Liver Fibrosis is Associated with a Decrease in Gait Speed in Older Men with Chronic Liver Disease: A Retrospective Cross-Sectional Study

2021 ◽  
Author(s):  
Kenichi Fudeyasu ◽  
Takuo Nomura ◽  
Toshihiro Kawae ◽  
Daisuke Iwaki ◽  
Yuki Nakashima ◽  
...  
Keyword(s):  
Liver Disease ◽  
Liver Fibrosis ◽  
Chronic Liver Disease ◽  
Motor Function ◽  
Gait Speed ◽  
Older Patients ◽  
Knee Extension ◽  
Chronic Liver ◽  
Cross Sectional ◽  
The Impact

Abstract Background: Although it has already been reported that chronic liver disease (CLD) can induce sarcopenia, the impact of sarcopenia, especially on motor function, in older patients with CLD is still unclear. Therefore, we investigated the effects of liver fibrosis on motor function in these patients.Methods: In all, 117 older patients with CLD aged above 60 years (men, n=70; women, n=47) were included in this study. We examined the presence or absence of sarcopenia and checked motor functions such as muscle strength and walking speed. The results were compared between patients with FIB-4 index of >3.25, indicative of severe-degree liver fibrosis (SLF), and those with an index of <3.25, indicative of low-degree liver fibrosis (LLF). We also analyzed the factors related to the decrease in gait speed.Results: The decrease in gait speed (<1.0 m/s) was significantly higher (P = 0.027) and the knee extension force (KEF) was significantly lower (P = 0.010) in men with SLF than in those with LLF. In this study, liver fibrosis (odds ratio [OR] = 0.71, 95% confidence interval [CI] = 0.56–0.90) and KEF (OR = 1.09, 95% CI = 1.02–1.16) were identified as factors associated with the decrease in gait speed.Conclusions: Older male patients with CLD have decreased motor function as the disease progresses. We found that the decrease in gait speed is related to liver fibrosis and KEF. It is necessary to focus on the motor function of older patients with CLD, especially the gait speed.

scholarly journals Possible unrecognised liver injury is associated with mortality in critically ill COVID-19 patients

2021 ◽  
Vol 14 ◽  
pp. 175628482110234
Author(s):  
Mario Romero-Cristóbal ◽  
Ana Clemente-Sánchez ◽  
Patricia Piñeiro ◽  
Jamil Cedeño ◽  
Laura Rayón ◽  
...  
Keyword(s):  
Liver Disease ◽  
Liver Fibrosis ◽  
Liver Injury ◽  
Chronic Liver Disease ◽  
Critically Ill ◽  
Cox Regression ◽  
Chronic Liver ◽  
Cox Regression Analysis ◽  
Risk Of Death ◽  
The Impact

Background: Coronavirus disease (COVID-19) with acute respiratory distress syndrome is a life-threatening condition. A previous diagnosis of chronic liver disease is associated with poorer outcomes. Nevertheless, the impact of silent liver injury has not been investigated. We aimed to explore the association of pre-admission liver fibrosis indices with the prognosis of critically ill COVID-19 patients. Methods: The work presented was an observational study in 214 patients with COVID-19 consecutively admitted to the intensive care unit (ICU). Pre-admission liver fibrosis indices were calculated. In-hospital mortality and predictive factors were explored with Kaplan–Meier and Cox regression analysis. Results: The mean age was 59.58 (13.79) years; 16 patients (7.48%) had previously recognised chronic liver disease. Up to 78.84% of patients according to Forns, and 45.76% according to FIB-4, had more than minimal fibrosis. Fibrosis indices were higher in non-survivors [Forns: 6.04 (1.42) versus 4.99 (1.58), p < 0.001; FIB-4: 1.77 (1.17) versus 1.41 (0.91), p = 0.020)], but no differences were found in liver biochemistry parameters. Patients with any degree of fibrosis either by Forns or FIB-4 had a higher mortality, which increased according to the severity of fibrosis ( p < 0.05 for both indexes). Both Forns [HR 1.41 (1.11–1.81); p = 0.006] and FIB-4 [HR 1.31 (0.99–1.72); p = 0.051] were independently related to survival after adjusting for the Charlson comorbidity index, APACHE II, and ferritin. Conclusion: Unrecognised liver fibrosis, assessed by serological tests prior to admission, is independently associated with a higher risk of death in patients with severe COVID-19 admitted to the ICU.

scholarly journals Thromboelastometry in patients with advanced chronic liver disease stratified by severity of portal hypertension

