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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Gastroenterology & Hepatopancreatobiliary Medicine".

Deadline for manuscript submissions: closed (28 March 2023) | Viewed by 11672

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Special Issue Editors

Dr. Hiroki Nishikawa

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The Second Department of Internal Medicine, Osaka Medical College, 2-7, Daigakumachi, Takatsukishi 569-8686, Osaka, Japan
Interests: liver cirrhosis; sarcopenia; liver-gut axis; viral hepatitis; hepatocellular carcinoma; frailty; malignancies; NASH; interventional radiology
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Dr. Tadashi Namisaki

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Department of Gastroenterology, Nara Medical University, 840 Shijo-cho, Kashihara 634-8522, Nara, Japan
Interests: liver fibrosis; diabetes mellitus; inflammation; steatosis
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Dr. Takemi Akahane

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Department of Gastroenterology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan
Interests: leaky gut; endotoxin; nonalcoholic fatty liver disease; alcoholic liver disease; liver fibrosis; Toll-like receptors; probiotics; antibiotics
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Dr. Kosuke Kaji

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Department of Gastroenterology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan
Interests: hepatic encephalopathy; liver regeneration; cholangiocarcinoma; hepatocellular carcinoma; liver fibrosis

Special Issue Information

Dear Colleagues,

Skeletal muscle is the largest organ in the body, and skeletal muscle atrophy results from a shift in the balance of protein synthesis and degradation toward protein breakdown. Primary sarcopenia is defined as the loss of skeletal muscle mass and strength or physical function due to aging, and secondary sarcopenia is defined as the loss of skeletal muscle mass and strength or physical function due to underlying diseases. Gastrointestinal diseases have a high rate of complications such as chronic inflammation, malnutrition, infection, and advanced cancer. These complications suppress protein synthesis in skeletal muscle through various immune responses. Therefore, sarcopenia is very common in gastrointestinal diseases. Gastrointestinal diseases are the most common cause of secondary sarcopenia. The importance of this topic will certainly increase in the future as the number of gastrointestinal patients grows. In recent years, the Asian Sarcopenia Criteria and the European Sarcopenia Criteria have been revised, and the debate on sarcopenia has become more heated. In our country, a sarcopenia-assessment criteria specific to liver disease was created by the Japanese Society of Hepatology in 2016, and the criteria have been cited by many researchers. In this Special Issue, we invite a wide range of papers on basic research, clinical research, and review articles on the pathogenesis, diagnosis, and treatment of sarcopenia in gastrointestinal diseases (esophagus, gastroduodenum, small intestine, large intestine, pancreas, and liver). We look forward to receiving many high-quality papers from relevant researchers.

Dr. Hiroki Nishikawa
Dr. Tadashi Namisaki
Dr. Takemi Akahane
Dr. Kosuke Kaji
Guest Editor

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Keywords

sarcopenia
gastrointestinal disease
mechanism
immune response
treatment
intervention
clinical outcome

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Published Papers (4 papers)

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Research

13 pages, 1028 KiB

Open AccessArticle

Thickness of Biceps and Quadriceps Femoris Muscle Measured Using Point-of-Care Ultrasound as a Representation of Total Skeletal Muscle Mass

by Rianne N. M. Hogenbirk, Alain R. Viddeleer, Judith E. K. R. Hentzen, Willemijn Y. van der Plas, Cees P. van der Schans, Geertruida H. de Bock, Schelto Kruijff and Joost M. Klaase

