PMID- 34817929
OWN - NLM
STAT- MEDLINE
DCOM- 20220303
LR  - 20230202
IS  - 1478-3231 (Electronic)
IS  - 1478-3223 (Print)
IS  - 1478-3223 (Linking)
VI  - 42
IP  - 2
DP  - 2022 Feb
TI  - Sarcopenia is highly prevalent in children with autoimmune liver diseases and is 
      linked to visceral fat and parent-perceived general health.
PG  - 394-401
LID - 10.1111/liv.15108 [doi]
AB  - BACKGROUND: Patients with autoimmune hepatitis (AIH) and primary or autoimmune 
      sclerosing cholangitis are at nutritional risk; their body composition and has 
      not been extensively studied. We aimed to describe their body composition and 
      identify clinical links. METHODS: Using magnetic resonance imaging (MRI), two 
      reviewers segmented total psoas muscle area (tPMSA), visceral fat area (VFA) and 
      subcutaneous fat area (mm(2) ) and measured visceral and subcutaneous thickness 
      (mm). Clinical, laboratory and quality of life (QoL; using PedsQL) data were 
      collected. Sarcopenia was defined as tPMSA </=5th percentile. Analysis of variance, 
      Wilcoxon rank test and multivariable modelling were performed. A paediatric 
      cohort with non-alcoholic fatty liver disease (NAFLD) was used as a comparator 
      following propensity score matching. RESULTS: Fifty-eight patients with 
      autoimmune liver disease (AILD) (33 [57%] with AIH) were included: median age 
      16 years (interquartile range [IQR]: 13-18), 33 (57%) male. Median time from 
      diagnosis to MRI was 15 months (IQR: 2-39 months). Two patients (3%) had a BMIz 
      indicative of mild malnutrition. tPMSA was measurable in 52 subjects (90%). Of 
      those, 25 (48%) had sarcopenia. Sarcopenic patients had a lower blood urea 
      nitrogen compared to non-sarcopenic (median [IQR]: 9.5 [8.0, 12.0] vs 11 [10, 
      14] mg/dL; P = .023). There was no difference in corticosteroid use between 
      groups. The VFA of sarcopenic patients was higher (3156 [2064, 7492]) vs 2084 
      [688, 3092]) mm(2) ; P = .005). Patient-reported QoL negatively associated with 
      VFA and general health negatively associated with VFA. Compared with NAFLD, the 
      odds ratio for sarcopenia with AILD was 14.5 (95% confidence interval: 2.3-90.7). 
      CONCLUSION: In autoimmune liver diseases, sarcopenia is highly prevalent, 
      associated with increased visceral fat and QoL.
CI  - (c) 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
FAU - Amevor, Antoinette A
AU  - Amevor AA
AUID- ORCID: 0000-0002-2395-5382
AD  - Division of Gastroenterology, Hepatology and Nutrition, Cincinnati Children's 
      Hospital Medical Center, Cincinnati, Ohio, USA.
AD  - Department of Pediatrics, University of Cincinnati College of Medicine, 
      Cincinnati, Ohio, USA.
FAU - Yodoshi, Toshifumi
AU  - Yodoshi T
AUID- ORCID: 0000-0001-7260-731X
AD  - Division of Gastroenterology, Hepatology and Nutrition, Cincinnati Children's 
      Hospital Medical Center, Cincinnati, Ohio, USA.
AD  - Department of Pediatrics, University of Cincinnati College of Medicine, 
      Cincinnati, Ohio, USA.
FAU - Trout, Andrew T
AU  - Trout AT
AD  - Department of Radiology, Cincinnati Children's Hospital Medical Center, 
      Cincinnati, Ohio, USA.
AD  - Department of Radiology, University of Cinncinati College of Medicine, 
      Cincinnati, Ohio, USA.
FAU - Dillman, Jonathan R
AU  - Dillman JR
AD  - Department of Radiology, Cincinnati Children's Hospital Medical Center, 
      Cincinnati, Ohio, USA.
AD  - Department of Radiology, University of Cinncinati College of Medicine, 
      Cincinnati, Ohio, USA.
FAU - Singh, Ruchi
AU  - Singh R
AD  - Division of Gastroenterology, Hepatology and Nutrition, Cincinnati Children's 
      Hospital Medical Center, Cincinnati, Ohio, USA.
FAU - Jarvis, Ryan
AU  - Jarvis R
AD  - Division of Gastroenterology, Hepatology and Nutrition, Cincinnati Children's 
      Hospital Medical Center, Cincinnati, Ohio, USA.
FAU - Fei, Lin
AU  - Fei L
AD  - Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital 
      Medical Center, Cincinnati, Ohio, USA.
FAU - Liu, Chunyan
AU  - Liu C
AD  - Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital 
      Medical Center, Cincinnati, Ohio, USA.
FAU - Taylor, Amy
AU  - Taylor A
AD  - Division of Gastroenterology, Hepatology and Nutrition, Cincinnati Children's 
      Hospital Medical Center, Cincinnati, Ohio, USA.
AD  - Department of Pediatrics, University of Cincinnati College of Medicine, 
      Cincinnati, Ohio, USA.
FAU - Miethke, Alexander
AU  - Miethke A
AD  - Division of Gastroenterology, Hepatology and Nutrition, Cincinnati Children's 
      Hospital Medical Center, Cincinnati, Ohio, USA.
AD  - Department of Pediatrics, University of Cincinnati College of Medicine, 
      Cincinnati, Ohio, USA.
FAU - Mouzaki, Marialena
AU  - Mouzaki M
AUID- ORCID: 0000-0002-9809-6199
AD  - Division of Gastroenterology, Hepatology and Nutrition, Cincinnati Children's 
      Hospital Medical Center, Cincinnati, Ohio, USA.
AD  - Department of Pediatrics, University of Cincinnati College of Medicine, 
      Cincinnati, Ohio, USA.
LA  - eng
GR  - P30 DK078392/DK/NIDDK NIH HHS/United States
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20211129
PL  - United States
TA  - Liver Int
JT  - Liver international : official journal of the International Association for the 
      Study of the Liver
JID - 101160857
SB  - IM
MH  - Adolescent
MH  - Child
MH  - *Hepatitis, Autoimmune/complications/epidemiology
MH  - Humans
MH  - Intra-Abdominal Fat/diagnostic imaging
MH  - Male
MH  - *Non-alcoholic Fatty Liver Disease/complications
MH  - Parents
MH  - Quality of Life
MH  - *Sarcopenia/complications/diagnostic imaging/epidemiology
PMC - PMC9453636
MID - NIHMS1832617
OTO - NOTNLM
OT  - autoimmune liver disease
OT  - sarcopenia
OT  - visceral fat
COIS- CONFLICT OF INTEREST The authors have no conflicts of interest relevant to this 
      article to disclose.
EDAT- 2021/11/25 06:00
MHDA- 2022/03/04 06:00
PMCR- 2023/02/01
CRDT- 2021/11/24 12:37
PHST- 2021/07/20 00:00 [received]
PHST- 2021/11/22 00:00 [accepted]
PHST- 2021/11/25 06:00 [pubmed]
PHST- 2022/03/04 06:00 [medline]
PHST- 2021/11/24 12:37 [entrez]
PHST- 2023/02/01 00:00 [pmc-release]
AID - 10.1111/liv.15108 [doi]
PST - ppublish
SO  - Liver Int. 2022 Feb;42(2):394-401. doi: 10.1111/liv.15108. Epub 2021 Nov 29.