{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T05:18:30Z","timestamp":1768454310495,"version":"3.49.0"},"reference-count":34,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2024,8,28]],"date-time":"2024-08-28T00:00:00Z","timestamp":1724803200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Malnutrition frequently affects patients with alcoholic liver disease (ALD), with important impacts on disease prognosis. Sarcopenia, the clinical phenotype of malnutrition characterized by skeletal muscle loss, is the major component responsible for adverse events in this population. The aim of this study is to assess the use of ultrasound (US) skeletal muscle performance in stratifying ALD disease severity. We recruited 43 patients with ALD and divided them into two groups: alcoholic hepatitis (AH) and alcoholic cirrhosis (AC). We evaluated disease-specific clinical and biological parameters and their relation to US Rectus Femoris muscle (RFM) measurements, including RFM thickness, stiffness (RFMS) and echogenicity (RFE). A thirty-seconds chairs stand test (30sCST) was used as the sarcopenia surrogate test. RMF thickness correlated with platelet count and serum albumin (p &lt; 0.001). Both RFM and RFMS correlated with disease severity (p &lt; 0.001) and 30sCST (p &lt; 0.001, p = 0.002). Patients with AH had more severe US muscle abnormalities compared to AC (RFMS 1.78 m\/s vs. 1.35 m\/s, p = 0.001) and the highest prevalence of RFE (\u03c72 = 8.652, p = 0.003). Rectus Femoris US assessment could represent a reliable tool in the diagnosis and severity stratification of ALD-induced sarcopenia.<\/jats:p>","DOI":"10.3390\/diagnostics14171891","type":"journal-article","created":{"date-parts":[[2024,8,28]],"date-time":"2024-08-28T07:52:08Z","timestamp":1724831528000},"page":"1891","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Ultrasound Assessment of Sarcopenia in Alcoholic Liver Disease"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7998-4142","authenticated-orcid":false,"given":"Vlad-Teodor","family":"Enciu","sequence":"first","affiliation":[{"name":"Internal Medicine II and Gastroenterology Department, Emergency University Hospital Bucharest, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"Emergency University Hospital, 050098 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-4672-3014","authenticated-orcid":false,"given":"Priscila Madalina","family":"Ologeanu","sequence":"additional","affiliation":[{"name":"Internal Medicine II and Gastroenterology Department, Emergency University Hospital Bucharest, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"Emergency University Hospital, 050098 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carmen","family":"Fierbinteanu-Braticevici","sequence":"additional","affiliation":[{"name":"Internal Medicine II and Gastroenterology Department, Emergency University Hospital Bucharest, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"Emergency University Hospital, 050098 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,8,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Tadokoro, T., Morishita, A., Himoto, T., and Masaki, T. (2023). Nutritional Support for Alcoholic Liver Disease. Nutrients, 15.","DOI":"10.3390\/nu15061360"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1473","DOI":"10.1016\/j.cgh.2016.04.040","article-title":"A Model to Identify Sarcopenia in Patients with Cirrhosis","volume":"14","author":"Tandon","year":"2016","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_3","first-page":"207","article-title":"Alcoholic Myopathy: Pathophysiologic Mechanisms and Clinical Implications","volume":"38","author":"Simon","year":"2017","journal-title":"Alcohol. Res."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1093\/ageing\/afr051","article-title":"A review of the measurement of grip strength in clinical and epidemiological studies: Towards a standardised approach","volume":"40","author":"Roberts","year":"2011","journal-title":"Age Ageing"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1016\/j.clnesp.2021.05.029","article-title":"Evaluation of techniques used to assess skeletal muscle quantity in patients with cirrhosis","volume":"44","author":"Woodward","year":"2021","journal-title":"Clin. Nutr. ESPEN"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"4862","DOI":"10.3748\/wjg.v27.i29.4862","article-title":"Muscular abnormalities in liver cirrhosis","volume":"27","author":"Hari","year":"2021","journal-title":"World J. Gastroenterol."