Assessment and relevance of sarcopenia and frailty

Research output: Chapter in Book/Report/Conference proceedingConference contributionpeer-review

Abstract

• Sarcopenia is one of the most common complications of cirrhosis, leading to functional
deterioration and frailty.
• Sarcopenia may also occur in obese patients, but due to the coexistence of obesity, it might be
overlooked.
• Sarcopenia and frailty predict lower survival in patients with cirrhosis and patients undergoing
liver transplantation, independent of the Model for End-Stage Liver Disease (MELD) score.
• Limitations of the MELD score include its failure to assess the nutritional and functional status of
cirrhotic patients.
• Patients with a low MELD score and sarcopenia may be under prioritised.
• Adding sarcopenia to the MELD score is controversial since the added predictive value is modest
and inconsistent.
• Dietary and moderate exercise interventions in patients with cirrhosis are consistently beneficial
and safe, but large long-term studies are needed.
• All patients with cirrhosis should be encouraged to exercise, provided with practical advice
appropriate to their abilities, and always accompanied by nutritional intervention.

• Changing dietary composition without necessarily reducing caloric intake may promote
maintenance of weight reduction and liver steaatosis reducation in the long-term, and may
represent a more feasible alternative to treat NAFLD patients.
• Recent feeding studies and short-term clinical trials emphasised the independent therapeutic
effect of replacing an unhealthy Western dietary pattern, typical to NAFLD patients, with a
healthy pattern (e.g. Mediterranean diet).
• A heathy lifestyle is also important in terms of glycaemic control and primary prevention of
CVD and HCC.
Original languageAmerican English
Title of host publicationEuropean Association for the Study of the Liver postgraduate course international liver congress book
Pages86-97
Number of pages12
StatePublished - 2019
EventThe International Liver Congress: End Stage Liver Disease - Vienna, Austria
Duration: 10 Apr 201911 Apr 2019

Conference

ConferenceThe International Liver Congress
Country/TerritoryAustria
CityVienna
Period10/04/1911/04/19

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