Impact of sarcopenia on clinical outcomes in pediatric chronic liver disease post-liver transplantation: prevalence and implications Sarcopenia in Pediatric with Chronic Liver Disease
Gastroenterology and Hepatology from Bed to Bench,
Vol. 17 No. 2 (2024),
14 April 2024
https://doi.org/10.22037/ghfbb.v17i2.2908
Abstract
Aim: The purpose of this retrospective single-center study was to determine the frequency of sarcopenia and its association with mortality and other morbidities in children with chronic liver disease who had undergone liver transplantation.
Background: Sarcopenia, a muscle-wasting syndrome, is common in patients with advanced liver disease and is associated with increased morbidity and mortality. While sarcopenia in adults has been extensively studied, there is little information in this regard about children and adolescents with chronic liver diseases.
Methods: The study included 108 children and adolescents who had undergone liver transplantation. Sarcopenia was measured using skeletal muscle index at the third lumbar vertebral level and assessed using abdominal computed tomography imaging.
Results: The frequency of sarcopenia in the studied population was found to be 45.7%. Patients with sarcopenia were more likely to be male (P<0.0001), older (P<0.0001), and had lower height-for-age z-scores (P=0.012). Genetic/metabolic diseases were the most common underlying cause of sarcopenia in children. Except for a higher rate of transplant rejection in the sarcopenia group (P=0.035), there was no significant difference in mortality rates (P=0.688) or post-LT complications between the two groups. One year after LT, computed tomography-derived body composition parameters revealed no significant differences between children who survived and those who did not.
Conclusion: Our findings indicated a high frequency of sarcopenia in children with chronic liver disease, implying that more research is needed to better understand its impact on clinical outcomes in this population.
- chronic liver disease
- Liver transplant
- Sarcopenia
- Pediatric
How to Cite
References
Ooi PH, Hager A, Mazurak VC, Dajani K, Bhargava R, Gilmour SM, et al. Sarcopenia in Chronic Liver Disease: Impact on Outcomes. Liver Transpl. 2019;25(9):1422-38.
Dhaliwal A, Armstrong MJ. Sarcopenia in cirrhosis: A practical overview. Clin Med (Lond). 2020;20(5):489-92.
Fox R, Stenning K, Slee A, Macnaughtan J, Davies N. Sarcopenia in liver cirrhosis: Prevalence, pathophysiology and therapeutic strategies. Anal Biochem. 2022;647:114581.
Dasarathy S, Merli M. Sarcopenia from mechanism to diagnosis and treatment in liver disease. J Hepatol. 2016;65(6):1232-44.
Shen W, Punyanitya M, Wang Z, Gallagher D, St-Onge MP, Albu J, et al. Total body skeletal muscle and adipose tissue volumes: estimation from a single abdominal cross-sectional image. J Appl Physiol (1985). 2004;97(6):2333-8.
Ebadi M, Wang CW, Lai JC, Dasarathy S, Kappus MR, Dunn MA, et al. Poor performance of psoas muscle index for identification of patients with higher waitlist mortality risk in cirrhosis. J Cachexia Sarcopenia Muscle. 2018;9(6):1053-62.
Ebadi M, Bhanji RA, Mazurak VC, Montano-Loza AJ. Sarcopenia in cirrhosis: from pathogenesis to interventions. J Gastroenterol. 2019;54(10):845-59.
Kim G, Kang SH, Kim MY, Baik SK. Prognostic value of sarcopenia in patients with liver cirrhosis: A systematic review and meta-analysis. PLoS One. 2017;12(10):e0186990.
Grutters LA, Pennings JP, Bruggink JLM, Viddeleer AR, Verkade HJ, de Kleine RHJ, et al. Body Composition of Infants With Biliary Atresia: Anthropometric Measurements and Computed Tomography-based Body Metrics. J Pediatr Gastroenterol Nutr. 2020;71(4):440-5.
Chen C, Ayers M, Squires JH, Squires JE. Perspectives on Sarcopenia as a Predictor for Outcomes in Pediatric Patients with Chronic Liver Disease. Hepat Med. 2022;14:173-83.
Yodoshi T, Orkin S, Romantic E, Hitchcock K, Clachar AA, Bramlage K, et al. Impedance-based measures of muscle mass can be used to predict severity of hepatic steatosis in pediatric nonalcoholic fatty liver disease. Nutrition. 2021;91-92:111447.
Somasundaram E, Castiglione JA, Brady SL, Trout AT. Defining Normal Ranges of Skeletal Muscle Area and Skeletal Muscle Index in Children on CT Using an Automated Deep Learning Pipeline: Implications for Sarcopenia Diagnosis. AJR Am J Roentgenol. 2022;219(2):326-36.
Woolfson JP, Perez M, Chavhan GB, Johara FT, Lurz E, Kamath BM, et al. Sarcopenia in Children With End-Stage Liver Disease on the Transplant Waiting List. Liver Transpl. 2021;27(5):641-51.
Veraldi S, Pietrobattista A, Soglia G, Monti L, Alterio T, Mosca A, et al. Sarcopenia in children with chronic liver disease: Prevalence and impact on liver transplant outcomes. Frontiers in Pediatrics. 2022;10.
Ooi PH, Mazurak VC, Bhargava R, Dunichand-Hoedl A, Ayala Romero R, Gilmour SM, et al. Myopenia and Reduced Subcutaneous Adiposity in Children With Liver Disease Are Associated With Adverse Outcomes. JPEN J Parenter Enteral Nutr. 2021;45(5):961-72.
Mager DR, Hager A, Ooi PH, Siminoski K, Gilmour SM, Yap JYK. Persistence of Sarcopenia After Pediatric Liver Transplantation Is Associated With Poorer Growth and Recurrent Hospital Admissions. JPEN J Parenter Enteral Nutr. 2019;43(2):271-80.
Amevor AA, Yodoshi T, Trout AT, Dillman JR, Singh R, Jarvis R, et al. Sarcopenia is highly prevalent in children with autoimmune liver diseases and is linked to visceral fat and parent-perceived general health. Liver Int. 2022;42(2):394-401.
Sharif A, Vaid D, McGuirk S, Mears J, Gupte G. L5 Sarcopenia in children with liver disease: a pilot study. British Medical Journal Publishing Group; 2022.
Jitwongwai S, Lertudomphonwanit C, Junhasavasdikul T, Fuangfa P, Tanpowpong P, Gesprasert G, et al. Low psoas muscle index as an unfavorable factor in children with end-stage liver disease undergoing liver transplantation. Pediatr Transplant. 2021;25(5):e13996.
Takeda M, Sakamoto S, Uchida H, Shimizu S, Yanagi Y, Fukuda A, et al. Impact of sarcopenia in infants with liver transplantation for biliary atresia. Pediatr Transplant. 2021;25(5):e13950.
Boster JM, Browne LP, Pan Z, Zhou W, Ehrlich PF, Sundaram SS. Higher Mortality in Pediatric Liver Transplant Candidates With Sarcopenia. Liver Transpl. 2021;27(6):808-17.
Mangus RS, Bush WJ, Miller C, Kubal CA. Severe Sarcopenia and Increased Fat Stores in Pediatric Patients With Liver, Kidney, or Intestine Failure. J Pediatr Gastroenterol Nutr. 2017;65(5):579-83.
Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyère O, Cederholm T, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019;48(1):16-31.
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