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Decrease of Grip Strength is Associated with Progression of Sleep Disturbance in Chronic Liver Diseases
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  • Hiroki Nishikawa,
  • Kazunori Yoh,
  • Hirayuki Enomoto,
  • Takashi Nishimura,
  • Shuhei Nishiguchi,
  • Hiroko Iijima
Hiroki Nishikawa

Corresponding Author:[email protected]

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Kazunori Yoh
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Hirayuki Enomoto
Hyogo Coll Med
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Takashi Nishimura
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Shuhei Nishiguchi
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Hiroko Iijima
Hyogo Coll Med
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Abstract

Background and aims: The causal relationship between sarcopenia and sleep disorder in patients with chronic liver disease (CLDs) is unclear. We aimed examine the influence of sarcopenia-related factors (grip strength (GS) and muscle mass) on the progression of sleep disorder in patients with chronic liver disease (n=182, 46 cirrhotic cases, median age=64 years). Methods: Sleep quality was evaluated by the Japanese version of Pittsburgh Sleep Quality Index (PSQI-J). PSQI-J >6 points was defined as sleep disorder. In all analyzed patients, evaluation using PSQI-J questionnaire was performed twice or more during the follow-up period. Time interval from the date of baseline PSQI-J and the first confirmed date of elevation of PSQI-J score was calculated. Our primary endpoint was the elevation of PSQI-J score compared to the baseline PSQI-J score. GS decline was diagnosed with a GS of <26 kg for male and <18 kg for female. Loss of muscle mass was diagnosed by a skeletal muscle index of <7.0 kg/m2 for male and <5.7 kg/m2 for female on bioelectrical impedance analysis. Results: The median PSQI-J score was 5. PSQI-J >6 points at baseline was found in 83 patients (45.6%). In patients with GS decline (n=48), the 3-year cumulative elevation rate of PSQI-J score was 82.4%, while in patients with GS non-decline, that was 36.2% (P<0.0001). In patients with SMI decline (n=64), the 3-year cumulative elevation rate of PSQI-J score was 60.6%, while in patients with SMI non-decline, that was 43.4% (P=0.1822). On the multivariate analysis of factors associated with the elevation of PSQI-J score, only GS decline (P=0.0002) was a significant factor. Conclusions: Reduced GS rather than loss of muscle mass is independently associated with an elevated risk for the progression of sleep disorder in CLD patients.
20 Jan 2021Published in World Academy of Sciences Journal volume 3 issue 2. 10.3892/wasj.2021.87