{
  "abstract": "Introduction Sarcopenia is associated with adverse outcomes in decompensated cirrhosis. Few studies in liver disease have combined measures of muscle mass, strength and physical performance into distinct sarcopenia phenotypes. We explored the association between sarcopenia measures, phenotypes and outcomes.Methods 77 patients attending a tertiary liver centre were included. Sarcopenia was assessed using CT-derived psoas muscle index (PMI), hand-grip strength (HGS) and chair stand test (CST). Sex-specific PMI cut-offs were derived from the literature. Sarcopenia phenotypes were defined using EWGSOP2 criteria: probable (low HGS), confirmed (low HGS and PMI) and severe sarcopenia (low HGS, low PMI and impaired CST (>15 seconds or unable)). Correlations were assessed using Spearman’s rank. Sex-specific and exploratory mortality analyses were performed. MELD-sarcopenia scores (MELD+10.35 in patients with low PMI) were examined descriptively.Results Mean age was 64±10 years; 44% were women and 72% had alcohol-related liver disease (ARLD). Median BMI was 26 kg/m 2 (IQR 22–30). Median HGS was 15 kg (IQR 12–19) in women and 23 kg (IQR 17–29) in men.Low PMI was present in 45% of patients with recent imaging (n=55), low HGS in 60% and impaired CST in 74% patients. Phenotypic assessment identified 23% with probable sarcopenia, 31% with confirmed sarcopenia and 26% with severe sarcopenia. Sarcopenic obesity was present in 13% with confirmed sarcopenia versus 16% with low PMI alone.CT-derived sarcopenia (PMI) correlated moderately with HGS (ρ=0.44, p<0.001) but not CST. HGS was weakly correlated with CST (ρ=−0.26, p=0.037). Both PMI and HGS correlated with BMI. In women, PMI was strongly associated with HGS and CST (both p=0.01). Low PMI was more frequent in patients with ARLD than non-ARLD (55% vs 18%, p=0.07), whilst HGS was not. No associations with disease severity were identified.In sex-stratified survival analyses, women with severe sarcopenia had higher 12-month mortality than all other phenotypes (52% vs 14%; p=0.063), with no difference observed in men (17% vs 27%; p=0.791). MELD-sarcopenia scores were higher in patients who died within 12 months (median 22 vs 17).Conclusions In decompensated cirrhosis, bedside measures of muscle strength and function identified sarcopenia more frequently than CT-derived muscle mass alone, highlighting the importance of functional assessment. Associations between sarcopenia measures were stronger in women. EWGSOP2 definitions identified sarcopenia less often than single measures, but appeared to delineate a higher-risk group, with higher short-term mortality in women with severe sarcopenia. Combined phenotypic assessment may improve risk stratification. MELD-sarcopenia scores add prognostic value, compared to disease severity alone.",
  "authors": [
    {
      "affiliations": [
        "Manchester Royal Infirmary, Manchester, United Kingdom"
      ],
      "name": "Mareen Zachariah"
    },
    {
      "affiliations": [
        "Manchester Royal Infirmary, Manchester, United Kingdom"
      ],
      "name": "Miran Faily"
    },
    {
      "affiliations": [
        "Manchester Royal Infirmary, Manchester, United Kingdom"
      ],
      "name": "Katherine Martin"
    },
    {
      "affiliations": [
        "Manchester Royal Infirmary, Manchester, United Kingdom"
      ],
      "name": "Selena Dixon"
    }
  ],
  "title": "P63 Phenotypic assessment of sarcopenia in decompensated cirrhosis using psoas muscle index, hand-grip strength and chair stand tests",
  "uid": "fc377df5-a30e-5dd4-b77e-0dc2d5f001f5"
}