Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access
Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc
Journal website http://www.jocmr.org

Original Article

Volume 10, Number 12, December 2018, pages 920-927


Relationship Between Sarcopenia and Both Physical Activity and Lifestyle in Patients With Chronic Liver Disease

Figure

Figure 1.
Figure 1. ROC analysis. (a) age; (b) body mass index; (c) physical activity; (d) total time of sitting and lying on the day. AUC: area under the curve; CI: confidence interval; BMI: body mass index.

Tables

Table 1. Comparison of the Two Groups With and Without Sarcopenia
 
All patients (n = 214)Sarcopenia (n = 27)Non-sarcopenia (n = 187)P value
Data were expressed as means ± standard deviation or as median (interquartile range) or as n (%). P < 0.05 was considered significant. Categorical variables were compared by Fisher’s exact test and continuous variables were compared by Student’s t-tests or Mann-Whitney U test. BMI, body mass index.
Age (years)68.17 ± 11.1776.48 ± 6.6966.97 ± 11.19< 0.01
Sex, male (%)122 (57%)13 (48.1%)109 (58.3%)0.41
BMI (kg/m2)23.4 ± 3.720.8 ± 2.423.8 ± 3.7< 0.01
Etiology of liver disease (%)< 0.01
  Hepatitis B54 (25.2%)1 (3.7%)54 (29%)
  Hepatitis C78 (36.4%)12 (44.4%)68 (36%)
  Alcoholic hepatitis25 (11.7%)6 (22.2%)19 (10.2%)
  Non-alcoholic steatohepatitis28 (13.1%)2 (7.4%)26 (13.9%)
  Autoimmune hepatitis1 (0.5%)01 (0.5%)
  Primary biliary cirrhosis6 (2.8%)06 (3.2%)
  Others22 (10.3%)6 (22.2%)16 (8.6%)
Hepatocellular carcinoma, yes (%)55 (25.7%)10 (37%)45 (24.1%)0.16
ALBI-grade (%)0.03
  1168 (78.5%)16 (64%)152 (81.3%)
  245 (21%)9 (36%)34 (18.2%)
  31 (0.5%)01 (0.5%)
Branched chain amino acids, yes (%)84 (39.3%)15 (60%)72 (38%)0.09
Physical activity (METs-h/week)15.55 (6.6 - 34.46)6.6 (2.34 - 19.90)16.50 (6.6 - 41.23)< 0.01
Total time sitting and lying (h/day)5.90 ± 3.347.43 ± 4.095.68 ± 3.170.01
Living alone, yes (%)40 (18.7%)7 (25.9%)33 (17.6%)0.29
Currently smoking, yes (%)35 (16.4%)1 (3.7%)34 (18.2%)0.09
Currently drinking, yes (%)43 (20.1%)5 (18.5%)38 (20.3%)> 0.99
Driving of cars (%)172 (80.4%)17 (63.0%)155 (82.9%)0.02
Employment status, retired (%)112 (52.3%)22 (81.5%)90 (48.1%)< 0.01
Do home tasks, yes (%)121 (56.5%)20 (74.1%)101 (54%)0.06
Healthy eating, yes (%)185 (86.4%)25 (92.6%)160 (85.6%)0.54
Exercise habits, yes (%)151 (70.6%)19 (70.4%)132 (70.6%)> 0.99

 

