SARC‐F combined with a simple tool for assessment of muscle abnormalities in outpatients with chronic liver disease

Abstract

Aim/Background An easily performed method for examination of muscle abnormalities is anticipated. We aimed to elucidate the clinical usefulness of simple assessments for muscle abnormality including a simple five‐item questionnaire (SARC‐F) in chronic liver disease (CLD) patients. Materials/Methods From February to July 2019, 383 outpatients (median age 71, 259 males) [chronic hepatitis (CH):liver cirrhosis Child‐Pugh A (CP‐A):CP‐B:CP‐C=157:176:39:11] underwent a CT examination were enrolled. Previously reported cut‐off values for muscle strength decline (handgrip) (MSD), pre‐muscle volume loss (pre‐MVL), calf circumference (CC), and finger‐circle test results were used and these results were analyzed, retrospectively. Results A high SARC‐F score (≥4) were observed in 25 and a low score (<4) in 358. The frequency of high SARC‐F increased significantly with progression of CLD (CH:CP‐A:CP‐B/C=2.5%:8.0%:14.0%, P=0.010). MSD frequency was 22.4% in males and 41.1% in females. Muscle volume loss (MVL) and pre‐MVL were noted in 22% and 30.5%, respectively, of the male patients, and 9.7% and 32.3%, respectively, of the females. In cases with high SARC‐F and MSD, CC and finger‐circle abnormalities were found in 56% and 40.0%, respectively, while those values for cases with low SARC‐F and MSD were 14.5% and 10.6%, respectively (P<0.001, for each) (positive/negative predictive values: 0.560/0.855 and 0.400/0.894, respectively). Each SARC‐F item showed a good area under the curve for MSD but not pre‐MVL. Conclusion SARC‐F score in combination with MSD and CC or finger‐circle test results may be an easy and simple method for surveillance of CLD patients with high risk of sarcopenia and decline of QOL.