Determination of the frequency of sarcopenia in patients with liver cirrhosis by radiological imaging and research its relationship with metabolic markers

Various nutritional disorders are seen in patients with liver cirrhosis. Studies have shown that the frequency of malnutrition and sarcopenia is increased in patients with cirrhosis. In this study; we investigated the frequency of sarcopenia in patients with liver cirrhosis. Also, the relationship between sarcopenia and vitamin D level, somatomedin c (IGF-1), gender, stage of cirrhosis and its complications were investigated. 60 patients with liver cirrhosis between the ages of 18-80 who applied to the gastroenterology policlinic of Fırat University Medical Faculty Hospital between November 2019 and October 2020 were included in this prospective study. Patients were diagnosed with typical laboratory, clinical and imaging findings of cirrhosis. The surface areas of the skeletal muscles at the L3 caudal end were measured in abdominal CT images taken for HCC scanning or at the admission to the organ transplant unit. It was normalized by the square of the length (m2) to obtain the skeletal muscle index (SMI). Diagnostic criteria have been derived from oncology populations. Sarcopenia defined as L3 SMI is <38.5 cm2/m2 in women and <52.4 cm2/m2 in men (89). In this study, 23 (38.3%) of the patients had extremely low vitamin D levels. Vitamin D was found to be low in 21 (35%) patients, insufficent in 13 (21.7%) and sufficient in 3 (5%) patients. No significant difference was found between patients with and without sarcopenia in terms of vitamin D and IGF-1 (p> 0.05). There was no significant difference in Child-Pugh scores between patients with and without sarcopenia (p> 0.05). Although the presence of acid in sarcopenic patients was higher than in non-sarcopenic patients, there was no significant difference (p = 0.528). A significant positive correlation was found between SMI and vitamin D, IGF-1, albumin and hemoglobin (Hb). In this study, 39 (65%) of the patients had sarcopenia and it was shown that the frequency of sarcopenia increased. Similar to complications such as esophageal varices, ascites, hepatocellular carcinoma, patients with cirrhosis should also be screened for sarcopenia. Key Words: liver cirrhosis, malnutrition, sarcopenia, vitamin D, İGF-1, Skeletal Muscle İndex