scholarly journals Utility of the SARC-F Questionnaire for Sarcopenia Screening in Patients with Chronic Liver Disease: A Multicenter Cross-Sectional Study in Japan

2021 ◽  
Vol 10 (15) ◽  
pp. 3448
Author(s):  
Tatsunori Hanai ◽  
Atsushi Hiraoka ◽  
Makoto Shiraki ◽  
Ryosuke Sugimoto ◽  
Nobuhito Taniki ◽  
...  

Diagnosing sarcopenia is challenging. This multicenter cross-sectional study aimed to evaluate the utility of the SARC-F score system for identifying sarcopenia in patients with chronic liver disease (CLD). We enrolled 717 patients from five participating centers who completed the SARC-F between November 2019 and March 2021. Sarcopenia was diagnosed based on the Japan Society of Hepatology Working Group on Sarcopenia in Liver Disease Consensus. Muscle strength was estimated using a grip dynamometer, and muscle mass was assessed using computed tomography or bioelectrical impedance analysis. The association between SARC-F and sarcopenia was analyzed using a logistic regression model. The optimal SARC-F cutoff value for identifying sarcopenia was determined using receiver operating characteristic (ROC) curve analysis. Of the 676 eligible patients, 15% were diagnosed with sarcopenia. The SARC-F distribution was 0 points in 63% of patients, 1 point in 17%, 2 points in 7%, 3 points in 4%, and ≥4 points in 8%. The SARC-F items of “Strength” (odds ratio (OR), 1.98; 95% confidence interval (CI), 1.03–3.80) and “Falls” (OR, 2.44; 95% CI, 1.48–4.03) were significantly associated with sarcopenia. The SARC-F value of 1 point showed a higher discriminative ability for identifying sarcopenia than the 4 points that are conventionally used (p < 0.001), with an area under the ROC curve of 0.68, sensitivity of 0.65, specificity of 0.68, positive predictive value of 0.27, and negative predictive value of 0.92. SARC-F is useful for identifying patients with CLD who are at risk of sarcopenia.

2020 ◽  
Vol 7 (6) ◽  
pp. 1013
Author(s):  
Mohammed Jaleel P. ◽  
S. Bhagyabati Devi ◽  
Ningthoukhongjam Reema ◽  
Thangjam Gautam Singh ◽  
Dhileeban Maharajan P.

Background: Hepatic osteodystrophy encompasses the spectrum of metabolic bone diseases in chronic liver disease (CLD) patients. CLD causing changes in BMD is well known. Although BMD evaluation in CLD cirrhosis are recommended by societies of British and American gastroenterology ,very less number of literature exist from India and none from the North-eastern region of India. Aim of the study to determine the association and severity of bone mineral density changes in patients with CLD and to correlate it with different aetiologies and severity of CLD.Methods: This cross-sectional study which included 79 patients with CLD was conducted in RIMS, Manipur from September 2017 to August 2019. All CLD patients of age 18-60 years were included. DEXA scan and other related blood investigations were performed.Results: Chronic alcohol intake (56.9%), viral infection (20.3%) and mixed (17.7%) were the main aetiology of CLD in our study. Seventy three (92.4%) of the total 79 patients had low BMD (Osteopenia in 29 (36.7%) and osteoporosis in 44 (55.7%) patients). Osteoporosis was detected in 53.4% of alcohol related Cirrhosis, 25%of viral liver disease. Majority of the severe CLD patients (Child class C) had osteoporosis (70.6%) as compared to less severe groups (23.5% and 36.4% in class B and A respectively).Conclusions: CLD patients have high prevalence of osteoporosis. Severity of liver disease, alcoholic liver disease, serum calcium and vitamin D deficiency predisposes to osteoporosis in these patients. Hence early screening of BMD is necessary in CLD patients.


Author(s):  
Hashik P. Muhammed ◽  
Kezhakkut Jayaraj

Background: Many previous studies concluded variation in the lipid parameters such as total cholesterol (TC), triglyceride (TG), high density lipoprotein (HDL) and low density lipoprotein (LDL) with severity of liver disease. Hence, this study was conducted to find out the correlation of lipid profile in patients with severe liver disease.Methods: A cross sectional study which included 170 patients admitted with chronic liver disease. Severity of liver disease according to Child Pugh Turcotte Score. The patients were subjected to routine investigation and fasting lipid profile test. Correlation was studied using the Pearson correlation coefficient and the comparison of lipid parameters was also done.Results: Total of 170 consecutive chronic liver disease patients were analysed over a period of one year. Majority of the patients were of the age 51 to 60 years (39.8%). Among the total, 24 patients were in Child Pugh Turcotte Score class A, 47 patients were in class B and 52 were patients in class C. We could observe a significant (p<0.001) negative correlation of all the lipid profile parameters with the severity of liver disease.Conclusions: Serum TC, LDL TG and HDL were decreased in patients with cirrhosis and they are inversely correlated to severity of disease.


