The Journal of the Association of Physicians of India · 2025
The Utility of Psoas Muscle Index for the Detection of Sarcopenia and its Association with Severity of Alcoholic Liver Cirrhosis: Western India Perspective.
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Pandya Karan J, Pathak Jaya M, Judal Hitesh P, Patel Arushi M
Аннотация
INTRODUCTION: Alcoholic liver cirrhosis (LC) is a severe condition that can lead to malnutrition and negatively impact a person's quality of life. Malnutrition can also increase the risk of functional impairment, mortality, and poor response to stressors like infections and surgeries. Addressing malnutrition in these patients is essential for improving their health outcomes and overall well-being. Current prognostic scoring systems do not consider malnutrition, and sarcopenia is a refractory complication associated with alcoholic LC.
MATERIALS AND METHODS: The study aimed to quantify sarcopenia using the psoas muscle index (PMI) determined by computed tomography-guided imaging of the abdomen and associate it with the severity of cirrhosis and correlate it with the Child-Pugh score. The study included 50 alcoholic patients with the clinical-radiological diagnosis of cirrhosis and was stratified based on the Child-Pugh score. Computed tomography (CT) scans were used to calculate the PMI at the level of the third lumbar vertebra with cutoff values of <3.64 cm2/m2 in females and <4.25 cm2/m2 in males. Male patients were recruited due to cultural differences in alcohol consumption in Western India.
RESULTS: The prevalence of sarcopenia in the study was 50%, with the maximum number of patients falling in Child-Pugh score C (43/50 patients). The study found a strong negative correlation (r = -0.63) between high Child-Pugh class and lower PMI (p < 0.001, CI = 95%), while low PMI values were moderately associated with the occurrence of hepatic encephalopathy (r = -0.48; p < 0.001, CI: 95%). The study inferred that poor outcomes in alcoholic LC and its fatal neurological complications were attributed to loss of muscle mass (sarcopenia) and higher Child-Pugh scores.
CONCLUSION: In conclusion, malnutrition is a serious complication associated with alcoholic LC, and addressing it is critical for improving patients' morbidity and prognosis. The study quantified sarcopenia using the PMI and associated it with the severity of cirrhosis (Child-Pugh score) and its complication (hepatic encephalopathy). The study found a negative correlation between high Child-Pugh class and lower PMI and inferred poor outcomes in alcoholic LC attributed to sarcopenia and higher Child-Pugh scores.
MATERIALS AND METHODS: The study aimed to quantify sarcopenia using the psoas muscle index (PMI) determined by computed tomography-guided imaging of the abdomen and associate it with the severity of cirrhosis and correlate it with the Child-Pugh score. The study included 50 alcoholic patients with the clinical-radiological diagnosis of cirrhosis and was stratified based on the Child-Pugh score. Computed tomography (CT) scans were used to calculate the PMI at the level of the third lumbar vertebra with cutoff values of <3.64 cm2/m2 in females and <4.25 cm2/m2 in males. Male patients were recruited due to cultural differences in alcohol consumption in Western India.
RESULTS: The prevalence of sarcopenia in the study was 50%, with the maximum number of patients falling in Child-Pugh score C (43/50 patients). The study found a strong negative correlation (r = -0.63) between high Child-Pugh class and lower PMI (p < 0.001, CI = 95%), while low PMI values were moderately associated with the occurrence of hepatic encephalopathy (r = -0.48; p < 0.001, CI: 95%). The study inferred that poor outcomes in alcoholic LC and its fatal neurological complications were attributed to loss of muscle mass (sarcopenia) and higher Child-Pugh scores.
CONCLUSION: In conclusion, malnutrition is a serious complication associated with alcoholic LC, and addressing it is critical for improving patients' morbidity and prognosis. The study quantified sarcopenia using the PMI and associated it with the severity of cirrhosis (Child-Pugh score) and its complication (hepatic encephalopathy). The study found a negative correlation between high Child-Pugh class and lower PMI and inferred poor outcomes in alcoholic LC attributed to sarcopenia and higher Child-Pugh scores.