J. Clin. Med. 2022, 11(22), 6606; https://doi.org/10.3390/jcm11226606 - 8 Nov 2022

Cited by 12 | Viewed by 3464

Abstract

Generalized loss of muscle mass is associated with increased morbidity and mortality in patients with cancer. The gold standard to measure muscle mass is by using computed tomography (CT). However, the aim of this prospective observational cohort study was to determine whether point-of-care ultrasound (POCUS) could be an easy-to-use, bedside measurement alternative to evaluate muscle status. Patients scheduled for major abdominal cancer surgery with a recent preoperative CT scan available were included. POCUS was used to measure the muscle thickness of mm. biceps brachii, mm. recti femoris, and mm. vasti intermedius 1 day prior to surgery. The total skeletal muscle index (SMI) was derived from patients’ abdominal CT scan at the third lumbar level. Muscle force of the upper and lower extremities was measured using a handheld dynamometer. A total of 165 patients were included (55% male; 65 ± 12 years). All POCUS measurements of muscle thickness had a statistically significant correlation with CT-derived SMI (r ≥ 0.48; p < 0.001). The strongest correlation between POCUS muscle measurements and SMI was observed when all POCUS muscle groups were added together (r = 0.73; p < 0.001). Muscle strength had a stronger correlation with POCUS-measured muscle thickness than with CT-derived SMI. To conclude, this study indicated a strong correlation between combined muscle thickness measurements performed by POCUS- and CT-derived SMI and measurements of muscle strength. These results suggest that handheld ultrasound is a valid tool for the assessment of skeletal muscle status. Full article

(This article belongs to the Special Issue Sarcopenia and Gastrointestinal Disease)

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16 pages, 1453 KiB

Open AccessArticle

Sarcopenia and Myosteatosis Are Associated with Neutrophil to Lymphocyte Ratio but Not Glasgow Prognostic Score in Colorectal Cancer Patients

by Raila Aro, Sanna Meriläinen, Päivi Sirniö, Juha P. Väyrynen, Vesa-Matti Pohjanen, Karl-Heinz Herzig, Tero T. Rautio, Elisa Mäkäräinen, Reetta Häivälä, Kai Klintrup, Markus J. Mäkinen, Juha Saarnio and Anne Tuomisto

J. Clin. Med. 2022, 11(9), 2656; https://doi.org/10.3390/jcm11092656 - 9 May 2022

Cited by 6 | Viewed by 2308

Abstract

Cancer patients commonly present sarcopenia, myosteatosis, and systemic inflammation, which are risk factors of poor survival. In this study, sarcopenia and myosteatosis were defined from preoperative body computed tomography scans of 222 colorectal cancer (CRC) patients and analyzed in relation to tumor and patient characteristics, markers of systemic inflammation (modified Glasgow prognostic score (mGPS), neutrophil–lymphocyte ratio (NLR), serum levels of C-reactive protein (CRP), albumin, and 13 cytokines, and survival. Of the systemic inflammation markers, sarcopenia and/or myosteatosis associated with elevated NLR (p = 0.005) and low albumin levels (≤35 g/L) (p = 0.018), but not with mGPS or serum cytokine levels. In addition, myosteatosis was associated with a proximal tumor location (p = 0.039), serrated tumor subtype (p < 0.001), and severe comorbidities (p = 0.004). Multivariable analyses revealed that severe comorbidities and serrated histology were independent predictors of myosteatosis, and older age and elevated NLR were independent indicators of sarcopenia. Myosteatosis associated with shorter overall survival in univariable analysis (HR 1.959, 95% CI 1.24–3.10, p = 0.004) but not in multivariable analysis (p = 0.075). We conclude that sarcopenia and myosteatosis were associated with inflammatory marker NLR, but not with mGPS. Moreover, patients with serrated CRC may have an increased risk of myosteatosis. Myosteatosis or sarcopenia were not independent predictors of patient survival. Full article

(This article belongs to the Special Issue Sarcopenia and Gastrointestinal Disease)

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13 pages, 2038 KiB

Open AccessArticle

ADAMTS13, VWF, and Endotoxin Are Interrelated and Associated with the Severity of Liver Cirrhosis via Hypercoagulability

by Hiroaki Takaya, Tadashi Namisaki, Shohei Asada, Satoshi Iwai, Takahiro Kubo, Junya Suzuki, Masahide Enomoto, Yuki Tsuji, Yukihisa Fujinaga, Norihisa Nishimura, Yasuhiko Sawada, Kosuke Kaji, Hideto Kawaratani, Kei Moriya, Takemi Akahane, Masanori Matsumoto and Hitoshi Yoshiji