2021 ◽  
Author(s):  
Mohammad Farhadul Haque ◽  
ANM Shamsul Islam ◽  
Samina Pervin ◽  
Emily Akter ◽  
Mahmudul Hasan

Out-of-pocket (OOP) expenses for hospitalized patients with chronic liver disease (CLD) poses an economic challenge on affected household in the form of catastrophic health expenditure (CHE), distress financing and impoverishment. OOP Expenses data for hospitalized CLD patients from Bangladesh is scarce. This study aimed to estimate the OOP expenses and resulting CHE, distress financing and impoverishment among hospitalized patients with CLD. This cross-sectional study was conducted among conveniently selected 107 diagnosed CLD patients admitted at Bangabandhu Sheikh Mujib Medical University (BSMMU) and Dhaka Medical College Hospital (DMCH) aged 18 years and above. Data were collected from the respondents using a semi-structured questionnaire through face to face interview during discharge from hospital. Out of pocket expenditure for chronic liver disease in selected hospitals was Bangladeshi Taka (BDT) 19,262. Direct medical, direct non-medical and indirect cost was BDT 16,240; 2,165 and 1,510, respectively. Investigation cost and medicine cost contributed to 48.48% and 31.81% of the total OOP expenses, respectively. At 10% threshold level, 29% of the respondents were affected by CHE. 64.5% of the respondents were facing distress financing due to OOP expenses. Among the respondents, 1.9% slipped below the international poverty line of $1.90 (BDT 161.10, in 2019).There was statistically significant (p &lt; 0.05) difference among the mean OOP expenses for different etiological types of chronic liver disease. The study concluded that it requires establishing a more accessible and affordable decentralized health care system for CLD treatment along with the implementation of financial risk protection.


2021 ◽  
Vol 8 (27) ◽  
pp. 2373-2380
Author(s):  
Manabendra Nayak ◽  
Ghodke Chinmoy Pradeep

BACKGROUND Cirrhosis is a progressive clinical condition associated with considerable mortality and morbidity. It leads to a wide spectrum of characteristic clinical manifestations, mainly attributable to hepatic insufficiency and portal hypertension.1 In cirrhosis, primary diagnostic test for evaluation of upper-gastro-intestinal bleeding (UGIB) is endoscopy.2 The present study attempts to find out different clinical patterns of the chronic liver disease (CLD) with portal hypertension along with the endoscopic profile of the patients. METHODS It was a cross sectional study conducted in Down Town Hospital, Guwahati, Assam. RESULTS A cross sectional study was conducted at Downtown Hospital, Guwahati, Assam on patients diagnosed with chronic liver disease from 01 January 2017 to 31 January 2018. Male predominance was observed in this study with 84 % males and 16 % females. Male to female ratio was 5.25 : 1. Maximum patients (58 %) were observed in the age group of 40 to 60 years followed by 30 % in the age group of 60 to 80 years. The average age was 53.6 years. Most common aetiological factor was alcohol (66 %) followed by non-alcoholic steatohepatitis (NASH) (16 %). Other aetiologies were hepatitis-B, hepatitis-C and cryptogenic. 88 % cases were recorded in model for end stage liver disease (MELD) score range of 10 to 29. Ascites was noted in 88 % cases, of which 20 % had grade-1 and grade-2, 48 % had grade-3. Splenomegaly was noted in 70 % cases. Child-Pugh class-C consisted of 26 % cases (13) with grade-III varices followed by 18 % cases (9) with grade-II varices while Child-Pugh Class-B had 24 % cases (12) and 8 % cases (4) with grade-III and grade-II varices respectively. Child-Pugh class-A had all the cases with grade-I varices. CONCLUSIONS Alcoholism was the leading cause for cirrhosis followed by hepatitis-B, hepatitis-C, NASH and cryptogenic. Class-C had maximum number of cases with grade-III varices followed by class-B. MELD score ranged between 10 - 29 in majority. Severe anaemia was noted in 10 % cases. Thrombocytopenia a non-invasive indicator of oesophageal varices was noted in 70 % with different grades of oesophageal varices. KEYWORDS Endoscopy, Portal Hypertension, Chronic Liver Disease


2018 ◽  
Vol 18 (1) ◽  
Author(s):  
Stian Magnus Staurung Orlien ◽  
Nejib Yusuf Ismael ◽  
Tekabe Abdosh Ahmed ◽  
Nega Berhe ◽  
Trine Lauritzen ◽  
...  

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