Grip Strength, Gait Speed, and Chair Stands Predict Sarcopenia in Male But Not Female Liver Transplant Candidates
University of California, San Francisco, San Francisco, CA.
Meeting: 2015 American Transplant Congress
Abstract number: C104
Keywords: Hepatocellular carcinoma
Session Information
Session Name: Poster Session C: Liver Donation and Allocation
Session Type: Poster Session
Date: Monday, May 4, 2015
Session Time: 5:30pm-6:30pm
Presentation Time: 5:30pm-6:30pm
Location: Exhibit Hall E
Background: Sarcopenia, as determined by cross-sectional skeletal muscle index (SMI), is associated with waitlist mortality in liver transplant (LT) candidates, but has limited clinical utility given its cost and repeatability. We aimed to determine the relationship between sarcopenia and performance-based measures of functional status that can be performed at the bedside.
Methods: Adults enrolled in the prospective Functional Assessment in Liver Transplantation (FrAILT) Study, listed for LT with hepatocellular carcinoma (HCC), and who had an abdominal computed tomogram (CT) were included. SMI = total cross-sectional area of psoas, paraspinal, and abdominal wall muscles measured at L3 vertebra and normalized for stature (cm2/m2). Sarcopenia was defined using previously published SMI thresholds (SMI<53 cm2/m2 for men with BMI≥25 kg/m2, SMI<43 cm2/m2 for men with BMI<25 kg/m2, and SMI<41 cm2/m2 for women). Within 3 months of CT scan, physical function was tested using performance-based measures (grip strength, gait speed, and timed chair stands). Linear regression assessed the relationship between SMI and performance-based measures. Mann Whitney test compared performance-based measures between sarcopenic and non-sarcopenic patients.
Results: 103 men (M) and 33 women (W) were studied. M and W were similar by age, MELD, %HCV, and BMI. Median (interquartile range) SMI was 52 cm2/m2 (48-57) for M and 45 cm2/m2 (39-50) for W; 39%M vs. 31%W were classified as sarcopenic (p=0.42). Median performance-based test values for M and W were: grip strength 35 vs. 23 kg (p<0.01), gait speed 1.3 vs. 1.2 m/sec (p=0.08), and chair stands 11.2 vs. 10.9 sec (p=0.64). SMI and grip strength were strongly associated in M (coeff.=0.31; p<0.01), but not in W (coeff.=-0.09; p=0.68). Sarcopenic vs. non-sarcopenic M were more impaired by grip strength (34 vs. 37 kg; p<0.01), gait speed (1.2 vs. 1.4 m/sec; p=0.06), and chair stands (12.4 vs. 9.7 sec; p=0.02). Differences between sarcopenic and non-sarcopenic W by grip strength, gait speed, and chair stands were not observed (p>0.05 for each).
Conclusions: Simple performance-based measures of functional status are strongly associated with sarcopenia in male but not female LT patients. These inexpensive tests can be performed quickly and reliably. Further investigation into the gender differences of the prognostic power of these tests is needed.
To cite this abstract in AMA style:
Wang C, Feng S, Covinsky K, Hayssen H, Yeh B, Lai J. Grip Strength, Gait Speed, and Chair Stands Predict Sarcopenia in Male But Not Female Liver Transplant Candidates [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/grip-strength-gait-speed-and-chair-stands-predict-sarcopenia-in-male-but-not-female-liver-transplant-candidates/. Accessed May 12, 2025.« Back to 2015 American Transplant Congress