2020 ◽  
Author(s):  
Pierre Raeven ◽  
Joanna Baron-Stefaniak ◽  
Benedikt Simbrunner ◽  
Alexander Stadlmann ◽  
Philipp Schwabl ◽  
...  
Keyword(s):  
Portal Hypertension ◽  
Liver Disease ◽  
Chronic Liver Disease ◽  
Venous Pressure ◽  
Portal Pressure ◽  
Cross Sectional Study ◽  
Chronic Liver ◽  
Cross Sectional ◽  
Reactive Protein ◽  
The Impact

Abstract Background Rotational thromboelastometry (ROTEM) has been studied in patients with advanced chronic liver disease (ACLD) without considering the impact of portal hypertension. We evaluated the influence of the hepatic venous pressure gradient (HVPG) on ROTEM results in patients with ACLD. Methods Cross-sectional study; ACLD patients undergoing HVPG measurement within the prospective Vienna Cirrhosis Study (NCT03267615) underwent concomitant ROTEM testing. Results Among 159 patients (68% male; Child–Pugh-A: 53%, Child–Pugh-B: 34%, Child–Pugh-C: 13%), 21 patients (13%) had a HVPG between 6 and 10 mmHg, 84 patients (53%) between 10 and 19 mmHg, and 54 patients (34%) ≥ 20 mmHg. Child–Pugh-C patients (vs. Child–Pugh-A and vs. Child–Pugh-B patients, respectively) showed longer clot formation time (CFT: median 187 s vs. 122 s vs. 122 s, p = 0.007) and lower maximum clot firmness (MCF: median: 45 mm vs. 56 mm vs. 56 mm, p = 0.002) in extrinsic thromboelastometry (EXTEM), while platelet counts were similar across Child–Pugh stages. In the overall cohort, ROTEM parameters did not differ by severity of portal hypertension. However, among compensated Child–Pugh-A patients, MCF decreased with increasing portal pressure, i.e. in higher HVPG strata (HVPG 9–10 mmHg: median MCF: 59 mm vs. HVPG 10–19 mmHg: 56 mm vs HVPG ≥ 20 mmHg: 54 mm, p = 0.023). Furthermore, patients with short CFT and high MCF in EXTEM had higher levels of lipopolysaccharide-binding protein, C-reactive protein, and procalcitonin, as well as higher leukocyte counts (all p < 0.05). Conclusions Portal hypertension seems to impact ROTEM results only in compensated Child–Pugh-A patients. Bacterial translocation and systemic inflammation may trigger a procoagulant state in patients with ACLD.

scholarly journals Unrecognized liver injury assessed by fibrosis indexes is associated with mortality in critically ill COVID-19 patients

2020 ◽  
Author(s):  
Mario Romero-Cristobal ◽  
Ana Clemente ◽  
Patricia Piñeiro ◽  
Jamil Cedeño ◽  
Laura Rayón ◽  
...  
Keyword(s):  
Liver Disease ◽  
Liver Fibrosis ◽  
Liver Injury ◽  
Chronic Liver Disease ◽  
Critically Ill ◽  
Cox Regression ◽  
Chronic Liver ◽  
Cox Regression Analysis ◽  
Risk Of Death ◽  
The Impact

Abstract Background Coronavirus disease (COVID-19) with acute respiratory distress syndrome is a life-threatening condition. A previous diagnosis of chronic liver disease is associated with poorer outcomes. Nevertheless, the impact of silent liver injury has not been investigated. We aimed to explore the association of pre-admission liver fibrosis indexes with the prognosis of critically ill COVID-19 patients.Methods Observational study in 214 patients with COVID-19 consecutively admitted to the ICU. Pre-admission liver fibrosis indexes were calculated. In-hospital mortality and predictive factors were explored with Kaplan-Meier and Cox regression analysis.Results The mean age was 59.58 (13.79) years. Sixteen patients (7.48%) had previously recognized chronic liver disease. Up to 78.84% of patients according to Forns, and 45.76% according to FIB-4, had more than minimal fibrosis. Fibrosis indexes were higher in non-survivors [Forns: 6.04 (1.42) vs 4.99 (1.58), p < 0.001; FIB-4: 1.77 (1.17) vs 1.41 (0.91), p = 0.020)], but no differences were found in liver biochemistry parameters. Patients with any degree of fibrosis either by Forns or FIB-4 had a higher mortality, which increased according to the severity of fibrosis (p < 0.05 for both indexes). Both Forns [HR 1.41 (1.11-1.81); p = 0.006] and FIB-4 [HR 1.31 (0.99-1.72); p = 0.051] were independently related to survival after adjusting for the Charlson Comorbidity Index, APACHE II and ferritin.Conclusion Unrecognized liver fibrosis, assessed by serological tests prior to admission, is independently associated with a higher risk of death in patients with severe COVID-19 admitted to the ICU.