},{"key":"ref_7","first-page":"16","article-title":"Writing Group for the European Working Group on Sarcopenia in Older People 2 (EWGSOP2), and the Extended Group for EWGSOP2. Sarcopenia: Revised European consensus on definition and diagnosis","volume":"48","author":"Bahat","year":"2019","journal-title":"Age Ageing"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1002\/lt.24750","article-title":"Fitness, Life Enhancement, and Exercise in Liver Transplantation Consortium A multicenter study to define sarcopenia in patients with end-stage liver disease","volume":"23","author":"Carey","year":"2017","journal-title":"Liver Transpl."},{"key":"ref_9","unstructured":"European Association for the Study of the Liver (2019). Electronic address: easloffice@easloffice.eu; European Association for the Study of the Liver. EASL Clinical Practice Guidelines on nutrition in chronic liver disease. J. Hepatol., 70, 172\u2013193."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1055\/s-0039-3402745","article-title":"Ultrasound Biomarkers for Sarcopenia: What Can We Tell So Far?","volume":"24","author":"Vucetic","year":"2020","journal-title":"Semin. Musculoskelet. Radiol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1016\/j.jamda.2016.11.013","article-title":"Muscle ultrasound and sarcopenia in older individuals: A clinical perspective","volume":"18","author":"Ticinesi","year":"2017","journal-title":"J. Am. Med. Dir. Assoc."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Toptas, M., Yalcin, M., Akkoc, \u0130., Demir, E., Metin, C., Savas, Y., Kalyoncuoglu, M., and Can, M.M. (2018). The relation between sarcopenia and mortality in patients at intensive care unit. Biomed Res. Int.","DOI":"10.1155\/2018\/5263208"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1007\/s41999-020-00433-9","article-title":"Application of ultrasound for muscle assessment in sarcopenia: 2020 SARCUS update","volume":"12","author":"Perkisas","year":"2021","journal-title":"Eur. Geriatr. Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1007\/s13539-014-0161-y","article-title":"Prevalence, incidence, and clinical impact of sarcopenia: Facts, numbers, and epidemiology-update 2014","volume":"5","author":"Morley","year":"2014","journal-title":"J. Cachexia Sarcopenia Muscle"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"825","DOI":"10.1111\/apt.14279","article-title":"Review article: The role of the microcirculation in liver cirrhosis","volume":"46","author":"Davies","year":"2017","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Di Cola, S., D\u2019amico, G., Caraceni, P., Schepis, F., Loredana, S., Lampertico, P., Toniutto, P., Martini, S., Maimone, S., and Colecchia, A. (2024). Myosteatosis is closely associated with sarcopenia and significantly worse outcomes in patients with cirrhosis. J. Hepatol., epub ahead of print.","DOI":"10.1016\/j.jhep.2024.05.020"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"e00119","DOI":"10.1002\/phy2.119","article-title":"Development of a new Sonovue contrast-enhanced ultrasound approach reveals temporal and age-related features of muscle microvascular responses to feeding","volume":"1","author":"Mitchell","year":"2013","journal-title":"Physiol Rep."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"109038","DOI":"10.1016\/j.ejrad.2020.109038","article-title":"Evaluation of effects of aging on skeletal muscle elasticity using shear wave elastography","volume":"128","author":"Sendur","year":"2020","journal-title":"Eur. J. Radiol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1755","DOI":"10.1007\/s40520-019-01139-0","article-title":"The effect of ageing on shear wave elastography muscle stiffness in adults","volume":"31","author":"Alfuraih","year":"2019","journal-title":"Aging Clin. Exp. Res."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"102080","DOI":"10.1016\/j.clinre.2023.102080","article-title":"2D shear wave elastography of the rectus femoris muscle in patients with cirrhosis: Feasibility and clinical findings. A pilot study","volume":"47","author":"Becchetti","year":"2023","journal-title":"Clin. Res. Hepatol. Gastroenterol."},{"key":"ref_21","first-page":"100071","article-title":"Reliability and Validity of the Modified Heckmatt Scale in Evaluating Muscle Changes with Ultrasound in Spasticity","volume":"2","author":"Moreta","year":"2020","journal-title":"Arch. Rehabil. Res. Clin. Transl."