A Multidisciplinary Viewpoint from Sport, Nutritional Sciences, and Nursing: Managing Sarcopenia in Patients with Cirrhosis
Abstract
Cirrhosis, the final stage of hepatic diseases, affects over 112 million people worldwide, leading to issues such as varices, ascites, hepatic encephalopathy, and sarcopenia, which impacts 30% to 70% of cirrhotic patients. While sarcopenia is linked to poor outcomes, its prognostic effect remains unclear. Management strategies include medication, exercise, and nutritional support, but there is a lack of research on exercise programs targeting sarcopenia in cirrhosis. Patients often lack knowledge regarding the management of their condition, especially concerning exercise, nutrition, and treatment side effects. Issues like food insecurity and poor cooking skills can result in inadequate dietary intake. The disease induces sarcopenia through altered metabolism, causing an energy intake and need imbalance. Efforts to manage sarcopenia in cirrhosis patients focus on a three-level prevention framework: primary prevention through screening, secondary prevention by initiating therapy, and tertiary prevention by intensifying treatment for non-responders. Multidisciplinary healthcare teams, including sports, nursing and nutrition, enhance outcomes by utilizing resistance training to improve muscle mass and strength and aerobic exercise to boost aerobic capacity and cardiorespiratory fitness.
Keywords
References
- Brown S, Richardson B, Bouquet E, Reid E, Mercer E, Goncalves M, et al. Cirrhosis-related Sarcopenia May Not Resolve After Liver Tansplantation. JHEP Reports. 2023;5(11):100881. doi:10.1016/j.jhepr.2023.100881.
- Lai J C, Tandon P, Bernal W, Tapper EB, Ekong U, Dasarathy S, et al. Malnutrition, Frailty, and Sarcopenia in Patients with Cirrhosis: 2021 practice Guidance by the American Association for the Study of Liver Diseases. Hepatology. 2021;74(3):1611-1644. doi:10.1002/hep.32049.
- Duarte-Rojo A, Ruiz-Margáin A, Montaño-Loza AJ, Macías-Rodríguez RU, Ferrando A, Kim WR. Exercise and Physical Activity for Patients with End-Stage Liver Disease: Improving Functional Status and Sarcopenia While on the Transplant Waiting List. Liver Transpl. 2018;24(1):122-139. doi:10.1002/lt.24958.
- Lin YY, Qian D, Lin L, Chen S, Jing XC. Advanced Exercise Intervention for Liver Cirrhosis and Sarcopenia: A Development and Feasibility Study. Medicine. 2025;104(34): e43974.
- Sobhrakhshankhah E, Farahmand M, Hasan Rashedi M, Shahinfar H, Shab-Bidar S, Dinari S, et al. Efficacy of Different Nutrition Interventions on Sarcopenia in Patients with Cirrhosis: A Systematic Review and Network Meta-Analysis. BMC Nutr. 2025;11(1):39.
- Fabrellas N, Künzler-Heule P, Olofson A, Jack K, Carol M. Nursing Care for Patients with Cirrhosis. J Hepatol. 2023;79(1):218-225.
- Sharma SK, Mudgal SK, Davidson PM, Leino-Kilpi H. Role of nurses in prevention and control of liver disease. In: Bhadoria AS, Nundy S, editors. Preventive hepatology. Boca Raton: CRC Press; 2025. p. 205-16. doi:10.1201/9781003433071-15.
Details
Primary Language
English
Subjects
Internal Diseases Nursing
Journal Section
Letter to Editor
Early Pub Date
August 6, 2026
Publication Date
-
Submission Date
December 27, 2025
Acceptance Date
June 4, 2026
Published in Issue
Year 2026 Number: Advanced Online Publication
