Mayra Yazmin Viera Cervantes | ALES Graduate Seminar

A graduate exam seminar is a presentation of the student’s final research project for their degree.
This is an ALES MSc Final Exam Seminar by Mayra Yazmin Viera Cervantes. This seminar is open to the general public to attend.

Topic: Relationship between common pharmaceutical medications and muscle mass in patients with liver cirrhosis
MSc with Dr. Vera Mazurak.

Abstract

Background & aim: Severe muscle depletion (sarcopenia) is prevalent in patients with liver cirrhosis and relates to poor prognosis. Polypharmacy has been identified as a risk factor for sarcopenia.   Patients with cirrhosis are continuously medicated therefore this study was designed to investigate the relationship between commonly prescribed medications with the presence of sarcopenia as well as changes in muscle mass over time. Methods: Abdominal computed tomography (CT) scans taken at the 3^rd Lumbar vertebra at the time of evaluation for liver transplant were evaluated in a retrospective cohort of 136 patients with liver cirrhosis to quantify muscle mass. A second CT scan occurred approximately one year later and change in muscle mass determined.  Medical charts were reviewed for three common medications known to influence muss mass:   spironolactone, beta-blockers and lactulose prescribed within one year prior to the time of CT scans. Results: Approximately 27% of the patients were taking spironolactone, 19% lactulose and 15% B-Blockers. At the time of the first CT, 29% of the patients had sarcopenia, whereas by the time of the second CT, sarcopenia presented in 40% of the population. No association was observed between sarcopenia and medications at the time of each CT but lactulose was more common in patients who were gaining or maintaining muscle compared to the patients who were losing muscle over time (28% vs. 10%, P=0.009). Conclusion: Medications for comorbid conditions are common in patients with cirrhosis, presenting additional complexity to understanding treatments for low muscle mass in this population.  Lactulose might have a beneficial impact on muscle mass in cirrhosis. Further research is needed to determine the mechanism by which lactulose may impact muscle mass.