{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T06:03:01Z","timestamp":1791266581916,"version":"4.1.0"},"reference-count":45,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2023,5,11]],"date-time":"2023-05-11T00:00:00Z","timestamp":1683763200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["physoc.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Experimental Physiology"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Sarcopenia is associated with reduced quality of life and increased mortality in patients with end stage liver disease (ESLD). Historically, sarcopenia identification in ESLD utilised L3 skeletal muscle index (SMI). There are few data on muscle quality and function within lower limb muscle groups with high functional relevance. The aim of this prospective case\u2013control study was to evaluate the quadriceps muscle in patients with ESLD. Muscle mass and quality were evaluated using MRI (quadriceps anatomical cross sectional area (ACSA), quadriceps volume index, L3 SMI, quadriceps intermuscular adipose tissue (IMAT)), mid\u2010arm muscle circumference (MAMC) and ultrasonography (vastus lateralis (VL) thickness and quadriceps ACSA). Muscle strength\/function was assessed by handgrip strength, peak quadriceps isokinetic torque and chair rise time. Thirty\u2010nine patients with ESLD (55 years, 61% male, 48% alcoholic related liver disease (ArLD), 71% Child\u2013Pugh B\/C) and 18 age\/sex\u2010matched healthy control participants (HC) were studied. Quadriceps mass was significantly reduced in ESLD versus HC (\u221217%), but L3 SMI and MAMC were unchanged. Quadriceps IMAT percentage was increased in ESLD (+103%). Handgrip strength (\u221215%), peak isokinetic torque (\u221229%), and chair rise time (+56%) were impaired in ESLD. Ultrasound measures of VL thickness (<jats:italic>r<\/jats:italic>\u00a0=\u00a00.56, <jats:italic>r<\/jats:italic>\u00a0=\u00a00.57, <jats:italic>r<\/jats:italic>\u00a0=\u00a00.42) and quadriceps ACSA (<jats:italic>r<\/jats:italic>\u00a0=\u00a00.98, <jats:italic>r<\/jats:italic>\u00a0=\u00a00.86, <jats:italic>r<\/jats:italic>\u00a0=\u00a00.67) correlated to MRI quadriceps ACSA, quadriceps volume and L3 SMI, respectively. Quadriceps muscle mass, quality, and function were impaired in patients with ESLD, whereas conventional assessments of muscle (L3 SMI and MAMC) highlighted no differences between ESLD and HC. Full evaluation of lower limb muscle health is essential in ESLD in order to accurately assess sarcopenia and target future interventions.<\/jats:p>","DOI":"10.1113\/ep091157","type":"journal-article","created":{"date-parts":[[2023,5,11]],"date-time":"2023-05-11T14:35:13Z","timestamp":1683815713000},"page":"1066-1079","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Impaired lower limb muscle mass, quality and function in end stage liver disease: A cross\u2010sectional study"],"prefix":"10.1113","volume":"108","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1205-7069","authenticated-orcid":false,"given":"Jonathan I.","family":"Quinlan","sequence":"first","affiliation":[{"name":"NIHR Birmingham Biomedical Research Centre University Hospitals Birmingham NHS Foundation Trust and University of Birmingham  Birmingham UK"},{"name":"School of Sport, Exercise and Rehabilitation Sciences University of Birmingham  Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amritpal","family":"Dhaliwal","sequence":"additional","affiliation":[{"name":"NIHR Birmingham Biomedical Research Centre University Hospitals Birmingham NHS Foundation Trust and University of Birmingham  Birmingham UK"},{"name":"Institute of Inflammation and Ageing University of Birmingham  Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felicity R.","family":"Williams","sequence":"additional","affiliation":[{"name":"NIHR Birmingham Biomedical Research Centre University Hospitals Birmingham NHS Foundation Trust and University of Birmingham  Birmingham UK"},{"name":"Institute of Inflammation and Ageing University of Birmingham  Birmingham UK"},{"name":"Therapies Department University Hospitals Birmingham  Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie L.","family":"Allen","sequence":"additional","affiliation":[{"name":"NIHR Birmingham Biomedical Research Centre University Hospitals Birmingham NHS Foundation Trust and University of Birmingham  Birmingham UK"},{"name":"School of Sport, Exercise and Rehabilitation Sciences University of Birmingham  Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Surabhi","family":"Choudhary","sequence":"additional","affiliation":[{"name":"Department of Imaging University Hospitals Birmingham  Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex","family":"Rowlands","sequence":"additional","affiliation":[{"name":"NIHR Leicester Biomedical Research Centre  Leicester UK"},{"name":"Diabetes Research Centre University of Leicester, Leicester General Hospital  Leicester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leigh","family":"Breen","sequence":"additional","affiliation":[{"name":"NIHR Birmingham Biomedical Research Centre University Hospitals Birmingham NHS Foundation Trust and University of Birmingham  Birmingham UK"},{"name":"School of Sport, Exercise and Rehabilitation Sciences University of Birmingham  Birmingham UK"},{"name":"MRC\u2010Versus Arthritis Centre for Musculoskeletal Ageing Research University of Birmingham  Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gareth G.","family":"Lavery","sequence":"additional","affiliation":[{"name":"NIHR Birmingham Biomedical Research Centre University Hospitals Birmingham NHS Foundation Trust and University of Birmingham  Birmingham UK"},{"name":"MRC\u2010Versus Arthritis Centre for Musculoskeletal Ageing Research University of Birmingham  Birmingham UK"},{"name":"Department of Biosciences Nottingham Trent University  Nottingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janet M.","family":"Lord","sequence":"additional","affiliation":[{"name":"NIHR Birmingham Biomedical Research Centre University Hospitals Birmingham NHS Foundation Trust and University of Birmingham  Birmingham UK"},{"name":"Institute of Inflammation and Ageing University of Birmingham  Birmingham UK"},{"name":"MRC\u2010Versus Arthritis Centre for Musculoskeletal Ageing Research University of Birmingham  Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed M.","family":"Elsharkawy","sequence":"additional","affiliation":[{"name":"NIHR Birmingham Biomedical Research Centre University Hospitals Birmingham NHS Foundation Trust and University of Birmingham  Birmingham UK"},{"name":"Liver Unit Queen Elizabeth Hospital Birmingham  Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew J.","family":"Armstrong","sequence":"additional","affiliation":[{"name":"NIHR Birmingham Biomedical Research Centre University Hospitals Birmingham NHS Foundation Trust and University of Birmingham  Birmingham UK"},{"name":"Liver Unit Queen Elizabeth Hospital Birmingham  Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolyn A.","family":"Greig","sequence":"additional","affiliation":[{"name":"NIHR Birmingham Biomedical Research Centre University Hospitals Birmingham NHS Foundation Trust and University of Birmingham  Birmingham UK"},{"name":"School of Sport, Exercise and Rehabilitation Sciences University of Birmingham  Birmingham UK"},{"name":"MRC\u2010Versus Arthritis Centre for Musculoskeletal Ageing Research University of Birmingham  Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,5,11]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1155\/2014\/309570"},{"key":"e_1_2_9_3_1","first-page":"245","article-title":"Number of chair stands should not be considered a muscle function measure, but a physical performance measure. 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