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Sarcopenia is highly prevalent in children with autoimmune liver diseases and is linked to visceral fat and parent-perceived general health
Journal article   Peer reviewed

Sarcopenia is highly prevalent in children with autoimmune liver diseases and is linked to visceral fat and parent-perceived general health

Antoinette A Amevor, Toshifumi Yodoshi, Andrew T Trout, Jonathan R Dillman, Ruchi Singh, Ryan Jarvis, Lin Fei, Chunyan Liu, Amy Taylor, Alexander Miethke, …
Liver international, Vol.42(2), pp.394-401
02/2022
DOI: 10.1111/liv.15108
PMID: 34817929

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Abstract

Patients with autoimmune hepatitis (AIH) and primary or autoimmune sclerosing cholangitis are at nutritional risk; their body composition and has not been extensively studied. We aimed to describe their body composition and identify clinical links. Using magnetic resonance imaging (MRI), two reviewers segmented total psoas muscle area (tPMSA), visceral fat area (VFA) and subcutaneous fat area (mm ) and measured visceral and subcutaneous thickness (mm). Clinical, laboratory and quality of life (QoL; using PedsQL) data were collected. Sarcopenia was defined as tPMSA ≤5th percentile. Analysis of variance, Wilcoxon rank test and multivariable modelling were performed. A paediatric cohort with non-alcoholic fatty liver disease (NAFLD) was used as a comparator following propensity score matching. Fifty-eight patients with autoimmune liver disease (AILD) (33 [57%] with AIH) were included: median age 16 years (interquartile range [IQR]: 13-18), 33 (57%) male. Median time from diagnosis to MRI was 15 months (IQR: 2-39 months). Two patients (3%) had a BMIz indicative of mild malnutrition. tPMSA was measurable in 52 subjects (90%). Of those, 25 (48%) had sarcopenia. Sarcopenic patients had a lower blood urea nitrogen compared to non-sarcopenic (median [IQR]: 9.5 [8.0, 12.0] vs 11 [10, 14] mg/dL; P = .023). There was no difference in corticosteroid use between groups. The VFA of sarcopenic patients was higher (3156 [2064, 7492]) vs 2084 [688, 3092]) mm ; P = .005). Patient-reported QoL negatively associated with VFA and general health negatively associated with VFA. Compared with NAFLD, the odds ratio for sarcopenia with AILD was 14.5 (95% confidence interval: 2.3-90.7). In autoimmune liver diseases, sarcopenia is highly prevalent, associated with increased visceral fat and QoL.
Adolescent Child Hepatitis, Autoimmune - complications Hepatitis, Autoimmune - epidemiology Humans Intra-Abdominal Fat - diagnostic imaging Male Non-alcoholic Fatty Liver Disease - complications Parents Quality of Life Sarcopenia - complications Sarcopenia - diagnostic imaging Sarcopenia - epidemiology

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