Mac‐2 Binding Protein Glycan Isomer as non‐invasive tool to assess liver fibrosis in children with chronic liver disease

2021 ◽  
Author(s):  
Ola G Behairy ◽  
Soha A El‐Gendy ◽  
Dalia Y Ibrahim ◽  
Amira I Mansour ◽  
Ola S El‐Shimi
Keyword(s):  
Liver Disease ◽  
Liver Fibrosis ◽  
Chronic Liver Disease ◽  
Binding Protein ◽  
Chronic Liver ◽  
Non Invasive

Health-related quality of life in chronic liver disease: the impact of type and severity of disease

2001 ◽  
Vol 96 (7) ◽  
pp. 2199-2205 ◽  
Author(s):  
Zobair M Younossi ◽  
Navdeep Boparai ◽  
Lori Lyn Price ◽  
Michelle L Kiwi ◽  
Marilyn McCormick ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Liver Disease ◽  
Chronic Liver Disease ◽  
Chronic Liver ◽  
Health Related Quality ◽  
Severity Of Disease ◽  
Related Quality ◽  
Health Related ◽  
The Impact

108 ASSOCIATION OF GENES REGULATING VITAMIN D HOMEOSTASIS WITH VITAMIN D LEVELS AND LIVER FIBROSIS IN A COHORT OF PATIENTS WITH CHRONIC LIVER DISEASE

2011 ◽  
Vol 54 ◽  
pp. S48-S49
Author(s):  
F. Grünhage ◽  
K. Hochrath ◽  
M. Krawczyk ◽  
B. Obermayer-Pietsch ◽  
M. Trauner ◽  
...  
Keyword(s):  
Vitamin D ◽  
Liver Disease ◽  
Liver Fibrosis ◽  
Chronic Liver Disease ◽  
Chronic Liver ◽  
Vitamin D Levels

Enhanced liver fibrosis test can predict clinical outcomes in patients with chronic liver disease

Gut ◽  
2010 ◽  
Vol 59 (9) ◽  
pp. 1245-1251 ◽  
Author(s):  
J. Parkes ◽  
P. Roderick ◽  
S. Harris ◽  
C. Day ◽  
D. Mutimer ◽  
...  
Keyword(s):  
Liver Disease ◽  
Liver Fibrosis ◽  
Chronic Liver Disease ◽  
Clinical Outcomes ◽  
Chronic Liver

scholarly journals ANALISIS FERITIN DAN AST TO PLATELET RATIO INDEX SEBAGAI PETANDA DERAJAT FIBROSIS PENYAKIT HATI KRONIS (Analysis Ferritin and AST to Platelet Ratio Index as a Marker Degree of Fibrosis Chronic Liver Disease)

2018 ◽  
Vol 22 (1) ◽  
pp. 72
Author(s):  
Yulianti Yasin ◽  
Uleng Bahrun ◽  
Ibrahim Abdul Samad
Keyword(s):  
Liver Disease ◽  
Chronic Liver Disease ◽  
Cell Damage ◽  
Clinical Chemistry ◽  
Cross Sectional Study ◽  
Chronic Liver ◽  
Impedance Method ◽  
Iron Deposit ◽  
Cross Sectional ◽  
Modified Method

Chronic liver disease is an endemic disease in Indonesia which is still a global health problem and detected when it’s developinginto fibrosis. The determination of fibrosis is important for the treatment and prognosis of chronic liver disease. AST to Platelet RatioIndex (APRI) score is the most common used to assess the degree of liver fibrosis. Ferritin is an iron deposit that found in the liver andthe levels depend on the degree of the cell damage. The aim of this study was to analyze ferritin levels as a marker of the fibrosis degreein the chronic liver disease. This cross-sectional study of 47 patients with chronic liver disease performed at Dr. Wahidin SudirohusodoGeneral Hospital between May–June 2012. The subjects are grouped into cirrhotic and noncirrhotic, based on the theory that in cirrhoticliver fibrosis was considered as an irreversible condition. AST to platelet ratio index score based on the Wai CT formulation, includingthe examination of AST by optimizing UV-test according to International Federation of Clinical Chemistry (IFCC) modified method onthe ABX Pentra 400, examination of platelet by impedance method on Sysmex XT 2000i and ferritin levels were measured by ECLIAmethod using Elecsys 2010 Analyzer. The Spearman correlation tests showed no association between ferritin levels and APRI in cirrhoticand non cirrhotic patients (p=0.704 and r=–0.057). In conclusion, ferritin can not be used as the marker in determining the degreeof fibrosis patients suffering chronic liver disease. Further studies are expected using a more valid method for determining the degree offibrosis such as liver biopsy or fibro scan.

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