Rationale: Sarcopenia is a frequent complication in cirrhotic patients associated with worse prognosis. To date, Computed Tomography(CT) is considered the gold standard to quantify muscle mass in cirrhotic patients but is limited by cost, radiation exposure, and logistic difficulties. Quadriceps muscle thickness by ultrasound has been recently proposed as an easier bedside tool to detect sarcopenia [1]. The aim of our study was to evaluate the role of the quadriceps muscle (TPI: thickness pressure index) in the detection of sarcopenia in comparison to CT assessment of skeletal muscle index (SMI) in cirrhotic patients. Methods: Consecutive cirrhotic patients, who performed a CT scan between +8/-8 weeks from outpatient visit were included. Sarcopenia was evaluated by L3 SMI using previously reported cut-offs [2]. The TPI was performed in the middle point on a line connecting the patella with the upper anterior iliac spine. Three measurements with pressure to collapse the muscle were taken. TPI was obtained by the average of these measures normalized for the height. Results: Fifty-three patients were enrolled in the study (mean age 62±10 years, mean BMI 24.9±4 Kg/m2, 86% male). According to CT imaging, 70% of patients were sarcopenic. Sarcopenic patients were older (64±5 vs 55±8; p=0.01), with lower BMI (23±3 vs 28±3; p<0.001). We found a positive correlation between SMI and TPI (r=0.566; p<0.001). The area under ROC curve for TPI considering sarcopenia by SMI was 0.82. Conclusion: The results of our study show that TPI is an effective index for the assessment of muscle depletion in cirrhotic patients. US assessment of sarcopenia may allow monitoring the patient over time.
Lattanzi, B., Gioia, S., Dambrosio, D., Fabrini, N., Pigliacelli, A., Bruni, A., et al. (2018). The assessment of Sarcopenia by quadriceps muscle ultrasound in patients with liver cirrhosis. CLINICAL NUTRITION, 37, 1-4 [10.1016/j.clnu.2018.06.2058].
The assessment of Sarcopenia by quadriceps muscle ultrasound in patients with liver cirrhosis
Bruni, A.;
2018
Abstract
Rationale: Sarcopenia is a frequent complication in cirrhotic patients associated with worse prognosis. To date, Computed Tomography(CT) is considered the gold standard to quantify muscle mass in cirrhotic patients but is limited by cost, radiation exposure, and logistic difficulties. Quadriceps muscle thickness by ultrasound has been recently proposed as an easier bedside tool to detect sarcopenia [1]. The aim of our study was to evaluate the role of the quadriceps muscle (TPI: thickness pressure index) in the detection of sarcopenia in comparison to CT assessment of skeletal muscle index (SMI) in cirrhotic patients. Methods: Consecutive cirrhotic patients, who performed a CT scan between +8/-8 weeks from outpatient visit were included. Sarcopenia was evaluated by L3 SMI using previously reported cut-offs [2]. The TPI was performed in the middle point on a line connecting the patella with the upper anterior iliac spine. Three measurements with pressure to collapse the muscle were taken. TPI was obtained by the average of these measures normalized for the height. Results: Fifty-three patients were enrolled in the study (mean age 62±10 years, mean BMI 24.9±4 Kg/m2, 86% male). According to CT imaging, 70% of patients were sarcopenic. Sarcopenic patients were older (64±5 vs 55±8; p=0.01), with lower BMI (23±3 vs 28±3; p<0.001). We found a positive correlation between SMI and TPI (r=0.566; p<0.001). The area under ROC curve for TPI considering sarcopenia by SMI was 0.82. Conclusion: The results of our study show that TPI is an effective index for the assessment of muscle depletion in cirrhotic patients. US assessment of sarcopenia may allow monitoring the patient over time.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
