Relationship between Sarcopenia and minimal hepatic encephalopathy in patients with cirrhosis: a prospective observational study
1
Issued Date
2025-12-01
Resource Type
eISSN
1471230X
Scopus ID
2-s2.0-85218500370
Journal Title
BMC Gastroenterology
Volume
25
Issue
1
Rights Holder(s)
SCOPUS
Bibliographic Citation
BMC Gastroenterology Vol.25 No.1 (2025)
Suggested Citation
Wongtrakul W., Bandidniyamanon W., Charatcharoenwitthaya P. Relationship between Sarcopenia and minimal hepatic encephalopathy in patients with cirrhosis: a prospective observational study. BMC Gastroenterology Vol.25 No.1 (2025). doi:10.1186/s12876-025-03674-9 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/105497
Title
Relationship between Sarcopenia and minimal hepatic encephalopathy in patients with cirrhosis: a prospective observational study
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Abstract
Background: Sarcopenia, characterized by loss of muscle mass and function, has gained importance in the evaluation of cirrhotic patients. Evidence suggests its role in adverse clinical outcomes, including minimal hepatic encephalopathy (MHE). This study aimed to investigate the association between sarcopenia and MHE in patients with cirrhosis. Methods: We prospectively enrolled outpatients with cirrhosis to assess sarcopenia using the 2019 criteria from the Asian Working Group for Sarcopenia. MHE was diagnosed through the Psychometric Hepatic Encephalopathy Score. Results: Of the 210 cirrhotic patients (57.1% male, mean age 62.7 ± 9.6 years), 54 (25.7%) had sarcopenia, with 26 (12.3%) classified as severe. Thirty-seven patients (17.6%) were diagnosed with MHE. Sarcopenia prevalence was significantly higher in patients with MHE compared to those without MHE (45.9% vs. 21.4%). MHE was significantly associated with age, education level, Mini-Mental State Examination score, and a history of hepatic decompensation. No significant associations were found regarding gender, body mass index, comorbidities, sleep quality, and the etiology of cirrhosis. Multivariable logistic regression showed that MHE was significantly associated with age (adjusted odds ratio [aOR] 1.08, 95% CI 1.02–1.13), sarcopenia (aOR 3.29, 95% CI 1.44–7.50), history of overt hepatic encephalopathy (aOR 7.40, 95% CI 1.20-45.56), and variceal bleeding (aOR 3.13, 95% CI 1.38–7.10). Severe sarcopenia was also independently associated with MHE (aOR 3.64, 95% CI 1.32–10.05). Conclusions: Sarcopenia is prevalent in cirrhotic patients and is associated with an increased risk of MHE. Our findings emphasize the importance of assessing sarcopenia to potentially mitigate MHE risk in managing patients with cirrhosis.