1. In a cohort of patients with chronic liver disease, decreased vitamin D levels were independently and significantly associated with decreased skeletal muscle mass within 1 year.
2. Nonalcoholic fatty liver disease (NAFLD) showed the strongest association with decreased 25-hydroxyvitamin D levels and muscle loss.
Evidence evaluation level: 2 (good)
Sarcopenia, a loss of skeletal muscle mass and strength, is a common sequela of the disease in patients with liver cirrhosis. The presence of sarcopenia (or overall loss of muscle mass) also tends to worsen the prognosis of these patients. The loss of lean body mass in people without cirrhosis is 1% per year (from 30 to 70 years of age) and 1.5% per year thereafter, whereas the loss of skeletal muscle mass in people with cirrhosis is 2.2% per year. It gets worse in the more severe Child-Pugh grades. score. Supplementation with branched-chain amino acids (BCAAs) and/or vitamin D and exercise are preventive lifestyle measures, and many longitudinal studies in older adults have shown that supplementation with branched-chain amino acids (BCAAs) and/or vitamin D is associated with decreased vitamin D levels and muscle mass loss. , and its deficiency was found to be associated with fast-twitch muscle atrophy. – Muscle fiber spasms and fatty infiltration of skeletal muscles. The current retrospective study analyzed data from 166 individuals (59.0% female, median). [IQR] 68 years old [58-74] ), aimed to investigate several factors associated with muscle loss in a 1-year follow-up of patients with chronic liver disease. Etiologies include chronic hepatitis C virus infection (HCV), nonalcoholic fatty liver disease (NAFLD), chronic hepatitis B virus infection (HBV), alcohol-related liver disease (ALD), and primary biliary cholangitis. (PBC), autoimmune hepatitis (AIH), and others. Although there was no significant difference in skeletal muscle mass index (SMI) at 1-year follow-up (p = 0.07), a decrease in muscle mass was found in her 31% of patients. The only variable that was significantly different between those who experienced muscle loss and those who did not was serum 25-hydroxyvitamin D levels (p = 0.0025). Muscle loss was most pronounced in NAFLD patients (48.7%; p < 0.05), followed by ALD (28.6%), HBV/HCV (28.4%), and PBC/AIH (18.5%). A serum 25-hydroxyvitamin D level cutoff of 12.7 ng/mL or higher was significantly associated with decreased muscle mass (p < .0001), complex cirrhosis (p < .01), decreased hemoglobin (p < .01), and decreased platelet count. was a significant predictor. (p < .01), prothrombin time (p < .01), and total cholesterol (p < .01). Patients with 25-hydroxyvitamin D levels above the cutoff had significantly lower gamma-glutamyl transpeptidase (GGT) levels (p < .01). Levels above 12.7 ng/mL were most strongly associated with muscle loss in NAFLD patients. The results of this study show that low baseline 25-hydroxyvitamin D levels (<12.7 ng/mL) are independently associated with muscle loss, a sequela of this chronic liver disease. This suggests that there may be complications associated with this decline and that there are opportunities to mitigate this. Risks of early supplement intake. Further longitudinal studies using larger cohorts will be required to confirm the generalizability of these results.
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