Prevention and treatment of malnutrition, sarcopenia, and osteoporosis in patients with liver cirrhosis

Huijuan XIAO; Tao HAN

doi:10.3969/j.issn.1001-5256.2021.01.006

Volume 37 Issue 1

Jan. 2021

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Prevention and treatment of malnutrition, sarcopenia, and osteoporosis in patients with liver cirrhosis

DOI: 10.3969/j.issn.1001-5256.2021.01.006

Huijuan XIAO^{1, 2a, 3, 4, 5},
Tao HAN^{1, 2b, 3, 4, 5
,
,}

1.
The Third Central Clinical College of Tianjin Medical University, Tianjin 300170, China
2a.
Department of Nutrition, Tianjin Third Central Hospital, Tianjin 300170, China
2b.
Department of Hepatology, Tianjin Third Central Hospital, Tianjin 300170, China
3.
Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Tianjin 300170, China
4.
Artificial Cell Engineering Technology Research Center, Tianjin 300170, China
5.
Tianjin Institute of Hepatobiliary Disease, Tianjin 300170, China

Received Date: 2020-10-05
Accepted Date: 2020-11-14
Published Date: 2021-01-20

Abstract

Abstract

Malnutrition, sarcopenia, and osteoporosis are common nutrition-related complications in patients with liver cirrhosis. Sarcopenia is an important manifestation of malnutrition, while malnutrition and sarcopenia are risk factors for osteoporosis. There is a close relationship among them, and they all have adverse effects on the clinical outcomes and prognosis of patients with liver cirrhosis. Therefore, it is necessary to identify them as early as possible and take active measures for prevention and treatment. Insufficient intake of nutrients, metabolic disorders, abnormal hormone levels, and lack of physical activity all contribute to the development of malnutrition, sarcopenia, and osteoporosis in patients with liver cirrhosis. In addition, medications commonly used in the treatment of liver diseases, such as glucocorticoids and some antiviral drugs, may have potential impact on bone metabolism, which needs to be taken seriously in clinical practice. Reasonable nutritional intervention, appropriate exercise, and treatment of underlying diseases are the basis of the prevention and treatment of malnutrition, sarcopenia, and osteoporosis. Some targeted drugs can improve these nutrition-related complications, which needs to be confirmed by further studies.
- Liver Cirrhosis,
- Malnutrition,
- Sarcopenia,
- Osteoporosis

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References(35)

