Accepted Manuscript Sarcopenia impairs prognosis of patients with liver cirrhosis Tatsunori Hanai, M.D. Makoto Shiraki, M.D., Ph.D. Kayoko Nishimura, Sachiyo Ohnishi, M.D. Kenji Imai, M.D., Ph.D. Atsushi Suetsugu, M.D., Ph.D. Koji Takai, M.D., Ph.D. Masahito Shimizu, M.D., Ph.D. Hisataka Moriwaki, M.D., Ph.D. PII:
S0899-9007(14)00344-X
DOI:
10.1016/j.nut.2014.07.005
Reference:
NUT 9341
To appear in:
Nutrition
Received Date: 9 January 2014 Revised Date:
30 June 2014
Accepted Date: 20 July 2014
Please cite this article as: Hanai T, Shiraki M, Nishimura K, Ohnishi S, Imai K, Suetsugu A, Takai K, Shimizu M, Moriwaki H, Sarcopenia impairs prognosis of patients with liver cirrhosis, Nutrition (2014), doi: 10.1016/j.nut.2014.07.005. This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
1
ACCEPTED MANUSCRIPT
Title: Sarcopenia impairs prognosis of patients with liver cirrhosis
RI PT
Running head: Sarcopenia impairs prognosis of patients with LC
Tatsunori Hanai M.D.a, Makoto Shiraki M.D., Ph.D.a,*, Kayoko Nishimurab, Sachiyo Ohnishi M.D.a, Kenji Imai M.D., Ph.D.a, Atsushi Suetsugu M.D., Ph.D.a,
SC
Koji Takai M.D., Ph.D.a, Masahito Shimizu M.D., Ph.D.a and Hisataka Moriwaki
M AN U
M.D., Ph.D.a
a
First Department of Internal Medicine, Gifu University School of Medicine,
b
TE D
Yanagido, Gifu, Japan
Center of Nutrition Support and Infection Control, Gifu University Hospital,
EP
Yanagido, Gifu, Japan
AC C
*Corresponding author: Makoto Shiraki First Department of Internal Medicine, Gifu University School of Medicine 1-1 Yanagido, Gifu City, Gifu 501-1194, Japan Tel: +81-58-230-6308; Fax: +81-58-230-6310. E-mail: [email protected]
2
ACCEPTED MANUSCRIPT
Role of each author in the work Conception and design of the study: Tatsunori Hanai, Makoto Shiraki, Masahito
RI PT
Shimizu and Hisataka Moriwaki; Generation, collection, assembly, analysis and/or interpretation of data: Tatsunori Hanai, Makoto Shiraki, Kayoko Nishimura, Sachiyo Ohnishi, Kenji Imai, Atsushi Suetsugu and Koji Takai; Drafting or
SC
revision of the manuscript: Tatsunori Hanai, Makoto Shiraki, Masahito Shimizu
M AN U
and Hisataka Moriwaki; Approval of the final version of the manuscript: All authors read and approved the final manuscript. All authors declare no conflicts
TE D
of interest.
AC C
EP
5534 words, 6 Figures, 5 Tables
4
ACCEPTED MANUSCRIPT
ABSTRACT Objective: Sarcopenia is characterized by the loss of skeletal muscle mass, and is reported to appear in patients with liver cirrhosis (LC). Our objective was to
RI PT
investigate the prevalence of sarcopenia in any cirrhotic patients, and to test the relation between sarcopenia and patients’ outcome. We also analyzed the effect of branched-chain amino acid (BCAA) supplementation on sarcopenic LC.
