{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T16:12:04Z","timestamp":1786119124941,"version":"build-2736575974"},"reference-count":47,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2019,1,4]],"date-time":"2019-01-04T00:00:00Z","timestamp":1546560000000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2019,1,1]],"date-time":"2019-01-01T00:00:00Z","timestamp":1546300800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001518","name":"Maurice and Phyllis Paykel Trust","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001518","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver Transpl"],"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:p>\n                    Sarcopenia as defined by reduced skeletal muscle area (SMA) on cross\u2010sectional abdominal imaging has been proposed as an objective measure of malnutrition, and it is associated with both wait\u2010list mortality and posttransplant complications in patients with cirrhosis. SMA, however, has never been validated against the gold standard measurement of total body protein (TBP) by in vivo neutron activation analysis (IVNAA). Furthermore, overhydration is common in cirrhosis, and its effect on muscle area measurement remains unknown. We aimed to examine the relationship between SMA and TBP in patients with cirrhosis and to assess the impact of overhydration on this relationship. Patients with cirrhosis who had undergone IVNAA and cross\u2010sectional imaging within 30 days were retrospectively identified. Patients with significant clinical events between measurements were excluded. Psoas muscle area (PMA) and SMA at the level of the third lumbar vertebrae were determined. Total body water was estimated from a multicompartment model and expressed as a fraction of fat\u2010free mass (FFM), as determined by dual\u2010energy X\u2010ray absorptiometry, to provide an index of hydration status. In total, 107 patients underwent 109 cross\u2010sectional imaging studies (87 computed tomography; 22 magnetic resonance imaging) within 30 days of IVNAA. Median time between measurements was 1 day (IQR, \u20131 to 3 days). Between 43% and 69% of the cohort was identified as sarcopenic, depending on muscle area cutoff values used. TBP was strongly correlated with SMA (\n                    <jats:italic toggle=\"yes\">r<\/jats:italic>\n                    \u00a0=\u00a00.78;\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u00a0&lt;\u00a00.001) and weakly correlated with PMA (\n                    <jats:italic toggle=\"yes\">r<\/jats:italic>\n                    \u00a0=\u00a00.49;\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u00a0&lt;\u00a00.001). Multiple linear regression showed SMA was significantly and positively associated with FFM hydration (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u00a0&lt;\u00a00.001) independently of TBP. In conclusion, SMA is more closely related to TBP than is PMA, and it should be preferred as a measure of sarcopenia. Overhydration significantly affects the measurement of cross\u2010sectional muscle area.\n                  <\/jats:p>","DOI":"10.1002\/lt.25314","type":"journal-article","created":{"date-parts":[[2018,7,24]],"date-time":"2018-07-24T21:20:20Z","timestamp":1532467220000},"page":"45-55","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Relationship Between Total Body Protein and Cross\u2010Sectional Skeletal Muscle Area in Liver Cirrhosis Is Influenced by Overhydration"],"prefix":"10.1097","volume":"25","author":[{"given":"Cameron I.","family":"Wells","sequence":"first","affiliation":[{"name":"Department of Surgery,University of Auckland,Auckland,New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John L.","family":"McCall","sequence":"additional","affiliation":[{"name":"New Zealand Liver Transplant Unit,Auckland City Hospital,Auckland,New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lindsay D.","family":"Plank","sequence":"additional","affiliation":[{"name":"Department of Surgery,University of Auckland,Auckland,New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2019,1,4]]},"reference":[{"key":"lt25314-bib-0001-20240115","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1093\/ageing\/afq034","article-title":"Sarcopenia: European consensus on definition and diagnosis: Report of the European Working Group on Sarcopenia in Older People","volume":"39","year":"2010","journal-title":"Age Ageing"},{"key":"lt25314-bib-0002-20240115","doi-asserted-by":"crossref","first-page":"2277","DOI":"10.1111\/ajt.13732","article-title":"Systematic review and meta\u2010analysis of the impact of computed tomography\u2013assessed skeletal muscle mass on outcome in patients awaiting or undergoing liver 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