References

[1]	CAMPILLO B, RICHARDET JP, SCHERMAN E, et al. Evaluation of nutritional practice in hospitalized cirrhotic patients: Results of a prospective study[J]. Nutrition, 2003, 19(6): 515-521. DOI: 10.1016/S0899-9007(02)01071-7
[2]	GUGLIELMI FW, PANELLA C, BUDA A, et al. Nutritional state and energy balance in cirrhotic patients with or without hypermetabolism.Multicentre prospective study by the'Nutritional Problems in Gastroenterology'Section of the Italian Society of Gastroenterology (SIGE)[J]. Dig Liver Dis, 2005, 37(9): 681-688. DOI: 10.1016/j.dld.2005.03.010
[3]	CRUZ-JENTOFT AJ, BAEYENS JP, BAUER JM, et al. Sarcopenia:European consensus on definition and diagnosis: Report of the European Working Group on sarcopenia in older people[J]. Age Ageing, 2010, 39(4): 412-423. DOI: 10.1093/ageing/afq034
[4]	PERIYALWAR P, DASARATHY S.Malnutrition in cirrhosis:Contribution and consequences of sarcopenia on metabolic and clinical responses[J]. Clin Liver Dis, 2012, 16(1): 95-131. DOI: 10.1016/j.cld.2011.12.009
[5]	PONZIANI FR, GASBARRINI A.Sarcopenia in patients with advanced liver disease[J]. Curr Protein Pept Sci, 2018, 19(7): 681-691. DOI: 10.2174/1389203718666170428121647
[6]	TANDON P, NEY M, IRWIN I, et al. Severe muscle depletion in patients on the liver transplant wait list:Its prevalence and independent prognostic value[J]. Liver Transpl, 2012, 18(10): 1209-1216. DOI: 10.1002/lt.23495
[7]	XIAO HJ, YE Q, HAN T, et al. Risk factors for sarcopenia and its impact on clinical outcome in patients with liver cirrhosis[J]. Chin J Hepatol, 2020, 28(1): 53-57(in Chinese) 肖慧娟, 叶青, 韩涛, 等. 肝硬化合并肌肉减少症的危险因素及其对临床结局的影响[J]. 中华肝脏病杂志, 2020, 28(1): 53-57.
[8]	WELCH N, DASARATHY J, RUNKANA A, et al. Continued muscle loss increases mortality in cirrhosis:Impact of aetiology of liver disease[J]. Liver Int, 2020, 40(5): 1178-1188. DOI: 10.1111/liv.14358
[9]	EBADI M, MONTANO-LOZA AJ. Sarcopenia and frailty in the prognosis of patients on the liver transplant waiting list[J]. Liver Transpl, 2019, 25(1): 7-9. DOI: 10.1002/lt.25386
[10]	PLAUTH M, BERNAL W, DASARATHY S, et al. ESPEN guideline on clinical nutrition in liver disease[J]. Clin Nutr, 2019, 38(2): 485-521. DOI: 10.1016/j.clnu.2018.12.022
[11]	SINCLAIR M, GOW PJ, GROSSMANN M, et al. Review article:Sarcopenia in cirrhosis aetiology, implications and potential therapeutic interventions[J]. Aliment Pharmacol Ther, 2016, 43(7): 765-777. DOI: 10.1111/apt.13549
[12]	MONTANO-LOZA AJ, DUARTE-ROJO A, MEZA-JUNCO J, et al. Inclusion of sarcopenia within MELD (MELD-Sarcopenia) and the prediction of mortality in patients with cirrhosis[J]. Clin Transl Gastroenterol, 2015, 6(7): e102. DOI: 10.1038/ctg.2015.31
[13]	LUPOLI R, di MINNO A, SPADARELLA G, et al. The risk of osteoporosis in patients with liver cirrhosis: A meta-analysis of literature studies[J]. Clin Endocrinol (Oxf), 2016, 84(1): 30-38. DOI: 10.1111/cen.12780
[14]	JEONG HM, KIM DJ. Bone diseases in patients with chronic liver disease[J]. Int J Mol Sci, 2019, 20(17): 1-27. http://www.ncbi.nlm.nih.gov/pubmed/31480433
[15]	HAYASHI M, ABE K, FUJITA M, et al. Association between sarcopenia and osteoporosis in chronic liver disease[J]. Hepatol Res, 2018, 48(11): 893-904. DOI: 10.1111/hepr.13192
[16]	DUAN ZP. Clinical recommendations to address malnutrition in patients with end-stage liver disease[J]. Chin J Hepatol, 2013, 21(10): 721-722.(in Chinese) DOI: 10.3760/cma.j.issn.1007-3418.2013.10.001 段钟平. 应重视终末期肝病的营养不良问题[J]. 中华肝脏病杂志, 2013, 21(10): 721-722. DOI: 10.3760/cma.j.issn.1007-3418.2013.10.001
[17]	CHEUNG K, LEE SS, RAMAN M. Prevalence and mechanisms of malnutrition in patients with advanced liver disease, and nutrition management strategies[J]. Clin Gastroenterol Hepatol, 2012, 10(2): 117-125. DOI: 10.1016/j.cgh.2011.08.016
[18]	QIU J, THAPALIYA S, RUNKANA A, et al. Hyperammonemia in cirrhosis induces transcriptional regulation of myostatin by an NF-kappa B-mediated mechanism[J]. Proc Natl Acad Sci USA, 2013, 110(45): 18162-18167. DOI: 10.1073/pnas.1317049110
[19]	Chinese Society of Infectious Diseases, Chinese Medical Association; Chinese Society of Hepatology, Chinese Medical Association.Guidelines for the prevention and treatment of chronic hepatitis B (version 2019)[J]. J Clin Hepatol, 2019, 35(12): 2648-2669.(in Chinese) DOI: 10.3969/j.issn.1001-5256.2019.12.007 中华医学会感染病学分会, 中华医学会肝病学分会. 慢性乙型肝炎防治指南(2019年版)[J]. 临床肝胆病杂志, 2019, 35(12): 2648-2669 DOI: 10.3969/j.issn.1001-5256.2019.12.007
