University of Worcester Worcester Research and Publications

Handgrip strength is associated with 12 months survival in male patients suffering with advanced chronic liver disease

Cortes, D.M., Boulhosa, R.S.S.B., Paz, C.L.S.L., Cunha, C.M., Oliveira, L.P.M., Lyra, A.C., Bueno, Allain ORCID: and Jesus, R.P. (2023) Handgrip strength is associated with 12 months survival in male patients suffering with advanced chronic liver disease. Journal of Human Nutrition and Dietetics. ISSN Print: 0952-3871 Electronic: 1365-277X

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Advanced chronic liver disease (ACLD) patients are usually malnourished, and both conditions in combination increase the likelihood of unfavourable clinical outcomes. Handgrip strength (HGS) has been suggested as a relevant parameter for nutritional assessment and predictor of adverse clinical outcomes in ACLD. However, the HGS cutoff values for ACLD patients have not yet been reliably established. The aims of this study were to preliminarily identify HGS reference values in a sample population of ACLD male patients, and to assess their association with survival over a 12-month follow-up period. This was a prospective observational study with preliminary analysis of outpatients and inpatients. One hundred eighty-five male patients with a medical diagnosis of ACLD met the inclusion criteria and were invited to participate in the study. The physiological variation in muscle strength related to the age of the individuals included in the study was considered to obtain cutoff values. After categorising HGS by age group (adults: 18 to 60 years; elderly: ≥ 60 years), the reference values obtained were 32.5 kg for adults and 16.5 kg for the elderly. During the 12-month follow-up, 20.5% of the patients died, and 76.3% of those had been identified with reduced HGS. Patients with adequate HGS showed significantly higher 12-month survival compared to those with reduced HGS within the same period. Our findings show that HGS is an important predictive parameter for clinical and nutritional follow-up in ACLD male patients. This article is protected by copyright. All rights reserved.

Item Type: Article
Additional Information:

This is the peer reviewed version of the following article: doi: 10.1111/jhn.13160, which will be published in final form at This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. This article may not be enhanced, enriched or otherwise transformed into a derivative work, without express permission from Wiley or by statutory rights under applicable legislation. Copyright notices must not be removed, obscured or modified. The article must be linked to Wiley’s version of record on Wiley Online Library and any embedding, framing or otherwise making available the article or pages thereof by third parties from platforms, services and websites other than Wiley Online Library must be prohibited.

This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi: 10.1111/jhn.13160

Uncontrolled Discrete Keywords: 12 months survival, advanced chronic liver disease, Child-Pugh, cutoff values, Handgrip strength, Subjective Global Assessment
Subjects: R Medicine > R Medicine (General)
Divisions: College of Health, Life and Environmental Sciences > School of Science and the Environment
Copyright Info: This article is protected by copyright. All rights reserved.
Depositing User: Allain Bueno
Date Deposited: 20 Feb 2023 16:30
Last Modified: 21 Feb 2023 14:19

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