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Interventions to improve sarcopenia in cirrhosis: A systematic review

dc.contributor.authorNaseer, Maliha
dc.contributor.authorTurse, Erica P
dc.contributor.authorSyed, Ali
dc.contributor.authorDailey, Francis E
dc.contributor.authorZatreh, Mallak
dc.contributor.authorTahan, Veysel
dc.date.accessioned2020-04-17T18:03:32Z
dc.date.available2020-04-17T18:03:32Z
dc.date.issued2019-01-26
dc.description.abstractBACKGROUND: Sarcopenia, i.e., muscle loss is now a well-recognized complication of cirrhosis and in cases of non-alcoholic fatty liver disease can contribute to accelerate liver fibrosis leading to cirrhosis. Hence, it is imperative to study interventions which targets to improve sarcopenia in cirrhosis. AIM: To examine the relationship between interventions such nutritional supplementation, exercise, combined life style intervention, testosterone replacement and trans jugular intrahepatic portosystemic shunt (TIPS) to improve muscle mass in cirrhosis. METHODS: We search PubMed, EMBASE and Cochrane between June-August 2018, without a limiting period and the types of articles (RCTs, clinical trial, comparative study) in adult patients with sarcopenia and cirrhosis. The primary outcome of interest was improvement in muscle mass, strength and physical function interventions mentioned above. In the screening process, 154 full text articles were included in the review and 129 studies were excluded. RESULTS: We identified 24 studies that met review inclusion criteria. The studies were diverse in terms of the design, setting, interventions, and outcome measurements. We performed only qualitative synthesis of evidence due to heterogeneity amongst studies. Risk of bias was medium in most of the included studies and low quality of evidence showed improvement in the muscle mass, strength and physical function following aerobic exercise. 60% of the included studies on the nutritional intervention, 100% of the studies on testosterone replacement in hypogonadal men and trans-jugular portosystemic shunt were proved to be effective in improving sarcopenia in cirrhosis. CONCLUSION: Although the quality of evidence is low, the findings of our systematic review suggest improvement in the sarcopenia in cirrhosis with exercise, nutritional interventions, hormonal and TIPS interventions. High quality randomized controlled trials needed to further strengthen these findings.en_US
dc.identifier.doi10.12998/wjcc.v7.i2.156
dc.identifier.urihttp://hdl.handle.net/10342/8227
dc.subjectSarcopenia; Cirrhosis; Treatment; Intervention; Nutrition; Therapy; Exercise; Testosterone; Trans jugular intrahepatic portosystemic shunten_US
dc.titleInterventions to improve sarcopenia in cirrhosis: A systematic reviewen_US
dc.typeArticleen_US
ecu.journal.issue2en_US
ecu.journal.nameWorld Journal of Clinical Casesen_US
ecu.journal.pages156-170en_US
ecu.journal.volume7en_US

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