SC
Methods: Clinical and blood biochemical data of 130 cirrhotic patients who underwent abdominal computed tomography (CT) were analyzed in this
M AN U
retrospective study. The cross-sectional area of skeletal muscles was measured at the level of the third lumbar vertebra on CT. The skeletal muscle index was calculated to identify sarcopenia. Cirrhotic patients who were treated with BCAA supplementation of 12 g/day for one or more years were defined as the BCAA
TE D
group, and the effect of BCAA on sarcopenic LC was evaluated. Results: Sixty-eight percent of all patients (82% of males and 50% of females) were diagnosed with sarcopenia. Male sex (P = 0.01) and body mass index (P
S0899-9007(14)00344-X
DOI:
10.1016/j.nut.2014.07.005
Reference:
NUT 9341
To appear in:
Nutrition
Received Date: 9 January 2014 Revised Date:
30 June 2014
Accepted Date: 20 July 2014
Please cite this article as: Hanai T, Shiraki M, Nishimura K, Ohnishi S, Imai K, Suetsugu A, Takai K, Shimizu M, Moriwaki H, Sarcopenia impairs prognosis of patients with liver cirrhosis, Nutrition (2014), doi: 10.1016/j.nut.2014.07.005. This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
1
ACCEPTED MANUSCRIPT
Title: Sarcopenia impairs prognosis of patients with liver cirrhosis
RI PT
Running head: Sarcopenia impairs prognosis of patients with LC
Tatsunori Hanai M.D.a, Makoto Shiraki M.D., Ph.D.a,*, Kayoko Nishimurab, Sachiyo Ohnishi M.D.a, Kenji Imai M.D., Ph.D.a, Atsushi Suetsugu M.D., Ph.D.a,
SC
Koji Takai M.D., Ph.D.a, Masahito Shimizu M.D., Ph.D.a and Hisataka Moriwaki
M AN U
M.D., Ph.D.a
a
First Department of Internal Medicine, Gifu University School of Medicine,
b
TE D
Yanagido, Gifu, Japan
Center of Nutrition Support and Infection Control, Gifu University Hospital,
EP
Yanagido, Gifu, Japan
AC C
*Corresponding author: Makoto Shiraki First Department of Internal Medicine, Gifu University School of Medicine 1-1 Yanagido, Gifu City, Gifu 501-1194, Japan Tel: +81-58-230-6308; Fax: +81-58-230-6310. E-mail: [email protected]
2
ACCEPTED MANUSCRIPT
Role of each author in the work Conception and design of the study: Tatsunori Hanai, Makoto Shiraki, Masahito
RI PT
Shimizu and Hisataka Moriwaki; Generation, collection, assembly, analysis and/or interpretation of data: Tatsunori Hanai, Makoto Shiraki, Kayoko Nishimura, Sachiyo Ohnishi, Kenji Imai, Atsushi Suetsugu and Koji Takai; Drafting or
SC
revision of the manuscript: Tatsunori Hanai, Makoto Shiraki, Masahito Shimizu
M AN U
and Hisataka Moriwaki; Approval of the final version of the manuscript: All authors read and approved the final manuscript. All authors declare no conflicts
TE D
of interest.
AC C
EP
5534 words, 6 Figures, 5 Tables
4
ACCEPTED MANUSCRIPT
ABSTRACT Objective: Sarcopenia is characterized by the loss of skeletal muscle mass, and is reported to appear in patients with liver cirrhosis (LC). Our objective was to
RI PT
investigate the prevalence of sarcopenia in any cirrhotic patients, and to test the relation between sarcopenia and patients’ outcome. We also analyzed the effect of branched-chain amino acid (BCAA) supplementation on sarcopenic LC.
SC
Methods: Clinical and blood biochemical data of 130 cirrhotic patients who underwent abdominal computed tomography (CT) were analyzed in this
M AN U
retrospective study. The cross-sectional area of skeletal muscles was measured at the level of the third lumbar vertebra on CT. The skeletal muscle index was calculated to identify sarcopenia. Cirrhotic patients who were treated with BCAA supplementation of 12 g/day for one or more years were defined as the BCAA
TE D
group, and the effect of BCAA on sarcopenic LC was evaluated. Results: Sixty-eight percent of all patients (82% of males and 50% of females) were diagnosed with sarcopenia. Male sex (P = 0.01) and body mass index (P
