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. 2017 Jun 16;9(6):620.
doi: 10.3390/nu9060620.

Impact of Virtual Touch Quantification in Acoustic Radiation Force Impulse for Skeletal Muscle Mass Loss in Chronic Liver Diseases

Hiroki Nishikawa  1 , Takashi Nishimura  2 , Hirayuki Enomoto  3 , Yoshinori Iwata  4 , Akio Ishii  5 , Yuho Miyamoto  6 , Noriko Ishii  7 , Yukihisa Yuri  8 , Ryo Takata  9 , Kunihiro Hasegawa  10 , Chikage Nakano  11 , Kazunori Yoh  12 , Nobuhiro Aizawa  13 , Yoshiyuki Sakai  14 , Naoto Ikeda  15 , Tomoyuki Takashima  16 , Shuhei Nishiguchi  17 , Hiroko Iijima  18
Affiliations

Impact of Virtual Touch Quantification in Acoustic Radiation Force Impulse for Skeletal Muscle Mass Loss in Chronic Liver Diseases

Hiroki Nishikawa et al. Nutrients. .

Abstract

Background and aims: We sought to clarify the relationship between virtual touch quantification (VTQ) in acoustic radiation force impulse and skeletal muscle mass as assessed by bio-electronic impedance analysis in patients with chronic liver diseases (CLDs, n = 468, 222 males and 246 females, median age = 62 years).

Patients and methods: Decreased skeletal muscle index (D-SMI) was defined as skeletal muscle index (SMI) <7.0 kg/m² for males and as SMI <5.7 kg/m² for females, according to the recommendations in current Japanese guidelines. We examined the correlation between SMI and VTQ levels and investigated factors linked to D-SMI in the univariate and multivariate analyses. The area under the receiver operating curve (AUROC) for the presence of D-SMI was also calculated.

Results: In patients with D-SMI, the median VTQ level was 1.64 meters/second (m/s) (range, 0.93-4.32 m/s), while in patients without D-SMI, the median VTQ level was 1.11 m/s (range, 0.67-4.09 m/s) (p < 0.0001). In the multivariate analysis, higher VTQ was found to be an independent predictor linked to the presence of D-SMI (p < 0.0001). In receiver operating characteristic analysis, body mass index had the highest AUROC (0.805), followed by age (0.721) and VTQ (0.706).

Conclusion: VTQ levels can be useful for predicting D-SMI in patients with CLDs.

Keywords: bio-electronic impedance analysis; liver fibrosis marker; predictive ability; skeletal muscle mass; virtual touch quantification.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
(A) Correlation between virtual touch quantification (VTQ) and skeletal muscle index (SMI) in males. Significant inverse correlation between VTQ and SMI was found (rs = −0.4276, p < 0.0001); (B) Correlation between VTQ and SMI in females. Significant inverse correlation between VTQ and SMI was found (rs = −0.2384, p = 0.0002).
Figure 2
Figure 2
(A) VTQ level according to liver fibrosis stage for the entire cohort (excluding 21 patients with missing data for liver histology, n = 447). The stepwise increase of VTQ level was found according to the severity of liver fibrosis (overall significance, p < 0.0001); (B) VTQ level according to liver fibrosis stage for patients with hepatitis C virus (HCV) (excluding patients with missing data for liver histology, n = 246). The stepwise increase of VTQ level was found according to the severity of liver fibrosis (overall significance, p < 0.0001).
Figure 3
Figure 3
(A) VTQ level in patients with and without decreased skeletal muscle mass (D-SMI). In patients with D-SMI, the median VTQ level was 1.64 m/s (range, 0.93–4.32 m/s), while in patients without D-SMI, the median VTQ level was 1.11 m/s (range, 0.67–4.09 m/s) (p < 0.0001); (B) VTQ level according to liver cirrhosis (LC) status. In patients with LC, the median VTQ level was 2.18 m/s (range, 0.73–4.32 m/s), while in patients without LC, the median VTQ level was 1.11 m/s (range, 0.67–3.67 m/s) (p < 0.0001).
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