Journal of Clinical Research & Bioethics

Abstract

Evaluating Sarcopenia in Liver Disease: Assessment of Skeletal Muscle Mass by Computed Tomography is not Related to MASLD by Liver Biopsy

Carine Luíze Panke, Gabriela Perdomo Coral, Fábio Kunihiro Maeda, Eiji Suwa, Angelo Alves de Mattos, Cristiane Valle Tovo and Luis Fernando Ferreira*

Background: The relationship between sarcopenia and Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) has been widely studied. However, there are still a lack in the knowledge about the best tools to asses sarcopenia in MASLD patients, and what cut-off points for the diagnosis criteria for sarcopenia are suitable for this population.

Objective: T o com par e the Sk ele t al Muscle Mass (SMM) assessed b y Com put ed T omogr aph y (CT) in patients with MASLD assessed by Liver Biopsy (LB). Methods: Cross-sectional study with patients attended at the outpatient clinic in a tertiary hospital of southern Brazil. Were included individual aged >18 years, with MASLD confirmed by LB. The SMM was assessed by the quantification of the transverse area of the third lumbar vertebra (L3) in the CT. The results were analyzed using the test Anova one-way.

Results: 66 patients were included, and analyzed in groups by the level of fibrosis by LB. The mean age was 58.75 years, and most were women (77%; n=51). There was significant difference in diabetes, weight, abdominal circumference, AST levels, bilirubin, LDL cholesterol, all increasing according the level of fibrosis. The SMM were also higher, according to the level of fibrosis, being 46.61+7.28 cm²/m² in F0; 46.30+6.8 in F1; 45.34+11.09 in F2; 55.08+15.97 in F3 and; 50.2+9.09 in F4, although without a difference statistically significant (p=0.172).

Discussion: The CT assess only a transverse area of one muscle, and it has been debated if it represents well the whole-body SMM. Also, the CT is evaluator-dependent, which can lead to analyzing bias.

Conclusion: For this sample, the SMM assessment by CT do not showed difference, and the SMM increasing with worst fibrosis diagnosis go against the state-of-the-art in sarcopenia assessment. Further studies are necessary comparing SMM assessment specifically for liver patients.

Published Date: 2023-12-14; Received Date: 2023-11-12