Role of Renal Biomarkers in Sarcopenia or Frailty in Patients With Liver Cirrhosis.

Abstract

Background: Sarcopenia and frailty are risk factors for poor prognosis in patients with liver cirrhosis. This study investigated the role of renal biomarkers in sarcopenia or frailty in patients with cirrhosis.

Methods: A total of 78 patients with liver cirrhosis and serum creatinine levels < 1.5 mg/dL were analysed for serum renal biomarkers (creatinine-to-cystatin C ratio, interleukin [IL]-18, kidney injury molecule [KIM]-1, and neutrophil gelatinase-associated lipocalin [NGAL]), sarcopenia, and liver frailty index. Sarcopenia was assessed using the skeletal muscle index of the third vertebra. We analysed the risk of sarcopenia or frailty based on various renal biomarkers of cirrhosis.

Results: The mean age was 59.2 years and 67.9% were men. The Child-Pugh class B score was noted in 17.9%. Sarcopenia or frailty (pre-frail and frail) was observed in 43 patients (55.1%). No significant differences in serum IL-18 (P = 0.285), NGAL (P = 0.537), or KIM-1 (P = 0.482) levels were observed according to sarcopenia or frailty. However, the creatinine-to-cystatin C ratio was significantly lower in patients with sarcopenia or frailty than in those without sarcopenia or frailty (0.73 vs. 0.83, P = 0.002). Multivariable analysis indicated that the risk factors for sarcopenia or frailty were Child-Pugh class B (odds ratio [OR], 9.04; 95% confidence interval [CI], 1.06-76.85; P = 0.044) and creatinine-to-cystatin C ratio < 0.8 (OR, 4.03; 95% CI, 1.45-11.25; P = 0.008). Serum IL-18, NGAL, and KIM-1 levels were not associated with sarcopenia or frailty.

Conclusion: A lower serum creatinine-to-cystatin C ratio was associated with an increased risk of sarcopenia or frailty in patients with cirrhosis and favourable renal function.