Background and study aim: Irrespective of etiology, liver cirrhosis together with its complications can affect other body organs and lead to a great morbidity and mortality. In Cirrhotic patients, Sarcopenia block normal life activities. Low serum testosterone has been reported in up to 90% of men with liver cirrhosis. This study aimed to assess the correlation between serum testosterone level and sarcopenia in Egyptian male patients with liver cirrhosis.
Patients and Methods: This prospective study included sixty cirrhotic males. Three groups were designed according to Child-Pugh classification. Twenty healthy males were included as control group. Patients and controls were subjected to complete blood picture, liver and kidney functions. Serum total & free testosterone was analyzed by specific enzyme-linked immunosorbent assay (ELISA) kit and Skeletal Muscle Index (L3 SMI) was assessed by CT scan.
Results: There was significant decrease in serum levels of free and total testosterone in cirrhotic patients than controls, with lowest levels in child C cirrhotic males (p value <0.001). 32 (53.3%) cirrhotic patients were sarcopenic‏.‏ At cutoff point 14.1 nmol/L total testosterone level has Sensitivity 91%, Specificity 94% and Accuracy 93.0% to predict sarcopenia in cirrhotic males with AUC = 0.938. There was significant positive correlation between total testosterone level and the L3 SMI (r= 0.819, P<0.001). In addition, a positive correlation was detected between total testosterone and hemoglobin (r= 0.668, P<0.001), serum Na (r= 0.846, P<0.001) and Platelet count (r= 0.904, P<0.001), also negative correlation with MELD score (r= - 0.928, P<0.001).
Conclusion: Significant positive correlation between total testosterone level and Skeletal Muscle Index (L3 SMI) and low testosterone level is associated with sarcopenia in cirrhotic males.