Utility of handgrip strength (HGS) and bioelectrical impedance analysis (BIA) in the diagnosis of sarcopenia in cirrhotic patients

Lalida Luengpradidgun; Naichaya Chamroonkul; Pimsiri Sripongpun; Apichat Kaewdech; Pramot Tanutit; Natee Ina; Teerha Piratvisuth

doi:10.1186/s12876-022-02236-7

Utility of handgrip strength (HGS) and bioelectrical impedance analysis (BIA) in the diagnosis of sarcopenia in cirrhotic patients

BMC Gastroenterol. 2022 Mar 30;22(1):159. doi: 10.1186/s12876-022-02236-7.

Authors

Lalida Luengpradidgun¹, Naichaya Chamroonkul², Pimsiri Sripongpun¹, Apichat Kaewdech¹, Pramot Tanutit³, Natee Ina³, Teerha Piratvisuth^{1

4}

Affiliations

¹ Gastroenterology and Hepatology Unit, Division of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, 90110, Thailand.
² Gastroenterology and Hepatology Unit, Division of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, 90110, Thailand. naichaya@gmail.com.
³ Division of Radiology, Faculty of Medicine, Prince of Songkla University, Hat Yai, 90110, Thailand.
⁴ NKC Institute of Gastroenterology and Hepatology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand.

Abstract

Background: Sarcopenia is associated with disability, mortality, and poorer survival in cirrhotic patients. For the evaluation of muscle volume, computed tomography (CT) is the most accurate tool. Unfortunately, it would be hard to apply a muscle mass measuring CT to daily practice. This research aims to study the utility of handgrip strength (HGS) and bioelectrical impedance analysis (BIA) to detect sarcopenia in cirrhotic patients compared with CT as the reference.

Methods: In cirrhotic patients who met inclusions criteria (age 20-70 years, ascites < grade 2 of International Ascites Club grading system, no active malignancy, and no cardiac implanted device), HGS were measured using a Jamar dynamometer. Subsequently, patients with low muscle strength (defined as JSH criteria, < 26 kg in male, < 18 kg in female) were then underwent CT and BIA (Tanita MC780 MA) on the same day to measure muscle volume, the definition of sarcopenia by CT was according to the Japan Society of Hepatology (JSH). We also collected data from patients with normal HGS whose CT results were available in the study period.

Results: From 146 cirrhotic patients who underwent HGS, 30 patients (20.5%) had diagnosed low HSG. Data from 50 patients whose available CT results included 30 low HGS and 20 patients with normal HSG. The HGS was strongly correlated with skeleton muscle index (SMI) by CT (r = 0.81, p < 0.001) and had an excellent diagnostic performance for detecting sarcopenia by using JSH criteria the sensitivity, specificity, NPV and PPV were 88.2%, 100%, 100%, and 98.7% respectively. In contrast, only 6 of 30 patients (20%) met sarcopenic criteria by BIA. Among sarcopenic patients, the result showed a fair correlation between SMI and BIA (r = 0.54; p < 0.002).

Conclusion: Our study demonstrated an excellent correlation between HGS and SMI by CT in the mixed cirrhotic population from the sarcopenia and non-sarcopenia groups. The HGS using the JSH criteria showed an excellent performance in detecting sarcopenia compared to CT. Nonetheless, for the BIA by using the current cut-offs demonstrated unacceptable rate to detect sarcopenia.

Keywords: BIA; Cirrhosis; Handgrip strength; Sarcopenia.

MeSH terms

Adult
Aged
Electric Impedance
Female
Hand Strength / physiology
Humans
Liver Cirrhosis / complications
Liver Cirrhosis / diagnosis
Male
Middle Aged
Muscle Strength / physiology
Sarcopenia* / complications
Sarcopenia* / diagnosis
Young Adult