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Cirrhosis predisposes to abnormalities in energy, hormonal, and immunological homeostasis. Disturbances in these metabolic processes create susceptibility to sarcopenia or pathological muscle wasting. Sarcopenia is prevalent in cirrhosis and its presence portends significant adverse outcomes including the length of hospital stay, infectious complications, and mortality. This highlights the importance of identification of at-risk individuals with early nutritional, therapeutic and physical therapy intervention. This manuscript summarizes literature relevant to sarcopenia in cirrhosis, describes current knowledge, and elucidates possible future directions.
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UNLABELLED: The prevalence of sarcopenic obesity in community-dwelling women 70 years and older according to established sarcopenia and obesity definitions averaged between 0 and 2.3 % and can thus be considered as relatively low. However, the converse argument that sarcopenic obesity was incompatible with an independent life cannot be confirmed. INTRODUCTION: The primary aim of the study was to determine the prevalence of sarcopenic obesity (SO) in community-dwelling (CD) older females in Germany. The secondary aim was to assess whether these females really live independently and autonomously. METHODS: A total of 1325 CD females 70 years and older living in the area of Erlangen-Nürnberg, Germany were assessed. Sarcopenia as defined by (a) the European Working Group on Sarcopenia in older people (EWGSOP) and (b) the International working group on Sarcopenia (IWGS) combined with obesity defined as (a) BMI ≥ 30 kg/m(2) (NIH) or (b) body-fat ≥ 35 % (WHO) was determined. In participants with SO, Barthel Index, care level and social network were retrospectively evaluated via personal interview. RESULTS: Based on anthropometric data, family, education and social status, lifestyle, number and distribution of diseases and medication, the present cohort is representative for the corresponding German population. Sarcopenia prevalence was 4.5 % according to EWGSOP and 3.3 % according to the IWGS criteria. Obesity prevalence in our cohort averaged 19.8 % (BMI, NIH) and 63.8 % (body fat, WHO). The overlap between both factors (i.e. SO) ranged from 0 % (EWGSOP + NIH criteria) to 2.3 % (EWGSOP + WHO criteria). Factors that may represent limited autonomy or independence were very rarely identified in this SO cohort. CONCLUSION: The prevalence of sarcopenic obesity in the CD (female) German population 70 years + is relatively low. With respect to our second research aim, the hypothesis that SO was incompatible with independent life was rejected. However, the latter finding should be addressed with more dedicated study designs.