الفهرس 
Liver CirrhosisOnly 14 pages are availabe for public view
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Abstract
HCV infection is a major cause of chronic liver diseases and major indication for liver transplantation worldwide.
Sarcopenia or loss of musculoskeletal mass is a substantial clinical problem that impact patient’s quality of life and survival.
Sarcopenia in HCV related cirrhosis is important and frequently under estimated problem in spite of its considerable effect on patients prognosis.
BMD is also impaired in HCV related cirrhotic patients, we assessed in this study HGS testing as an easy applicable tool for assessment of sarcopenia in HCV related Egyptian cirrhotic patients, in combination with DEXA and anthropometric and laboratory measurement to assess those patient globally aiming to validate this method (HGS) in the workup for cirrhotic patients.
In 32 post hepatitis C cirrhotics, and 32 healthy control we found that HGS in Kg was able to detect sarrcopenia in 34.4% of cirrhotic patient versus 6.3% of the control group (P 0.005) and multivariate regression analysis showed that HGS is independent predictor of sarcopenia after adjustment of age and Child class (χ25.319, P< 0.02).
Prevalence of sarcopenia in the control group was 6.3% while it was 12.5% in Child A cirrhotics and 56.3% in Child C cirrhotics.
DEXA finding of osteopenia and osteoporosis were not significantly different in sarcopenic and non sarcopenic cirrhotic patients.
Sarcopenic and non sarcopenic cirrhotic patients were not statistically different in anthropometric parameters as BMI, MAC, MUAC, WC, HC, and HWR (P> 0.05).
DEXA scan in this study showed normal BMD in 40.6% of the control group and 12.5% in Child A cirrhosis and in non (0%) of Child C cirrhotic patients.
Osteopenia by DEXA scan was detected in 46.9% of the control group, in 56.3% of Child A cirrhosis and in 56.3% in Child C cirrhosis
Osteoprosis by DEXA scan was detected in12.5% of the control group, in 31.3% of Child A cirrhosis and in 43.8% of Child C cirrhosis.
This result reflects the deranged BMD in post hepatitis C cirrhotic patients in addition to sarcopenia and substantial impairment of musculoskeletal health of those patients.
ROC curve showed that HGS testing for detection of sarcopenia in HCV related cirrhosis has AUC of 0.879 with cutoff value ≤ 28.6kg with sensitivity 100%, specifity 66.7%, positive predictive value 61.1% and negative predictive value 100%.
These results are encouraging to conduct more studies on larger number of patients for validating the diagnostic and prognostic value of HGS testing in chronic liver disease patients (post hepatitis C) and other etiologies for better and global patient assessment, better decision making and better followup of those patients.
Combinations of HGS testing and DEXA seems practical, accurate and cost effective method for assessment of musculoskeletal health of chronic liver disease patients of different etiologies, particularly in the era of NAFLD and sarcopenic obesity.