Lower values of handgrip strength and adductor pollicis muscle thickness are associated with hepatic encephalopathy manifestations in cirrhotic patients

Author(s):Show less -

Augusti, L. ^[1] ; Franzoni, L. C. ^[1] ; Santos, L. A. A. ^[1] ; Lima, T. B. ^[1] ; Ietsugu, M. V. ^[1] ; Koga, K. H. ^[2] ; Moriguchi, S. M. ^[2] ; Betting, L. E. ^[3] ; Caramori, C. A. ^[1] ; Silva, G. F. ^[1] ; Romeiro, F. G. ^[1]

Affiliation

^[1] UNESP Univ Estadual Paulista, Botucatu Med Sch, Dept Internal Med, Ave Prof Mario Rubens Guimaraes Montenegro S-N, BR-18618687 Sao Paulo - Brazil

^[2] UNESP Univ Estadual Paulista, Botucatu Med Sch, Dept Trop Dis & Imaging Diag, Botucatu, SP - Brazil

^[3] UNESP Univ Estadual Paulista, Botucatu Med Sch, Dept Neurol Psychol & Psychiat, Botucatu, SP - Brazil

• Document type: Journal article
• Source: METABOLIC BRAIN DISEASE; v. 31, n. 4, p. 909-915, AUG 2016.
• Web of Science Citations: 6

Abstract

Hepatic encephalopathy (HE) is a late complication of liver cirrhosis and is clearly associated with poor outcomes. Chronic liver insufficiency leads to progressive muscle wasting, impairing ammonia metabolism and thus increasing the risk for HE. Given the association between lean mass and adductor pollicis muscle thickness (APMT), it has been used to predict outcome and complications in many conditions, but not yet in cirrhotic patients. Therefore, this article aimed to study the association between HE manifestations and measures related to muscle mass and strength. This cross-sectional study included 54 cirrhotic outpatients with HE varying from subclinical to grade II according to the West-Haven criteria, who were submitted to neuropsychometric tests, electroencephalogram, brain Single Photon Emission Computed Tomography (SPECT), anthropometric measurements, handgrip strength (HGS) and dual energy X-ray absorptiometry exam (DXA). Multiple logistic regression analysis was performed to investigate the association between body composition measures and HE grade. Analysis of the area under the receiver operator characteristic (AUROC) curve revealed the values related to neurological manifestations (HE grades I and II). Reductions in APMT and HGS were associated with higher HE grades, suggesting a big impact caused by the loss of muscle mass and function on HE severity. The link between HE manifestations and anthropometric measures, namely APMT and HGS, point to a significant relation concerning skeletal muscles and the neurological impairment in this population. (AU)

• FAPESP's process: 13/15121-8 - The effects of leucine versus isoleucine in the treatment of hepatic encephalopathy, according to the nutritional status of cirrhotic patients: a randomized, double blind controlled trial
• Grantee: Lais Augusti
• Support Opportunities: Scholarships in Brazil - Master
• FAPESP's process: 13/11761-2 - Effect of isolated branched chain amino acids in the serum pH and cerebral blood flow of cirrhotic patients: a randomized, double blind controlled trial
• Grantee: Fernando Gomes Romeiro
• Support Opportunities: Regular Research Grants