OBJECTIVES Frailty is prevalent in patients with cirrhosis and is hypothesized to result in part from sarcopenia, but the precise contribution of sarcopenia to frailty in this population is poorly understood. METHODS Included were patients with cirrhosis from 2011 to 2014 who had an ambulatory frailty assessment and abdominal computed tomography scan within 3 months. Logistic regression assessed the associations between frailty (=Liver Frailty Index ≥4.5), and sarcopenia (=skeletal muscle index of <39 cm/m for women and <50 cm/m for men). RESULTS Two hundred ninety-one participants were included: 33% were female. The median (interquartile range) Liver Frailty Index was 3.7 (3.3-4.2); 19% were frail. The median (interquartile range) skeletal muscle index was 49 cm/m (31-69); 36% had sarcopenia. Among the 54 frail participants, 48% had sarcopenia. In univariable logistic regression, sarcopenia was associated with a 1.86× increased odds of being frail (95% confidence interval [CI], 1.02-3.38). After adjusting for sex, etiology, hepatocellular carcinoma, MELDNa, ascites, encephalopathy, and hypertension, sarcopenia was associated with a 2.38× increased odds of being frail (95% CI, 1.17-4.85). After stratifying by sex and adjusting for MELDNa, sarcopenia among males was associated with a significantly increased odds of frailty (odds ratio 2.81, 95% CI, 1.19-6.67), whereas sarcopenia among females was not (odds ratio 1.38; 95% CI, 0.45-4.25). DISCUSSION In patients with cirrhosis, sarcopenia was associated with a nearly 2-fold increased odds of being frail. Two-thirds of frail men displayed sarcopenia compared with only one-quarter of frail women. Contributors to the frail phenotype may differ by sex and support the need for sex-specific strategies to reduce frailty in this population.

中文翻译：

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肝硬化患者虚弱与肌肉减少症之间关联的性别差异。

目的衰弱在肝硬化患者中普遍存在，并被认为部分是由于肌肉减少症所致，但对于这一人群中肌肉减少症对衰弱的确切贡献知之甚少。方法包括2011年至2014年肝硬化患者，他们在3个月内进行了门诊脆弱性评估和腹部计算机断层扫描。Logistic回归评估了虚弱（=肝脏虚弱指数≥4.5）和肌肉减少症（=女性的骨骼肌指数<39 cm / m，男性的骨骼肌指数<50 cm / m）之间的关联。结果包括211名参与者：33％是女性。中位（四分位间距）肝脏衰弱指数为3.7（3.3-4.2）；19％虚弱。中位（四分位间距）骨骼肌指数为49 cm / m（31-69）；36％患有肌肉减少症。在54位体弱的参与者中，48％有肌肉减少症。在单变量逻辑回归中，肌肉减少症与体弱的几率增加1.86倍（95％置信区间[CI]，1.02-3.38）。在对性别，病因，肝细胞癌，MELDNa，腹水，脑病和高血压进行调整后，肌肉减少症的患病几率增加了2.38倍（95％CI，1.17-4.85）。在按性别分层并调整了MELDNa后，男性的肌肉减少症与体弱的几率显着增加相关（奇数比2.81、95％CI，1.19-6.67），而女性的少肌症则没有（奇数比1.38； 95％CI 0.45-4.25）。讨论在肝硬化患者中，肌肉减少症与体弱的几率增加了近两倍。三分之二的脆弱男性表现出肌肉减少症，而四分之一的女性则表现为肌肉减少。