Effect of Sarcopenia on Sleep Disturbance in Patients with Chronic Liver Diseases

We sought to investigate the influence of sarcopenia as defined by muscle strength and skeletal muscle mass (SMM) on sleep disturbance as evaluated by the Japanese version of Pittsburgh Sleep Quality Index (PSQI-J) in chronic liver diseases (CLDs) (n = 419). Muscle strength and muscle mass were determined by grip strength (GS) and SMM using bioimpedance analysis. Patients were classified into four types: type A (n = 61); decreased GS and decreased SMM; type B (n = 45); decreased GS and non-decreased SMM; type C (n = 102); non-decreased GS and decreased SMM; and type D (n = 211); non-decreased GS and non-decreased SMM. Factors associated with PSQI-J score 6 or more were examined. PSQI-J score 0–5 (normal) was found in 253 (60.4%); 6–8 (mild) in 97 (23.2%); 9–11 (moderate) in 45 (10.7%) and 12 or more (severe) in 24 (5.7%). Univariate analysis identified three factors to be significantly associated with PSQI-J score 6 or more: presence of liver cirrhosis (LC) (P = 0.0132); our classification of type A; B; C and D (P < 0.0001) and serum albumin level (P = 0.0041). Multivariate analysis showed that type A (P = 0.0021) and type B (P = 0.0220) were significant independent factors. In conclusion, sarcopenia in CLDs appears to be closely associated with sleep disturbance mainly due to muscle strength decline.

Download Full-text

Grip Strength: A Useful Marker for Composite Hepatic Events in Patients with Chronic Liver Diseases

Diagnostics ◽

10.3390/diagnostics10040238 ◽

2020 ◽

Vol 10 (4) ◽

pp. 238 ◽

Cited By ~ 3

Author(s):

Kazunori Yoh ◽

Hiroki Nishikawa ◽

Hirayuki Enomoto ◽

Yoshinori Iwata ◽

Naoto Ikeda ◽

...

Keyword(s):

Grip Strength ◽

Muscle Mass ◽

Cumulative Incidence ◽

Liver Diseases ◽

Short Form ◽

Incidence Rates ◽

Chronic Liver ◽

Prognostic Impact ◽

Chronic Liver Diseases

Here we sought to clarify the prognostic impact of sarcopenia-related markers (grip strength (GS), muscle mass using bioimpedance analysis and patient quality of life as assessed by the 36-Item Short-Form Health Survey (SF36)) in patients with chronic liver diseases (CLDs, n = 411; 160 liver cirrhosis patients; median age, 64 years) on the incidence of composite hepatic events (CHEs). A GS decrease was defined as <26 kg in men and <18 kg in women, while a skeletal muscle mass index (SMI) decrease was defined as <7.0 kg/m2 in men and <5.7 kg/m2 in women based on the current guidelines. The physical and metal component summary scores on the SF36 were also included into the analysis. Sixty-two patients (15.1%) had the first incidence of CHEs. The three-year cumulative incidence rates of CHEs in patients with GS decrease or non-decrease were 24.51% and 12.44% (p = 0.0057). The three-year cumulative incidence rates of CHEs in patients with an SMI decrease or non-decrease were 19.65% and 12.99% (p = 0.0982). Multivariate analysis revealed that GS decrease (p = 0.0350) and prothrombin time (p = 0.0293) were significantly associated with the incidence of CHEs. In conclusion, GS can be an independent predictor for CHE development in patients with CLDs.

Download Full-text

Association between Sarcopenia and Depression in Patients with Chronic Liver Diseases

Journal of Clinical Medicine ◽

10.3390/jcm8050634 ◽

2019 ◽

Vol 8 (5) ◽

pp. 634 ◽

Cited By ~ 4

Author(s):

Hiroki Nishikawa ◽

Hirayuki Enomoto ◽

Kazunori Yoh ◽

Yoshinori Iwata ◽

Yoshiyuki Sakai ◽

...

Keyword(s):

Liver Diseases ◽

Independent Predictor ◽

Univariate Analysis ◽

Chronic Liver ◽

Chronic Liver Diseases ◽

Average Standard Deviation ◽

Factors Associated ◽

Group A ◽

Group B ◽

Group D

Association between sarcopenia, as evaluated by grip strength (GS) and skeletal muscle mass (SMM), and depression, as evaluated by Beck Depression Inventory-2nd edition (BDI-II) in chronic liver diseases (CLDs, n = 414, average age = 61.5 years), was investigated. Study subjects were classified into four groups: Group A (n = 60), lower GS and lower SMM (sarcopenia); group B (n = 44), lower GS and higher SMM; group C (n = 100), higher GS and lower SMM; group D (n = 210), higher GS and higher SMM. Factors associated with BDI-II score ≥11 were examined. BDI-II score 0–10 (normal) was found in 284 (68.6%), 11–16 (minimal) in 76 (18.4%), 17–20 (mild) in 24 (5.8%), 21–30 (moderate) in 15 (3.6%), and ≥31 (severe) in 15 (3.6%). The average ± standard deviation BDI-II score in liver cirrhosis (LC) patients (10.2 ± 9.6, n = 152) was significantly higher than that in non-LC patients (7.4 ± 7.2, n = 262) (p = 0.0058). Univariate analysis identified three factors to be significantly associated with BDI-I score ≥11: Our classification (groups of A, B, C, and D) (p = 0.0259), serum albumin (p = 0.0445), and the presence of LC (p = 0.0157). Multivariate analysis revealed that only group A (p = 0.0074, group D as a reference) was significant. In conclusion, sarcopenia can be an independent predictor for depression in CLDs.

