Background
Methods
Study cohort
Testing for MHE
Judgement of sarcopenia
Statistical analysis
Results
Patient characteristics
Age (years) | 70.0 (42–90) |
---|---|
Male, n (%) | 61 (61.6) |
Etiology | |
HBV, n (%) | 18 (18.2) |
HCV (including SVR), n (%) | 52 (52.5) |
NBNC, n (%) | 29 (29.3) |
Taking BCAA, n (%) | 28 (28.3) |
Taking diuretic, n (%) | 25 (25.3) |
Alcohol, n (%) | 39 (39.4) |
Diabetes, n (%) | 33 (33.3) |
HCC, n (%) | 70 (70.7) |
Esophageal or gastric varices, n (%) | 40 (40.4) |
Porto-systemic shunts, n (%) | 35 (35) |
Ascites, n (%) | 10 (10.1) |
Child–Pugh Class | |
A | 60 (60.6) |
B | 25 (25.3) |
C | 4 (4.0) |
Sarcopenia, n (%) | 6 (6.1) |
Body height (m) | 1.59 (1.37–1.90) |
Body weight (kg) | 57.4 (36.6–92.8) |
BMI (kg/m2) | 23.7 (16.0–33.9) |
Grip strength (kg) | 24.6 (7.2–43.5) |
Hemoglobin (g/L) | 128 (79–169) |
Platelets (× 103/μL) | 107 (21–390) |
ALT (U/L) | 23 (8–123) |
γ-GTP (U/L) | 41 (13–696) |
Cholinesterase (U/L) | 206 (53–379) |
Albumin (g/L) | 38 (22–49) |
Total cholesterol (mmol/L) | 4.16 (2.20–6.59) |
Ammonia (mol/L) | 31.1 (4.11–157.37) |
Prothrombin time (%) | 80 (31–115) |
Sodium (mEq/L) | 140 (133–146) |
BCAA (mmol/L) | 423.7 (228.3–1459.9) |
Tyrosine (mmol/L) | 96.2 (37.1–174.0) |
BTR | 4.75 (1.44–11.07) |
Subcutaneous fat area (cm2) | 101.61 (3.84–332.49) |
Visceral fat area (cm2) | 111.37 (7.03–287.84) |
CT level of skeletal muscles (HU) | 22.70 (− 16.42–47.52) |
Skeletal muscle area (cm2) | 118.74 (72.12–188.46) |
Skeletal muscle index (cm2/m2) | 47.9 (29.4–68.5) |
Psoas muscle area (cm2) | 12.47 (5.11–24.49) |
Psoas muscle index (cm2/m2) | 5.02 (2.45–9.20) |
Difference between presence or absence of MHE
MHE (-) (n = 51) | MHE ( +) (n = 48) | P value | |
---|---|---|---|
Age (years) | 72 | 68 | 0.944 |
Male, n (%) | 34 (66.7) | 27 (56.3) | 0.287 |
Etiology | 0.677 | ||
HBV, n (%) | 11 (21.6) | 7 (14.6) | |
HCV (include SVR), n (%) | 24 (47.0) | 28 (58.3) | |
NBNC, n (%) | 16 (31.4) | 13 (27.1) | |
Taking BCAA, n (%) | 11 (21.6) | 17 (35.4) | 0.126 |
Taking diuretic, n (%) | 12 (23.5) | 13 (27.1) | 0.684 |
Alcohol, n (%) | 22 (43.1) | 17 (35.4) | 0.432 |
Diabetes, n (%) | 17 (33.3) | 16 (33.3) | 1.000 |
HCC, n (%) | 36 (70.6) | 34 (75.0) | 0.979 |
Esophageal or gastric varices, n (%) | 19 (38.0) | 21 (43.8) | 0.563 |
Porto-systemic shunts, n (%) | 22 (43.1) | 13 (27.1) | 0.095 |
Ascites, n (%) | 4 (7.8) | 6 (12.5) | 0.332 |
Child–Pugh Class | 0.879 | ||
A | 30 (66.7) | 30 (68.4) | |
B or C | 15 (33.3) | 14 (31.8) | |
Sarcopenia, n (%) | 3 (5.9) | 3 (6.3) | 0.632 |
Body height (m) | 1.61 | 1.56 | 0.023 |
Body weight (kg) | 60.8 | 53.9 | 0.002 |
BMI (kg/m2) | 24.52 | 22.66 | 0.021 |
Grip strength (kg) | 28.3 | 21.9 | 0.041 |
Hemoglobin (g/L) | 133 | 124 | 0.181 |
Platelet (× 103/μL) | 107 | 106.5 | 0.563 |
ALT (U/L) | 26 | 23 | 0.385 |
