Assessment of the importance of sarcopenia associated with quality of life and oxidative stress in patients with chronic liver disease
Chronic liver disease. sarcopenia. Oxidative stress. Quality of life.
Responsible for protein synthesis, bile production, glucose balance, micronutrient storage, cholesterol production, detoxification and metabolism of some hormones, among others, the liver plays an extremely important role in the body's homeostasis. Constant aggression to the liver by alcohol, viral hepatitis, metabolic and autoimmune diseases can lead to irreversible damage, with impaired liver function. The natural history of chronic liver disease is characterized by a long asymptomatic (silent) or compensated phase (VUILLELESSARD; RODRIGUES; BERZIGOTTI, 2021), which can progress to clinical decompensation, a phase characterized by the systemic manifestation of liver damage. One of the main consequences of advanced chronic liver disease (ACHD) is portal hypertension, which is responsible for the main complications in clinical decompensation that manifests itself with ascites, hepatic encephalopathy and digestive hemorrhage due to rupture of esophagogastric varices. After the first episode of decompensation, the disease progresses more quickly, increasing morbidity and mortality, and the patient should be evaluated for the possibility of liver transplantation (LTx). The transition from compensated cirrhosis to decompensated cirrhosis occurs at a rate of 5 to 7% per year (D'AMICO; GARCIA-TSAO; PAGLIARO, 2006). The progression of decompensated disease can be further accelerated by the development of other complications such as rebleeding, acute kidney injury, with or without the features of hepatorenal syndrome, hepatopulmonary syndrome, portopulmonary hypertension, cirrhotic cardiomyopathy, and bacterial infections. 2018).