Download Full-text

Immunosuppressive therapy in chronic liver diseases of type B with special reference to its effects on HBeAg/anti-HBe systems in serum and HBcAg in the liver.

Kanzo ◽

10.2957/kanzo.26.993 ◽

1985 ◽

Vol 26 (8) ◽

pp. 993-1003

Author(s):

Nobuyoshi YAMAMURA

Keyword(s):

Special Reference ◽

Immunosuppressive Therapy ◽

Liver Diseases ◽

Chronic Liver ◽

Type B ◽

Chronic Liver Diseases

Download Full-text

Frailty and Sleep Disorder in Chronic Liver Diseases

Life ◽

10.3390/life10080137 ◽

2020 ◽

Vol 10 (8) ◽

pp. 137

Author(s):

Hiroki Nishikawa ◽

Kazunori Yoh ◽

Hirayuki Enomoto ◽

Yoshinori Iwata ◽

Takashi Nishimura ◽

...

Keyword(s):

Sleep Quality ◽

Sleep Disorder ◽

Liver Diseases ◽

Body Weight Loss ◽

Japanese Version ◽

Chronic Liver ◽

Chronic Liver Diseases ◽

Sleep Complaints ◽

Slow Walking ◽

Slow Walking Speed

We aimed to investigate the association in frailty and sleep disorder as assessed by the Japanese version of Pittsburgh Sleep Quality Index (PSQI-J) in patients with chronic liver diseases (CLDs, n = 317, 141 males). Frailty was determined using the following five phenotypes: unintentional body weight loss, self-reported exhaustion, muscle weakness, slow walking speed, and low physical activity. Sleep disorder was defined as patients with PSQI-J score 6 or greater. Robust (phenotype, 0), prefrail (1 or 2 phenotypes) and frailty (3 phenotypes or greater) were observed in 101 (31.9%), 174 (54.9%) and 42 (13.2%), respectively. The median (interquartile range (IQR)) PSQI-J score was 4 (3, 7). Sleep disorder was found in 115 patients (36.3%). The median (IQR) PSQI-J scores in patients of the robust, prefrail, and frail groups were 3 (2, 5), 5 (3, 7), and 8 (4.75, 10.25), respectively (p < 0.0001 between any two groups and overall p < 0.0001). The ratios of sleep disorder in patients with robust, prefrail and frailty were 15.8% (16/101), 39.1% (68/174), and 73.8% (31/42), respectively (overall p < 0.0001). In conclusion, CLD patients with frailty can involve poorer sleep quality. As sleep disorder in CLDs is potentially remediable, future frailty-preventive strategies must take sleep complaints into account.

Download Full-text

Respiratory muscle strength and exercise capacity of children and adolescents with chronic liver diseases Exercise capacity in liver disease

Revista de Ciências Médicas e Biológicas ◽

10.9771/cmbio.v20i2.42775 ◽

2021 ◽

Vol 20 (2) ◽

pp. 321-326

Author(s):

Michelli Christina Magalhães Novais ◽

Mansueto Gomes Neto ◽

Yuri Da Silva Oliveira ◽

Tatiane De Souza Pereira ◽

Suzana Souza Moreira de Almeida ◽

...

Keyword(s):

Liver Disease ◽

Muscle Strength ◽

Children And Adolescents ◽

Exercise Capacity ◽

Liver Diseases ◽

Respiratory Muscle ◽

Chronic Liver ◽

Wilcoxon Test ◽

Respiratory Muscle Strength ◽

Chronic Liver Diseases

Introdution: Chronic liver diseases are characterized by inflammatory and fibrotic lesions of the liver that cause systemic complications. These complications can negatively interfere with the respiratory muscle strength and exercise capacity of developing children and adolescents. Objectives: To compare respiratory muscle strength and exercise capacity in children and adolescents with chronic hepatopathy, using reference values from healthy individuals of the same age. Methods: A cross-sectional study was performed. Children and adolescents from 6 to 16 years old with chronic hepatopathies were included. For the evaluation of respiratory muscle strength, the maximal respiratory pressures were measured through manovacuometry. A six-minute walk test was used to assess exercise capacity. The Wilcoxon test was used to verify the difference between the evaluated and predicted values of the distance traveled. Results: In total, 40 subjects were analyzed; 57.5% of the subjects were female, and the subjects had a mean age of 11.68±2.82 years. In the comparison between the measured and predicted maximal respiratory pressures, a difference of -17.71 cmH2O (p< 0.001) was found for the maximal inspiratory pressure, and a difference of -30.68 cmH2O (p< 0.001) was found for the maximal expiratory pressure. Regarding exercise capacity, the measured average distance traveled was 346.46±49.21 m, which was 185.54m (p< 0.001) less than the predicted value. Conclusions: Children and adolescents with chronic liver disease have reduced respiratory muscle function and exercise capacity.

Download Full-text