γ-GTP (U/L) | 43 | 39 | 0.975 |
Cholinesterase (U/L) | 210 | 203 | 0.416 |
Albumin (g/L) | 39 | 38 | 0.863 |
Total cholesterol (mmol/L) | 4.16 | 4.16 | 0.991 |
Ammonia (μmol/L) | 31.1 | 30.5 | 0.674 |
Prothrombin time (%) | 79.0 | 81.5 | 0.483 |
Sodium (mEq/L) | 140 | 139.5 | 0.946 |
BCAA (mmol/L) | 465.9 | 404.0 | 0.093 |
Tyrosine (mmol/L) | 99.5 | 91.1 | 0.076 |
BTR | 4.62 | 4.78 | 0.978 |
Subcutaneous fat area (cm2) | 119.99 | 97.35 | 0.198 |
Visceral fat area (cm2) | 111.37 | 111.09 | 0.385 |
CT level of skeletal muscle (HU) | 23.46 | 22.51 | 0.287 |
Skeletal muscle area (cm2) | 125.85 | 108.23 | 0.003 |
Skeletal muscle index (cm2/m2) | 51.22 | 46.40 | 0.027 |
Psoas muscle area (cm2) | 14.34 | 10.85 | 0.002 |
Psoas muscle index (cm2/m2) | 5.53 | 4.24 | 0.003 |
Sarcopenia and muscle mass loss
Predictive factors for incidence of MHE
Univariate | ||
---|---|---|
Odds ratio | P value | |
Body weight, kg | ||
< 60 | 1 | |
≥ 60 | 0.357 | 0.016 |
BMI, kg/m2 | ||
≥ 24 | 1 | |
≥ 24 | 0.318 | 0.007 |
BCAA, μmol/L | ||
< 450 | 1 | |
≥ 450 | 0.355 | 0.018 |
Skeletal muscle area, cm2 | ||
< 120 | 1 | |
≥ 120 | 0.297 | 0.004 |
Skeletal muscle index, cm2/m2 | ||
< 50 | 1 | |
≥ 50 | 0.338 | 0.011 |
Psoas muscle area, cm2 | ||
< 9.5 | 1 | |
≥ 9.5 | 0.205 | 0.002 |
Psoas muscle index, cm2/m2 | ||
< 4.3 | 1 | |
≥ 4.3 | 0.224 | 0.001 |
Multivariate (using SMI) | |||
---|---|---|---|
Odds ratio | P value | 95% CI | |
BMI, kg/m2 | |||
< 24 | |||
≥ 24 | |||
BCAA, μmol/L | |||
< 450 | |||
≥ 450 | |||
Skeletal muscle index, cm2/m2 | |||
< 50 | |||
≥ 50 | 0.300 | 0.006 | 0.126–0.712 |
Multivariate (using PMI) | |||
---|---|---|---|
Odds ratio | P value | 95% CI | |
BMI, kg/m2 | |||
< 24 | |||
≥ 24 | |||
BCAA, μmol/L | |||
< 450 | |||
≥ 450 | |||
Psoas muscle index, cm2/m2 | |||
< 4.3 | |||
≥ 4.3 | 0.192 | 0.001 | 0.075–0.491 |
Incidence of MHE classified by sex and age
Male (n = 61) | Female (n = 38) | P value | |
---|---|---|---|
(A) SMI and PMI by sex | |||
Grip strength (kg) | 30.9 (14.2–43.5) | 17.6 (7.2–25.2) | < 0.001 |
Skeletal muscle area (cm2) | 131.90 (86.99–188.46) | 98.32 (72.12–143.99) | < 0.001 |
Skeletal muscle index (cm2/m2) | 51.0 (29.4–68.5) | 45.1 (32.5–65.0) | 0.001 |
Psoas muscle area (cm2) | 14.88 (6.46–24.49) | 8.89 (5.11–15.79) | < 0.001 |
Psoas muscle index (cm2/m2) | 5.6 (3.1–9.2) | 4.0 (2.5–7.6) | < 0.001 |
< 80 years (n = 84) | ≥ 80 years (n = 15) | P value | |
---|---|---|---|
(B) SMI and PMI by age | |||
Grip strength (kg) | 26.8 (8.9–43.5) | 17.0 (7.2–28.3) | < 0.001 |
Skeletal muscle area (cm2) | 122.01 (72.12–188.46) | 99.59 (72.31–173.66) | 0.023 |
Skeletal muscle index (cm2/m2) | 47.9 (29.4–68.5) | 47.3 (32.5–66.7) | 0.507 |
Psoas muscle area (cm2) | 13.19 (5.11–24.49) | 9.00 (5.33–23.29) | 0.028 |
Psoas muscle index (cm2/m2) | 5.2 (2.5–9.2) | 4.1 (2.5–8.9) | 0.212 |