Association of Sarcopenia with Severity and Prognosis in Patients with Chronic Liver Disease

Abstract

Background
Chronic liver disease (CLD) is associated with progressive hepatic dysfunction and multiple complications that contribute to increased morbidity and mortality. Sarcopenia, characterized by loss of skeletal muscle mass and function, has emerged as an important extrahepatic manifestation of cirrhosis and a potential predictor of poor outcomes. This study was conducted to evaluate the association of sarcopenia with severity and prognosis among patients with chronic liver disease.

Methods
This prospective observational study included 90 patients diagnosed with chronic liver disease. All patients underwent clinical evaluation, laboratory investigations, assessment of liver disease severity using Child–Turcotte–Pugh (CTP) and Model for End-Stage Liver Disease (MELD) scores, and evaluation of skeletal muscle mass using computed tomography (CT)-based skeletal muscle index (SMI) at the third lumbar vertebral level. Patients were categorized into sarcopenic and non-sarcopenic groups, and their association with hepatic complications, hospitalization, and short-term outcomes was analyzed.

Results
Sarcopenia was identified in 35 patients (38.9%). Sarcopenic patients had significantly higher CTP scores (9.1 ± 1.8 vs 7.3 ± 1.6; p<0.001) and MELD scores (17.8 ± 5.4 vs 12.6 ± 4.3; p<0.001) compared with non-sarcopenic patients. Hepatic encephalopathy (45.7% vs 18.2%; p=0.008) and ascites (77.1% vs 45.5%; p=0.003) were significantly more frequent among sarcopenic individuals. Hospitalization rates were also higher in the sarcopenic group (65.7% vs 40.0%; p=0.020). Mortality showed a higher trend among sarcopenic patients (17.1% vs 5.5%), although statistical significance was not reached.

Conclusion
Sarcopenia is frequently observed in patients with chronic liver disease and is significantly associated with advanced disease severity, hepatic complications, and increased hospitalization risk. Assessment of skeletal muscle status may provide additional prognostic information and should be considered as an important component of comprehensive CLD management.