Sarcopenia in Liver Transplantation

AbstractPurpose of ReviewSarcopenia is highly prevalent in end-stage liver disease (ESLD) patients and has been linked to poor outcomes on the wait list and post-transplantation. This current perspectives article reviews the ongoing challenges to define sarcopenia in ESLD patients, describes associations of sarcopenia with wait list and post-transplantation outcomes, and provides summarized data on efforts to prevent and treat sarcopenia through novel interventions.Recent FindingsSupervised exercise programs improve muscle strength, but muscle mass outcomes are limited by short study follow-up times. Branched-chain amino acid supplementation may ameliorate sarcopenia in ESLD patients, but studies are limited by low participant numbers and confounding. Myostatin inhibition is shown to improve sarcopenia in elderly, frail patients; further study is needed in ESLD patients. Correction of low testosterone improves sarcopenia in male ESLD patients.SummaryRecent literature supports sarcopenia as an independent risk factor for poor outcomes in ESLD patients. Ongoing study is limited by poor standardization of sarcopenia definition and relevant muscle mass cutoffs. Supervised exercise programs should be encouraged for all ESLD patients. More advanced therapies require further clinical investigation before their widespread use.
Source: Current Transplantation Reports - Category: Transplant Surgery Source Type: research

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Abstract Men with obesity often present with low testosterone (T) and sex hormone-binding globulin (SHBG) levels. Several mechanisms for this have been proposed, but as SHBG is secreted by hepatocytes and sex steroids undergo hepatic metabolization, this study investigates whether severity and histological components of nonalcoholic fatty liver disease (NAFLD) are associated with sex steroid levels in obese men. This cross-sectional study included 80 obese men (age: 46 ± 11 years; body mass index: 42.2 ± 5.5 kg m-2). Serum levels of total T and estradiol (E2) were measured using liquid chromatography...
Source: Asian Journal of Andrology - Category: Urology & Nephrology Authors: Tags: Asian J Androl Source Type: research
Zinc deficiency has a global impact on health in both developing and developed countries, especially among children and the elderly. By modulating anti-inflammatory and antioxidant pathways, zinc supplementation is recommended for the treatment of several ailments, such as liver disease, male hypogonadism, cancers, heart disease (e.g. dyslipidemia) and central nervous system disorders; however, the topic of dietary vs. pharmacological doses of zinc remains controversial. This paper provides a detailed critical review of the effects of zinc supplementation in medicinal doses (i.e.
Source: Clinical Nutrition - Category: Nutrition Authors: Tags: Review Source Type: research
Authors: Moctezuma-Velázquez C, Low G, Mourtzakis M, Ma M, Burak KW, Tandon P, Montano-Loza AJ Abstract INTRODUCTION AND AIM: Sarcopenia is an independent predictor of mortality in cirrhosis. Hypogonadism is common in cirrhosis and has been associated with sarcopenia in non-cirrhotic chronic liver disease populations. The aim of this study is to investigate if sarcopenia is associated with low testosterone levels in patients with cirrhosis. MATERIAL AND METHODS: This is a retrospective analysis of prospectively collected data of 211 cirrhotic patients undergoing evaluation for liver transplantation. Sarc...
Source: Annals of Hepatology - Category: Gastroenterology Tags: Ann Hepatol Source Type: research
CONCLUSIONS: Clinicians should exercise caution when considering TRT for hypogonadal men with TM. ( PMID: 31125000 [PubMed - in process]
Source: Acta Bio-Medica : Atenei Parmensis - Category: General Medicine Authors: Tags: Acta Biomed Source Type: research
Conclusions: A significant number of TI patients have high LIC, short stature and endocrine disorders. Patients who require occasional transfusions have more liver iron overload and higher hepatic dysfunction. Females appear to attain better final adult height and have higher IGF1- SDS versus males. Our data emphasize the need for long term surveillance for identification of organ-specific risk factors and early disease manifestations.We also recommend a close monitoring of endocrine and other complications, according to the international guidelines.
Source: Mediterranean Journal of Hematology and Infectious Diseases - Category: Hematology Source Type: research
In conclusion, Test deficiency could be an independent risk factor for the development of NAFLD by upregulation of lipid synthesis and disturb fatty acids oxidation whereas Test therapy is a protective strategy. Graphical abstract
Source: Steroids - Category: Drugs & Pharmacology Source Type: research
CONCLUSION: Low testosterone levels are associated with sarcopenia in male cirrhotic patients. The potential therapeutic effect of testosterone to reverse sarcopenia in these patients warrants evaluation in future trials. PMID: 29893704 [PubMed - in process]
Source: Annals of Hepatology - Category: Gastroenterology Tags: Ann Hepatol Source Type: research
Authors: Dwyer AA, Quinton R Abstract The metabolic syndrome (MetS) is a term used to describe the constellation of cardiometabolic risk factors including central adiposity, dyslipidemia, insulin resistance, non-alcoholic fatty liver disease and arterial hypertension. Notably, a number of studies have shown high rates of testosterone (T) deficiency in men with MetS and type 2 diabetes mellitus (T2DM). Both hypogonadism and MetS confer increased health risk for morbidity and mortality as men with the MetS are at twice the risk for developing cardiovascular disease and at 5-fold higher risk for developing T2DM. Moreo...
Source: Frontiers of Hormone Research - Category: Endocrinology Tags: Front Horm Res Source Type: research
This article provides a narrative review of hepatic osteodystrophy. The aim is to revise the prevalence, pathophysiology, diagnosis and management of hepatic osteodystrophy. We searched medical literature via PubMed, Google Scholar, Wiley, Science Direct, and Springer Link using respective keywords to obtain data on low bone mineral density connected to chronic liver diseases. Many studies have reported an increased prevalence of osteoporosis/osteopenia in patients with chronic liver diseases. The pathogenesis is multifactorial, involving genetic factors, vitamin deficiencies, proinflammatory cytokines, hypogonadism, hyper...
Source: Acta Clinica Croatica - Category: General Medicine Tags: Acta Clin Croat Source Type: research
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Source: Liver International - Category: Gastroenterology Authors: Tags: Reviews Source Type: research
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