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. 2019 Dec 20;14(5):167–170. doi: 10.1002/cld.851

Table 2.

Mechanisms That Contribute to Sarcopenia in Cirrhosis1, 4

  • Malnutrition and malabsorption

    • o

      Anorexia, nausea, dysgeusia

    • o

      Hypermetabolism

    • o

      Decreased intake

    • o

      Decreased bile production and pancreatic insufficiency

  • Altered lipid and amino acid metabolism

    • o

      Decreased gluconeogenesis

    • o

      Increased ketogenesis

    • o

      Increased whole‐body protein turnover

  • Decreased hepatic ammonia clearance → hyperammonemia

  • Increased inflammatory markers (TNF‐α, IL‐6)

  • Increased myostatin

  • Decreased anabolic hormones (IGF‐1 and testosterone)

  • Inactivity