},{"key":"ref_22","first-page":"e212","article-title":"Performance of Acoustic Radiation Force Impulse imaging for the staging of liver fibrosis: A pooled meta-analysis","volume":"19","author":"Nierhoff","year":"2011","journal-title":"J. Viral Hepat."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"735","DOI":"10.1007\/s13244-016-0514-5","article-title":"ARFI: From basic principles to clinical applications in diffuse chronic disease\u2014A review","volume":"7","author":"Bruno","year":"2016","journal-title":"Insights Imaging"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"97","DOI":"10.2739\/kurumemedj.MS6723009","article-title":"Subcutaneous Fat Thickness of the Lower Limb is Associated with Trunk Muscle Mass in Patients with Hepatocellular Carcinoma: A Simple Assessment for Sarcopenia Using Conventional Ultrasonography","volume":"67","author":"Sakai","year":"2022","journal-title":"Kurume Med. J."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"841","DOI":"10.1097\/MCG.0000000000001745","article-title":"Assessment of Sarcopenia Using Muscle Ultrasound in Patients with Cirrhosis and Sarcopenic Obesity (AMUSE STUDY)","volume":"57","author":"Dhariwal","year":"2023","journal-title":"J. Clin. Gastroenterol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1016\/j.clnesp.2017.01.011","article-title":"Hand grip strength: A reliable, reproducible, cost-effective tool to assess the nutritional status and outcomes of cirrhotics awaiting liver transplant","volume":"19","author":"Daphnee","year":"2017","journal-title":"Clin. Nutr. ESPEN"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1590\/1516-3180.2019.000406082019","article-title":"Is rectus abdominis thickness associated with survival among patients with liver cirrhosis? A prospective cohort study","volume":"137","author":"Diculescu","year":"2019","journal-title":"Sao Paulo Med. J."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"e618","DOI":"10.1097\/TXD.0000000000001067","article-title":"Feasibility of Serial Ultrasound Measurements of the Rectus Femoris Muscle Area to Assess Muscle Loss in Patients Awaiting Liver Transplantation in the Intensive Care Unit","volume":"6","author":"Pita","year":"2020","journal-title":"Transplant. Direct"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1016\/j.cger.2011.03.010","article-title":"Clinical trials on sarcopenia: Methodological issues regarding phase 3 trials","volume":"27","author":"Chumlea","year":"2011","journal-title":"Clin. Geriatr. Med."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1002\/jcsm.12039","article-title":"Sarcopenic obesity and myosteatosis are associated with higher mortality in patients with cirrhosis","volume":"7","author":"Angulo","year":"2016","journal-title":"J. Cachex-Sarcopenia Muscle"},{"key":"ref_31","first-page":"491","article-title":"Muscle fat infiltration assessed by total psoas density on computed tomography predicts mortality in cirrhosis","volume":"31","author":"Kalafateli","year":"2018","journal-title":"Ann. Gastroenterol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"781","DOI":"10.1002\/jcsm.12901","article-title":"Pathogenesis of sarcopenia and the relationship with fat mass: Descriptive review","volume":"13","author":"Li","year":"2022","journal-title":"J. Cachexia Sarcopenia Muscle"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"677","DOI":"10.4161\/auto.27918","article-title":"Alcohol-induced autophagy contributes to loss in skeletal muscle mass","volume":"10","author":"Thapaliya","year":"2014","journal-title":"Autophagy"},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Ebadi, M., Tsien, C., Bhanji, R.A., Dunichand-Hoedl, A.R., Rider, E., Motamedrad, M., Mazurak, V.C., Baracos, V., and Montano-Loza, A.J. (2022). Myosteatosis in Cirrhosis: A Review of Diagnosis, Pathophysiological Mechanisms and Potential Interventions. Cells, 11.","DOI":"10.3390\/cells11071216"}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/14\/17\/1891\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T15:44:10Z","timestamp":1760111050000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/14\/17\/1891"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,28]]},"references-count":34,"journal-issue":{"issue":"17","published-online":{"date-parts":[[2024,9]]}},"alternative-id":["diagnostics14171891"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics14171891","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,8,28]]}}}