J. Clin. Med. 2022, 11(7), 1835; https://doi.org/10.3390/jcm11071835 - 26 Mar 2022

Cited by 12 | Viewed by 2218

Abstract

ADAMTS13 specifically cleaves the multimeric von Willebrand factor (VWF), and an imbalance between ADAMTS13 activity (ADAMTS13:AC) and VWF antigen (VWF:Ag) levels is associated with the severity of liver cirrhosis (LC). However, the reason for this imbalance in patients with LC is unknown. This study investigated the relationship among ADAMTS13:AC, VWF:Ag, and endotoxin (Et) levels in patients with LC. ADAMTS13:AC and VWF:Ag levels were determined using ELISA, whereas Et levels were estimated using a chromogenic substrate assay. The levels of ADAMTS13 inhibitor (ADAMTS13:INH) were evaluated by measuring the extent that heat-inactivated patient’s plasma reduces the ADAMTS13:AC of the control. The status (degraded, normal, or unusually large [UL]) of the VWF multimer (VWFM) was determined through vertical agarose gel electrophoresis. ADAMTS13:AC, VWF:Ag, and Et levels decreased, increased, and increased, respectively, with the severity of LC. Patients with cirrhosis with high Et levels had lower and higher ADAMTS13:AC and VWF:Ag levels, respectively, than those with low Et levels. Patients with cirrhosis with detectable ADAMTS13:INH had higher Et levels than those with undetectable ADAMTS13:INH. Patients whose VWFM was either normal or UL had higher Et levels than those with degraded VWFM. In conclusion, ADAMTS13, VWF, and Et may be interrelated and associated with the severity of LC via hypercoagulability. Full article

(This article belongs to the Special Issue Sarcopenia and Gastrointestinal Disease)

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11 pages, 2424 KiB

Open AccessFeature PaperArticle

Clinical Usefulness of FRAX Score for Predicting Sarcopenia in Patients with Chronic Liver Disease

by Chisato Saeki, Mitsuru Saito, Tomoya Kanai, Masanori Nakano, Tsunekazu Oikawa, Yuichi Torisu, Masayuki Saruta and Akihito Tsubota

J. Clin. Med. 2021, 10(18), 4080; https://doi.org/10.3390/jcm10184080 - 9 Sep 2021

Cited by 2 | Viewed by 2201

Abstract

We investigated the usefulness of the Fracture Risk Assessment tool (FRAX) for predicting sarcopenia in chronic liver disease (CLD). In this cross-sectional study, we evaluated 321 patients with CLD. The FRAX with and without bone mineral density (BMD) was employed to calculate the 10-year risks of major osteoporotic and hip fractures. The FRAX score for high fracture risk was defined as a 10-year major osteoporotic fracture probability of ≥20% or a 10-year hip fracture probability of ≥3%. The diagnosis of sarcopenia was based on the Japan Society of Hepatology criteria. According to the FRAX, with and without BMD, 134 (41.7%) and 193 (60.1%) patients had a high fracture risk, respectively. The high fracture risk group had a significantly higher frequency of sarcopenia than the non-high fracture risk group. FRAX scores of major osteoporotic and hip fractures were negatively correlated with handgrip strength and muscle mass. Using the FRAX with BMD, the cutoff scores of major osteoporotic and hip fractures for predicting sarcopenia were 8.55% (sensitivity/specificity, 0.847/0.568) and 3.35% (0.729/0.746), respectively. Using the FRAX without BMD, they were 18.5% (0.635/0.725) and 7.65% (0.729/0.758), respectively. The FRAX is a simple and convenient screening tool for predicting sarcopenia in patients with CLD. Full article

(This article belongs to the Special Issue Sarcopenia and Gastrointestinal Disease)

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