Table 2. Comparison of Biochemical Measurements
 
VariableSarcopenia (n = 27)Non-sarcopenia (n = 187)P value
Data were expressed as median (interquartile range) or as n (%). P < 0.05 was considered significant. Categorical variables were compared by Fisher’s exact test and continuous variables were compared by Mann-Whitney U test. Alb: serum albumin; ALP: alkaline phosphatase; ALT: alanine transaminase; AST: aspartate aminotransferase; BUN: blood urea nitrogen; CK: creatine kinase; Cre: creatinine; ChE: cholinesterase; eGFR: estimated glomerular filtration rate; Hb: hemoglobin; HbA1c: hemogobinA1c; AFP: α-fetoprotein; K: potassium; Na: sodium; PT-INR: prothrombin time-international normalized ratio; T-bil: total bilirubin; T-cho: total cholesterol; TP: total protein; TG: triglyceride; RBC: red blood cell count; WBC: white blood cell count; TLC: total lymphocyte count; Plt: platelet count; CONUT-score: controlling nutritional status index score; Fib4-index: fibrosis 4 index.
Alb (g/dL)3.9 (3.4 - 4.3)4.2 (4.0 - 4.45)< 0.01
ALP (U/L)254.0 (197.5 - 353.5)245.0 (197.0 - 323.8)0.68
ALT (U/L)13.0 (10.5 - 18.0)18.0 (14.0 - 26.0)0.01
AST (U/L)23.0 (18.5 - 36.0)26.0 (22.0 - 32.0)0.38
BUN (mg/dL)17.2 (13.4 - 22.1)15.1 (13.0 - 17.3)0.05
CK (U/L)88.0 (59.0 - 109.50)102.5 (77.0 - 159.5)0.01
Cre (mg/dL)0.72 (0.51 - 0.92)0.72 (0.59 - 0.82)0.92
ChE (U/L)228.0 (173.0 - 301.5)289.5 (244.0 - 356.8)< 0.01
eGFR (mL/m/1.73 m2)68.8 (59.0 - 87.1)74.8 (66.3 - 86.6)0.23
Hb (g/dL)12.4 (11.2 - 13.4)13.5 (12.6 - 14.7)< 0.01
HbA1c (%)5.8 (5.4 - 6.3)5.80 (5.5 - 6.2)0.79
AFP (ng/mL)3.30 (2.3 - 4.3)3.10 (2.1 - 4.7)0.62
K (mmol)4.1 (3.9 - 4.4)4.09 (4.0 - 4.3)0.56
Na (mmol)141.0 (138.5 - 142.0)140.00 (139.00 - 142.00)0.49
PT-INR1.02 (0.97 - 1.05)1.00 (0.97 - 1.05)0.87
T-bil (mg/dL)0.52 (0.42 - 0.71)0.65 (0.49 - 0.80)0.02
T-cho (mg/dL)181.0 (167.5 - 203.0)174.0 (157.5 - 199.0)0.26
TP (g/dL)7.5 (6.9 - 7.7)7.4 (7.1 - 7.7)0.94
TG (mg/dL)102.0 (76.5 - 141.5)90.5 (65.0 - 130.5)0.36
RBC (× 104/µL)400.0 (371.5 - 437.5)437.0 (405.0 - 477.5)< 0.01
WBC (× 102/µL)54.0 (40.0 - 64.0)53.0 (42.0 - 64. 0)0.67
TLC1,361.1 (930.6 - 1,626.1)1,522.80 (1,160.8 - 2,136.70)< 0.01
Plt (× 104)18.10 (11.7 - 21.3)19.30 (15.9 - 24.2)0.11
CONUT-score2.0 (1.5 - 4.0)1.0 (1.0 - 2.5)0.02
CONUT-grade0.01
  Normal7 (25.9%)99 (52.9%)
  Light16 (59.3%)80 (42.8%)
  Moderate4 (14.8%)7 (3.7%)
  Severe malnutrition0 (0%)1 (0.5%)
Fib4-index2.7 (2.0 - 4.9)2.1 (1.6 - 3.0)< 0.01

 

Table 3. Logistic Regression Analysis of Variables Associated With Sarcopenia
 
VariableUnivariate analysisMultivariate analysis
OR95% CIP valueOR95% CIP value
Data were analyzed by logistic regression analysis model. OR: odds ratio; CI: confidence interval; BMI: body mass index.
Age (≥ 71/< 71 years)5.422.00 - 17.22< 0.015.892.15 - 16.20< 0.01
Employment status (retired/employed)4.221.52 - 11.70< 0.01
BMI (< 22.2/≥ 22.2)3.911.56 - 1048< 0.014.771.87 - 12.10< 0.01
Low frequency of driving (yes/no)2.831.06 - 7.280.02
Physical activity (< 10.2/≥ 10.2)3.401.38 - 8.85.< 0.013.652.15 - 16.20< 0.01
Total time sitting and lying (≥ 8/< 8)2.671.07 - 6.630.02