[20]	European Association for the Study of the Liver.EASL 2017 Clinical Practice Guidelines on the management of hepatitis B virus infection[J]. J Hepatol, 2017, 67(2): 370-398. DOI: 10.1016/j.jhep.2017.03.021
[21]	European Association for the Study of the Liver.EASL Clinical Practice Guidelines on nutrition in chronic liver disease[J]. J Hepatol, 2019, 70(1): 172-193. DOI: 10.1016/j.jhep.2018.06.024
[22]	CAREY EJ, LAI JC, WANG CW, et al. A multicenter study to define sarcopenia in patients with end-stage liver disease[J]. Liver Transpl, 2017, 23(5): 625-633. DOI: 10.1002/lt.24750
[23]	NISHIKAWA H, SHIRAKI M, HIRAMATSU A, et al. Japan Society of Hepatology guidelines for sarcopenia in liver disease (1st edition): Recommendation from the working group for creation of sarcopenia assessment criteria[J]. Hepatol Res, 2016, 46(10): 951-963. DOI: 10.1111/hepr.12774
[24]	Chinese Society of Osteoporosis and Bone Mineral Research.Sarcopenia consensus[J]. Chin J Osteoporosis Bone Miner Res, 2016, 9(3): 215-227.(in Chinese) DOI: 10.3969/j.issn.1674-2591.2016.03.001 中华医学会骨质疏松和骨矿盐疾病分会. 肌少症共识[J]. 中华骨质疏松和骨矿盐疾病杂志, 2016, 9(3): 215-227 DOI: 10.3969/j.issn.1674-2591.2016.03.001
[25]	Chinese Society of Hepatology, Chinese society of Gastroenterology, Chinese Medical Association.Clinical guidelines on nutrition in end-stage liver disease[J]. J Clin Hepatol, 2019, 35(6): 1222-1230.(in Chinese) DOI: 10.3969/j.issn.1001-5256.2019.06.010 中华医学会肝病学分会, 中华医学会消化病学分会. 终末期肝病临床营养指南[J]. 临床肝胆病杂志, 2019, 35(6): 1222-1230. DOI: 10.3969/j.issn.1001-5256.2019.06.010
[26]	BAJAJ JS, LAURIDSEN M, TAPPER EB, et al. Important unresolved questions in the management of hepatic encephalopathy: An ISHEN consensus[J]. Am J Gastroenterol, 2020, 115(7): 989-1002. http://kns.cnki.net/KCMS/detail/detail.aspx?dbcode=CJFD&filename=DQHB202006004
[27]	DUARTE-ROJO A, RUIZ-MARGÁIN A, MONTAÑO-LOZA AJ, et al. Exercise and physical activity for patients with end-stage liver disease:Improving functional status and sarcopenia while on the transplant waiting list[J]. Liver Transpl, 2018, 24(1): 122-139. DOI: 10.1002/lt.24958
[28]	SINCLAIR M, GROSSMANN M, HOERMANN R, et al. Testosterone therapy increases muscle mass in men with cirrhosis and low testosterone:A randomised controlled trial[J]. J Hepatol, 2016, 65(5): 906-913. DOI: 10.1016/j.jhep.2016.06.007
[29]	GRECH A, BRECK J, HEIDELBAUGH J.Adverse effects of testosterone replacement therapy:An update on the evidence and controversy[J]. Ther Adv Drug Saf, 2014, 5(5): 190-200. DOI: 10.1177/2042098614548680
[30]	KUMAR A, DAVULURI G, SILVA R, et al. Ammonia lowering reverses sarcopenia of cirrhosis by restoring skeletal muscle proteostasis[J]. Hepatology, 2017, 65(6): 2045-2058. DOI: 10.1002/hep.29107
[31]	SHARMA BC, SHARMA P, LUNIA MK, et al. A randomized, double-blind, controlled trial comparing rifaximin plus lactulose with lactulose alone in treatment of overt hepatic encephalopathy[J]. Am J Gastroenterol, 2013, 108(9): 1458-1463. DOI: 10.1038/ajg.2013.219
[32]	DASARATHY S, MCCULLOUGH AJ, MUC S, et al. Sarcopenia associated with portosystemic shunting is reversed by follistatin[J]. J Hepatol, 2011, 54(5): 915-921. DOI: 10.1016/j.jhep.2010.08.032
[33]	WOODHOUSE L, GANDHI R, WARDEN SJ, et al. A phase 2 randomized study investigating the efficacy and safety of myostatin antibody LY2495655 versus placebo in patients undergoing elective total hip arthroplasty[J]. J Frailty Aging, 2016, 5(1): 62-70. http://europepmc.org/abstract/MED/26980371
[34]	TSIEN C, SHAH SN, MCCULLOUGH AJ, et al. Reversal of sarcopenia predicts survival after a transjugular intrahepatic portosystemic stent[J]. Eur J Gastroenterol Hepatol, 2013, 25(1): 85-93. DOI: 10.1097/MEG.0b013e328359a759
[35]	Chinese Society of Bone Nutrition and Health, Chinese Society of Osteoporosis and Bone Mineral Research.Expert consensus on nutrition and exercise management in patients with primary osteoporosis[J]. Chin J Endocrinol Metab, 2020, 36(8): 643-653.(in Chinese) DOI: 10.3760/cma.j.cn311282-20200408-00261 中国营养学会骨营养与健康分会, 中华医学会骨质疏松和骨矿盐疾病分会. 原发性骨质疏松症患者的营养和运动管理专家共识[J]. 中华内分泌代谢杂志, 2020, 36(8): 643-653. DOI: 10.3760/cma.j.cn311282-20200408-00261

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Prevention and treatment of malnutrition, sarcopenia, and osteoporosis in patients with liver cirrhosis

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Prevention and treatment of malnutrition, sarcopenia, and osteoporosis in patients with liver cirrhosis

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