Evaluation of skeletal muscle mass in patients with chronic liver disease shows different results based on bioelectric impedance analysis and computed tomography

Aim: We aimed to evaluate the difference between computed tomography (CT) and bioelectrical impedance analysis (BIA) -based assessment of sarcopenia in patients with chronic liver disease (CLD).Methods: We enrolled a total of 257 patients who was diagnosed with sarcopenia by CT and BIA based on the Japan Society of Hepatology.To evaluate whether or not the different methods influence the diagnosis of sarcopenia for the patients with CLD, we assessed the number and characteristics of mismatch between the low SMI using BIA and CT. We also compared with the overall survival (OS) in patients with sarcopenia and non-sarcopenia base on CT and BIA to evaluate the appropriate methods.Results: The number of patients with low SMI using BIA and CT was 28 (10.9%) and 68 (26.5%) patients, respectively. Multivariate analysis revealed that hepatic ascites and body weight were independent factors of mismatch between SMI using BIA and CT (hazard ratio [HR] 3.232, P<0.001; HR 2.347, P = 0.005, respectively). The median OS in patients with the sarcopenia based on CT was significantly lower than those in patients with the non-sarcopenia (P = 0.006). In contrast, there was no difference between patients with the sarcopenia based on BIA (P = 0.217).Discussion/Conclusion: Patients with CLD may be overestimated by the BIA method compared to CT when assessing sarcopenia, especially in cases of fluid retention.