Association of ultrasound-derived muscle parameters and liver stiffness with low muscle mass in patients with cirrhosis.

OBJECTIVE

To explore the application value of high-frequency ultrasound combined with two-dimensional shear wave elastography (2D-SWE) in diagnosing low muscle mass in patients with cirrhosis.

METHODS

A total of 135 patients with cirrhosis were enrolled in this study. Participants were categorized into a Cirrhosis group (n = 77) and a CRS group (n = 58) based on the Arm Skeletal Muscle Index (ASMI). Concurrently, 66 age- and sex-matched healthy individuals were recruited as the normal control (NC) group. Analyzed the general characteristics and biochemical parameters of each group, comparing liver elastic modulus (LEM) alongside muscle thickness (MT) and shear wave velocity (SWV) in the right biceps brachii, rectus femoris, and medial head of the gastrocnemius.

RESULTS

Compared with the NC and cirrhosis groups, the CRS group showed lower MT and muscle SWV, but higher LEM (p < 0.05). Pearson correlation analysis showed that ASMI was positively correlated with body mass index (BMI), serum albumin levels, MT, and muscle SWV and negatively correlated with age, total bilirubin, LEM, and international normalized ratio (INR) (all p < 0.05). Stepwise logistic regression identified MG-SWV, RF-MT, and LEM as factors independently associated with CRS (all p < 0.05). The receiver operating characteristic curve (AUC) for CRS revealed the following. Muscle SWV: 0.760-0.820, MT: 0.782-0.878, LEM alone: 0.760, Combined application of muscle parameters and LEM: 0.919 (sensitivity 90.57%, specificity 83.13%) (all p < 0.05). The AUC for the combined use of muscle parameters and LEM significantly outperformed that of any single parameter, demonstrating superior diagnostic performance.

CONCLUSION

Ultrasound measurement of LEM, MT, and muscle SWV offers an effective diagnostic approach for CRS. The combined assessment of muscle parameters with LEM demonstrates enhanced diagnostic accuracy compared to any single parameter.