Liver cirrhosis is considered to be a risk factor for the loss of muscle mass, which is associated with numerous adverse health outcomes. In the current study, Ohnishi et al aimed to investigate the interrelationship of liver fibrosis with loss of skeletal muscle mass (SM) in older adults without any history of liver diseases.

The study enrolled a total of 2,028 older adults with a mean age of 69.8 ± 5.2 years, who had no past history of any treatment for liver diseases. Bioelectrical impedance analysis was performed to determine the SM of the whole body including the arms, legs, and trunk of the subjects. The Fib4 index based on the subjects age, AST level, ALT level, and platelet counts was used to assess liver fibrosis in these patients.

The outcome showed that the participants were categorized into three groups, according to cutoff values of the Fib4 index; low: <1.30, medium: 1.30-2.66, high: ≥2.67. Moreover, the SM index measured as kg/m2 was the lowest among these patients in the high-Fib4-index category, followed by the medium- and low-Fib4-index categories. After analysis, it was perceived that this dose-response decrease in the SM index was more significant among individuals with lower blood albumin level and  with more sedentary behavior. Out of the total selected 262 subjects who underwent SM measurement twice with an interval of 3 years, the patients with a high Fib4 index reported more decrease in the SM index in comparison to those with medium and low Fib4 indices. In addition, it was seen that Fib4 index was strongly linked with the SM index, irrespective of age, sex, albumin level, sedentary behavior, diabetes mellitus, alcohol intake, and smoking status.

Thus, based on the above observations, it is evident that the excessive loss of SM can be coorelated with the advancement of liver fibrosis in older patients even without any history of past treatment for liver diseases.

Source:Ohnishi S, Miyai N, Utsumi M, et al. Liver Fibrosis is Associated with Loss of Skeletal Muscle Mass in Community-Dwelling Older Adults with No History of Liver Diseases. Nihon Eiseigaku Zasshi. 2019;74(0):10.1265/jjh.18031.