A Multidisciplinary Viewpoint from Sport, Nutritional Sciences, and Nursing: Managing Sarcopenia in Patients with Cirrhosis

Vollständiger Abstract

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Cirrhosis, the final stage of hepatic diseases, affects over 112 million people worldwide, leading to issues such as varices, ascites, hepatic encephalopathy, and sarcopenia, which impacts 30% to 70% of cirrhotic patients. While sarcopenia is linked to poor outcomes, its prognostic effect remains unclear. Management strategies include medication, exercise, and nutritional support, but there is a lack of research on exercise programs targeting sarcopenia in cirrhosis. Patients often lack knowledge regarding the management of their condition, especially concerning exercise, nutrition, and treatment side effects. Issues like food insecurity and poor cooking skills can result in inadequate dietary intake. The disease induces sarcopenia through altered metabolism, causing an energy intake and need imbalance. Efforts to manage sarcopenia in cirrhosis patients focus on a three-level prevention framework: primary prevention through screening, secondary prevention by initiating therapy, and tertiary prevention by intensifying treatment for non-responders. Multidisciplinary healthcare teams, including sports, nursing and nutrition, enhance outcomes by utilizing resistance training to improve muscle mass and strength and aerobic exercise to boost aerobic capacity and cardiorespiratory fitness.