S1305 Thigh Ultrasound Correlates with Bioimpedance Analysis (BIA) on Cirrhotic Patients

Introduction: Sarcopenia defined by the European Working Group on Sarcopenia (EWGSOP2), comprising low muscle strength, low muscle quantity/quality, and low physical performance. In Chronic Liver Disease, sarcopenia is associated with HE, ascites, infection and is an independent risk factor for reduced survival. Currently CT scan is gold standard tool for diagnosis of sarcopenia. It is expensive, neither readily available nor portable and leads to radiation exposure. Thigh US is a novel non-invasive technique, easy to perform at bed side. BIA is validated for diagnosis of sarcopenia, body composition analysis and nutritional status. We aim for validation of anterior thigh US to quantify sarcopenia in CLD using: Total muscle thickness (TMT) and Superficial fat thickness (SF). Methods: A prospective cross-sectional study of Functional muscle (hand-grip and sit-to-stand), Performance (gait speed), Muscle mass using B-mode US is being carried out in cirrhotic patients and validated using SECA BIA. Frailty liver index score (https://liverfrailtyindex.ucsf.edu). Stata 17.0 was used for statistical analysis with t-test and Pearson correlation (Table). Results: 48 individuals recruited to date: 33 cirrhosis and 15 healthy controls. 30% of cirrhotic patients were actively drinking alcohol (Figure). Most patients were male (66%), with mean age 59 yrs (SD=2), BMI 29.44 kg/m2 (SD=1.2) and MELD 11 (SD=4) HC had lower BMI (p=0.06) and waist circumference (p=0.01). Impaired functional muscle strength in cirrhotic patients was noted. HC had lower Sit-to-stand time (8.84 vs 14.36 secs, P= 0.0005) and gait speed (2.78 vs 5.64, P=0.05) hand-grip strength were higher in HCs (P= 0.0004) and HCs were more active (P=0.0001). Higher frailty index scores were associated with lower gait speed (p=0.001), ASMM/height2 (p=0.06) Mean TMT was lower in cirrhotic cohort vs HC (3.69 vs 4.4, SD 0.2 vs 0.2 respectively, p=0.02) Lower TMT was associated with higher frailty index scores in cirrhotic patients (p=0.02) TMT did not correlate with MELD score in cirrhosis (p=0.06) Mean Fat mass measured with BIA was higher in cirrhosis vs HC (29 vs 22 kg, p= 0.04). Validation of Ant. Thigh US use in CLD BIA skeletal muscle mass strongly correlated with anterior thigh muscle thickness (r=0.54, p=0.0001) and BIA fat mass correlated with thigh US-measured SF (r=0.59. p=0.0001). Conclusion: There were strong correlation between thigh US and BIA measurements. Thigh Ultrasound is novel and potential new technique for diagnosis of muscle mass, fat mass and sarcopenia.Figure 1.: Anterior Thigh US Table 1. - CirrhosisN=33 Healthy controlsN=15 P-value Age (Mean, SD) 59, 2 45, 2 0.0001 Male Gender (n) 22 (66%) 7 (46%) Aetiology ALD (n=22)NASH (n=6)AIH (n=1)PBC (n=1)Cryptogenic (n=1)NASH/ASH/A1AT (n=1)HCV/HIV/ALD (n=1) MELD (mean, IQR) 11, 7-12 Clinical Ascites Female: 0Male: 9 (41%) Liver frailty index, Frail Female: 5 (45%)Male: 5 (23%) Active alcohol drinking 10 (30%) Smoker 16 (48%) 3 (20%) BMI kg/m2 (Mean, SD) 29.44, 1.2 26.65, 0.73 0.06 Albumin (mean, IQR) 39, 36-43 Bilirubin (mean, IQR) 20, 9-41 INR (mean, IQR) 1.2, 1.02-1.04 Platelet (mean, IQR) 143, 94-183 ALT (mean, IQR) 31, 21-36 Waist circumference (cm) {Mean, SD} 101, 2 91.6, 3 0.01 Waist circumference, excluding ascites (cm) {Mean, SD} 103.6, 3 91.6, 3 0.006 TMT (cm) {mean, SD} 3.69, 0.2 4.4, 0.2 0.02 Vastus intermedius (VI){Mean, SD} 1.45, 0.9 2.05, 0.1 0.0006 Rectus femoris (RF) {mean, SD} 1.9, 0.8 2.2, 0.1 0.05 SF (cm) {mean, SD} 1.42, 0.2 1.19, 0.1 0.26 Skeletal muscle mass (Kg) {Mean, SD} 24.2, 1.12 25.92, 1.55 0.39 Fat mass (Kg) Mean, SD 29, 3 22, 2 0.04 handgrip strength (Kg) {Mean, SD} 25, 2 38, 3 0.0005 Sit-to-stand (sec) {Mean, SD} 14.36, 1.24 8.84, 0.76 0.0005 Gait speed (sec){Mean, SD} 5.64, 1.42 2.78, 0.5 0.05 Physical activity level(Mean, SD) 1.75, 0.03 1.92, 0.03 0.0001