver disease (ALD)
  • Viral hepatitis (HBV and HCV)

These risk factors are growing due to changing lifestyles and social habits, making NAFLD and ALD particularly concerning. In total, CLDs accounted for 2.1% of all deaths in India.

Management of Sarcopenia

Physical Exercise

  • Aerobic Exercise
  • Resistance Exercise

Hormone Therapy

  • Testosterone Supplementation
  • Ghrelin Therapy
  • Growth Hormone (GH) Supplementation

Rational Nutrition

  • Adequate Protein Intake
  • Vitamin D Supplementation
  • Mediterranean Diet

Medications

  • ACE Inhibitors (ACEIs) and ARBs
  • Loop Diuretics

Myths and Facts

Myth

Sarcopenia in liver cirrhosis is a rare condition.

Fact

Sarcopenia in liver cirrhosis is a common complication, affecting up to 70% of patients with live cirrhosis.

Myth

Sarcopenia in liver cirrhosis only affects people with advanced disease

Fact

Sarcopenia in liver cirrhosis only affects people with advanced disease

Myth

Sarcopenia in liver cirrhosis is only caused by malnutrition

Fact

While malnutrition is a common contributor to sarcopenia in liver cirrhosis, other factors such as physical inactivity, hormonal imbalances, and inflammation also leads to muscle loss and frailty

Myth

Sarcopenia in liver cirrhosis is irreversible

Fact

Sarcopenia in liver cirrhosis can be reversed with a combination of nutritional support, physical exercise, and pharmacological interventions

Myth

Liver transplant is the only treatment for sarcopenia in liver cirrhosis

Fact

While liver transplant may improve or reverse sarcopenia in some cases, other treatments such as nutritional support, exercise, and medications can also be effective

Myth

Sarcopenia in liver cirrhosis is not a serious condition

Fact

Sarcopenia in liver cirrhosis is associated with an increased risk of complications, including malnutrition, infections, hepatic encephalopathy, and hepatorenal syndrome (HRS), and can negatively impact quality of life and also lead to early mortality.

Myth

Sarcopenia only affects older adults

Fact

Sarcopenia is more prevalent in older adults, but it can affect people with all ages

Myth

Sarcopenia is only caused by ageing

Fact

Sarcopenia is significantly caused by ageing, but other factors such as physical inactivity, poor nutrition, chronic diseases such as chronic liver disease, alcoholic liver disease contribute to the development of sarcopenia

Myth

Sarcopenia cannot be prevented or treated

Fact

Sarcopenia can be prevented and treated through lifestyle changes such as proper nutrition support. Exercise, aerobic exercise, as well as medical interventions.

Myth

Strength training is the only way to prevent or treat sarcopenia

Fact

Nutritional intervention is an essential component with strength training Exercise has an impact on both cardiovascular fitness and increasing muscle mass and promoting muscle protein synthesis

Disclaimer

ProNocte is a health supplement and is not intended to diagnose, treat, cure, or prevent any disease.

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