Wasting Away with Cirrhosis: A Review of Hepatic Sarcopenia
Main Article Content
Keywords
sarcopenia, cirrhosis, wasting, end-stage liver disease, muscle
Abstract
The complications of decompensated cirrhosis are well documented and include variceal bleeding, fluid retention, and hepatic encephalopathy. A less well recognized complication of cirrhosis is muscle wasting or sarcopenia. It is now recognized to have a significant impact on patient survival, especially in patients who are awaiting liver transplantation. An understanding of the pathophysiology of muscle protein homeostasis has led to several proposed mechanisms of sarcopenia and the potential to reverse muscle loss. This review discusses the potential mechanisms of sarcopenia and highlights the possible future means of reversing sarcopenia.
References
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11. Nishikawa H, Enomoto H, Ishii A, Iwata Y, Miyamoto Y, Ishii N, et al. Elevated serum myostatin level is associated with worse survival in patients with liver cirrhosis. J Cachexia Sarcopenia Muscle. 2017;8(6):915–25. https://doi.org/10.1002/jcsm.12212
12. Kumar A, Davuluri G, Silva R, Engelen M, Ten Have G, Prayson R, et al. Ammonia lowering reverses sarcopenia of cirrhosis by restoring skeletal muscle proteostasis. Hepatology. 2017;65(6):2045–58. https://doi.org/10.1002/hep.29107
13. Davuluri G, Krokowski D, Guan B, Kumar A, Thapaliya S, Singh D, et al. Metabolic adaptation of skeletal muscle to hyperammonemia drives the beneficial effects of l-leucine in cirrhosis. J Hepatol. 2016;65(5):929–37. https://doi.org/10.1016/j.jhep.2016.06.004
14. Dasarathy S, Hatzoglou M. Hyperammonemia and proteostasis in cirrhosis. Curr Opin Clin Nutr Metab Care. 2018;21(1):30–6. https://doi.org/10.1097/MCO.0000000000000426
15. Anda S, Zach R, Grallert B. Activation of Gcn2 in response to different stresses. PLoS One. 2017;12(8):e0182143 https://doi.org/10.1371/journal.pone.0182143
16. Glass C, Hipskind P, Tsien C, Malin S, Kasumov T, Shah S, et al. Sarcopenia and a physiologically low respiratory quotient in patients with cirrhosis: A prospective controlled study. J Appl Physiol. 2013;114(5):559–65. https://doi.org/10.1152/japplphysiol.01042.2012
17. Breuillard C, Cynober L, Moinard C. Citrulline and nitrogen homeostasis: An overview. Amino Acids. 2015;47(4):685–91. https://doi.org/10.1007/s00726-015-1932-2
18. Liu W, Thomas S, Asa S, Gonzalez-Cadavid N, Bhasin S, Ezzat S. Myostatin is a skeletal muscle target of growth hormone anabolic action. J Clin Endocrinol Metabol. 2003;88(11):5490–6. https://doi.org/10.1210/jc.2003-030497
19. Lakshman K, Bhasin S, Corcoran C, Collins-Racie L, Tchistiakova L, Forlow S, et al. Measurement of myostatin concentrations in human serum: Circulating concentrations in young and older men and effects of testosterone administration. Mol Cell Endocrinol. 2009;302(1):26–32. https://doi.org/10.1016/j.mce.2008.12.019
20. Handelsman D, Strasser S, McDonald J, Conway A, McCaughan G. Hypothalamic-pituitary-testicular function in end-stage non-alcoholic liver disease before and after liver transplantation. Clin Endocrinol. 1995;43(3):331–7. https://doi.org/10.1111/j.1365-2265.1995.tb02040.x
21. Dasarathy S, Mullen K, Dodig M, Donofrio B, McCullough A. Inhibition of aromatase improves nutritional status following portacaval anastomosis in male rats. J Hepatol. 2006;45(2):214–20. https://doi.org/10.1016/j.jhep.2006.02.016
22. Lang C, Frost R, Nairn A, MacLean D, Vary T. TNF-? impairs heart and skeletal muscle protein synthesis by altering translation initiation. Am J Physiol Endocrinol Metabol. 2002;282(2): E336–47. https://doi.org/10.1152/ajpendo.00366.2001
23. Keller C, Fokken C, Turville S, Lünemann A, Schmidt J, Münz C, et al. TNF-? induces macroautophagy and regulates MHC class ii expression in human skeletal muscle cells. J Biol Chem. 2010;286(5):3970–80. https://doi.org/10.1074/jbc.M110.159392
24. Fernández-Celemín L, Pasko N, Blomart V, Thissen J. Inhibition of muscle insulin-like growth factor I expression by tumor necrosis factor-?. Am J Physiology Endocrinol Metabol. 2002;283(6): E1279–90. https://doi.org/10.1152/ajpendo.00054.2002
25. Peng S, Plank L, McCall J, Gillanders L, McIlroy K, Gane E. Body composition, muscle function, and energy expenditure in patients with liver cirrhosis: A comprehensive study. Am J Clin Nutr. 2007;85(5):1257–66. https://doi.org/10.1093/ajcn/85.5.1257
26. Prado C, Lieffers J, McCargar L, Reiman T, Sawyer M, Martin L, et al. Prevalence and clinical implications of sarcopenic obesity in patients with solid tumours of the respiratory and gastrointestinal tracts: A population-based study. Lancet Oncol. 2008;9(7):629–35. https://doi.org/10.1016/S1470-2045(08)70153-0
27. Andersson K, Salomon J, Goldie S, Chung R. Cost-effectiveness of alternative surveillance strategies for hepatocellular carcinoma in patients with cirrhosis. Clin Gastroenterol Hepatol. 2008;6(12):1418–24. https://doi.org/10.1016/j.cgh.2008.08.005
28. Tandon P, Low G, Mourtzakis M, Zenith L, Myers R, Abraldes J, et al. A model to identify sarcopenia in patients with cirrhosis. Clin Gastroenterol Hepatol. 2016;14(10):1473–80.e3. https://doi.org/10.1016/j.cgh.2016.04.040
29. Dasarathy S. Nutrition and alcoholic liver disease. Clin Liver Dis. 2016;20(3):535–50. https://doi.org/10.1016/j.cld.2016.02.010
30. Plauth M, Bernal W, Dasarathy S, Merli M, Plank L, Schütz T, et al. ESPEN guideline on clinical nutrition in liver disease. Clin Nutr. 2019;38(2):485–521. https://doi.org/10.1016/j.clnu.2018.12.022
31. Iwasa M, Iwata K, Hara N, Hattori A, Ishidome M, Sekoguchi-Fujikawa N, et al. Nutrition therapy using a multidisciplinary team improves survival rates in patients with liver cirrhosis. Nutrition. 2013;29(11–12):1418–21. https://doi.org/10.1016/j.nut.2013.05.016
32. Rivera Irigoin R, Abilés J. Soporte nutricional en el paciente con cirrosis hepática. Gastroenterología y Hepatología. 2012;35(8):594–601. https://doi.org/10.1016/j.gastrohep.2012.03.001
33. Merli M, Berzigotti A, Zelber-Sagi S, Dasarathy S, Montagnese S, Genton L, et al. EASL clinical practice guidelines on nutrition in chronic liver disease. J Hepatol. 2019;70(1):172–93. https://doi.org/10.1016/j.jhep.2018.06.024
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Sep 9, 2019
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Wasting Away with Cirrhosis: A Review of Hepatic Sarcopenia. (2019). Journal of Renal and Hepatic Disorders, 3(1), 40-46. https://doi.org/10.15586/jrenhep.2019.56
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Review Hepatology
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