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Interventions to improve sarcopenia in cirrhosis: A systematic review

查看全文 作　　者：Maliha [1]Naseer;Erica P [2]Turse;Ali [3]Syed;Francis E [4]Dailey;Mallak [4]Zatreh;Veysel [4]Tahan 高影响力作者 机构地区：[1]Department of Internal Medicine, Division of Gastroenterology and Hepatology, East Carolina University;[2]Department of Internal Medicine, Division of Gastroenterology, St Joseph Hospital Medical Center/Creighton University;[3]Department of Internal Medicine, University of Missouri;[4]Department of Internal Medicine, Division of Gastroenterology and Hepatology, University of Missouri高影响力机构 出　　处：《World Journal of Clinical Cases》索引2019年第7卷第2期,共15页高影响力期刊 摘　　要：BACKGROUND 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. 关 键 词：SARCOPENIA CIRRHOSIS Treatment Intervention Nutrition Therapy Exercise TESTOSTERONE Trans JUGULAR INTRAHEPATIC portosystemic SHUNT
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