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Controversies in Diagnosing Sarcopenia in Cirrhosis—Moving from Research to Clinical Practice

1
Department of Medicine, The University of Melbourne, Parkville 3050, Australia
2
Austin Health, Liver Transplant Unit, 145 Studley Road, Heidelberg 3084, Australia
Nutrients 2019, 11(10), 2454; https://doi.org/10.3390/nu11102454
Received: 20 September 2019 / Revised: 7 October 2019 / Accepted: 10 October 2019 / Published: 14 October 2019
(This article belongs to the Special Issue Nutrition in Liver Cirrhosis and Liver Transplantation)
Sarcopenia, defined as loss of muscle mass and function, is increasingly recognized as a common consequence of advanced cirrhosis that is associated with adverse clinical outcomes. Despite the recent proliferation in publications pertaining to sarcopenia in end-stage liver disease, there remains no single ‘best method’ for its diagnosis. The inability to identify a gold standard is common to other specialties, including geriatrics from which many diagnostic tools are derived. Controversies in diagnosis have implications for the accuracy and reproducibility of cohort studies in the field, largely prohibit the introduction of sarcopenia measurement into routine patient care and impede the development of clinical trials to identify appropriate therapies. Difficulties in diagnosis are partly driven by our ongoing limited understanding of the pathophysiology of sarcopenia in cirrhosis, the mechanisms by which it impacts on patient outcomes, the heterogeneity of patient populations, and the accuracy, availability and cost of assessments of muscle mass and function. This review discusses the currently studied diagnostic methods for sarcopenia in cirrhosis, and outlines why reaching a consensus on sarcopenia diagnosis is important and suggests potential ways to improve diagnostic criteria to allow us to translate sarcopenia research into improvements in clinical care. View Full-Text
Keywords: sarcopenia; cirrhosis; diagnosis; muscle; mortality; transplant sarcopenia; cirrhosis; diagnosis; muscle; mortality; transplant
MDPI and ACS Style

Sinclair, M. Controversies in Diagnosing Sarcopenia in Cirrhosis—Moving from Research to Clinical Practice. Nutrients 2019, 11, 2454.

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