Clinical relevance of skeletal muscle abnormalities in patients with cirrhosis

Dig Liver Dis. 2019 Nov;51(11):1493-1499. doi: 10.1016/j.dld.2019.05.034. Epub 2019 Jun 17.


Recent advances in body composition evaluation have demonstrated abnormalities in skeletal muscle in patients with cirrhosis. Sarcopenia (severe muscle depletion) and myosteatosis (pathological fat accumulation in muscle) are prevalent muscle abnormalities in patients with cirrhosis that confer poor prognosis. Sarcopenia has become a well-defined factor for adverse clinical outcomes pre- and post-liver transplantation and emerging evidence has suggested the prognostic significance of myosteatosis in predicting mortality and overt hepatic encephalopathy in patients with cirrhosis. Advances in the understating of these muscle abnormalities might help improve therapeutic interventions to correct them and potentially improve outcomes of patients with cirrhosis. Moreover, inclusion of these muscle abnormalities within the current organ allocation policies might lead to a better mortality risk assessment in patients awaiting liver transplant and even to a decrease in the rates of futile liver transplants. This review summarizes the current knowledge regarding the modalities to evaluate skeletal muscle abnormalities in cirrhosis, the incidence and clinical impact of these abnormalities in cirrhosis; existing and potential novel therapeutic strategies are also discussed.

Keywords: Chronic liver disease; Liver transplantation; Myosteatosis; Sarcopenia.

Publication types

  • Review

MeSH terms

  • Body Composition
  • Hepatic Encephalopathy / diagnosis
  • Hepatic Encephalopathy / etiology*
  • Humans
  • Liver Cirrhosis / complications*
  • Liver Cirrhosis / mortality
  • Liver Cirrhosis / therapy*
  • Liver Transplantation
  • Muscle, Skeletal / pathology*
  • Prognosis
  • Risk Assessment
  • Risk Factors
  • Sarcopenia / diagnosis
  • Sarcopenia / etiology*
  • Tomography, X-Ray Computed