Search Results (2,199)

Background/Objectives: Sarcopenia is an emergent prognostic biomarker in clinical oncology. Albeit increasingly defined through skeletal muscle index (SMI) thresholding, the literature cut-offs fail to discern heterogeneous baseline muscularity across populations. This study assesses the prognostic impact of using cohort-specific SMI thresholds in a Portuguese metastatic non-small-cell lung cancer (mNSCLC) cohort. Methods: Retrospective study including mNSCLC patients treated between January 2017 and December 2022. ImageJ v1.54 g was used to assess cross-sectional CT imaging at the third lumbar vertebra (L3) and calculate L3SMI. Sarcopenia was defined both according to Prado et al. and L3SMI thresholds derived from receiver operating characteristic analysis. Overall survival (OS) was the primary endpoint. Secondary endpoints included first-line (1L) progression-free survival (PFS) and sarcopenia subgroup analysis regarding body mass index impact on OS. Results: The initial cohort included 197 patients. Mean age was 65 years (±11.31). Most tumors were adenocarcinomas (n = 165) and presented with metastasis (n = 154). SMI was evaluable in 184 patients: cohort-specific thresholds (<49.96 cm²/m² for men; <34.02 cm²/m² for women) yielded 46.74% sarcopenic patients (n = 86) versus 66.30% (n = 122) per the literature definition. Cohort-specific thresholds predicted both OS (12.75 versus 21.13 months, hazard ratio [HR] 1.654, p = 0.002) and PFS (7.92 versus 9.56 months, HR 1.503, p = 0.01). Among sarcopenic patients, overweight (HR 0.417, p = 0.01) and obesity (HR 2.723, p = 0.039) had contrasting impacts on OS. Conclusions: Amid reclassification of nearly one-fifth of the cohort, cohort-specific thresholds improved sarcopenia prognostication in mNSCLC. Homogeneity regarding both cancer treatment setting and ethnicity could be key to defining sarcopenia based on SMI. Full article

Background: Liver cirrhosis is associated with significant nutritional challenges, including malnutrition, sarcopenia, and frailty, which impact clinical outcomes. The severity of these issues may vary between inpatient and outpatient settings, but there is a limited understanding of how these conditions manifest in these populations. This study aims to compare the nutritional status, dietary intake, and frailty in outpatients and inpatients with liver cirrhosis and to explore potential sex-specific differences. Methods: This prospective observational study enrolled 195 patients with liver cirrhosis from the Gastroenterology ward and Outpatient Clinic of Policlinico Umberto I, Sapienza University of Rome, between May 2023 and July 2024. Nutritional status was assessed using anthropometric measurements, dietary recall, and food frequency questionnaires. Sarcopenia was evaluated using the SARC-F questionnaire and handgrip strength. Frailty was assessed using the Liver Frailty Index (LFI). Data on clinical characteristics, comorbidities, and disease severity were also recorded. Results: The inpatient group (n = 69) had significantly lower BMI, mid-upper arm circumference, and triceps skinfold compared to outpatients (n = 126). Inpatients exhibited higher frailty, with 73.9% classified as frail according to the LFI, compared to 39.6% in outpatients (p < 0.001). Dietary intake revealed that 91% of inpatients had an energy intake deficit compared to 76% of outpatients (p = 0.009). Protein intake was inadequate in 84% of inpatients versus 61% of outpatients (p < 0.001). Sex-specific analysis showed that females had a higher prevalence of sarcopenia than males (64.4% vs. 38.2%, p < 0.001) and experienced more significant protein deficits (74.3% vs. 57.6%, p = 0.021). Females also had higher LFI score (4.77 ± 0.88 vs. 4.45 ± 0.91, p = 0.034). Multivariate analysis showed that CTP, LFI, and protein deficit are independently associated with hospitalization. Conclusions: Inpatients with liver cirrhosis are at higher risk for malnutrition, frailty, and inadequate nutrient intake compared to outpatients, emphasizing the need for targeted nutritional interventions in hospital settings. Additionally, females with cirrhosis are more prone to sarcopenia and frailty, requiring gender-specific approaches to nutrition. Full article

Background and Objectives: This study aimed to investigate the clinical significance of sarcopenia, defined by the cross-sectional area of the masseter muscle (CSA-M), as an early marker for sarcopenia diagnosis and its association with mortality in patients with cerebrovascular events (CVE). Materials and Methods: In this retrospective cohort study, 120 patients aged 65 years or older with CVE admitted to Bilkent City Hospital between September 2020 and September 2023 were included. Patients with malignancy, prior CVE, or incomplete data were excluded. Parameters such as CSA-M measured via brain CT, Acute Physiology and Chronic Health Evaluation II (APACHE II) and Sequential Organ Failure Assessment (SOFA) scores, Nutritional Risk Score (NRS), duration of ICU and hospital stays, and 28-day mortality were evaluated. The CSA-M thresholds for sarcopenia were defined as <400 mm² for men and <300 mm² for women. Results: Sarcopenia prevalence was significantly associated with prolonged ICU (27.0 ± 33.1 days vs. 16.5 ± 22.4 days, p = 0.042) and hospital stays (34.8 ± 38.4 days vs. 21.3 ± 22.3 days, p = 0.017). Right and left CSA-M values were significantly lower in sarcopenic patients (p < 0.001). ROC analysis revealed CSA-M cut-off values of <300 mm² (AUC = 0.82) for men and <295 mm² (AUC = 0.83) for women as strong predictors of sarcopenia. Multivariate regression analysis showed a significant association between CSA-M and 28-day mortality (p < 0.05). Sarcopenia also correlated with lower albumin levels, a higher prevalence of ischemic stroke, and increased mechanical ventilation needs. Conclusions: CSA-M measured via brain CT is a reliable marker for sarcopenia and a predictor of clinical outcomes in CVE patients. Early identification and management of sarcopenia could improve patient prognosis. Further research is warranted to explore its potential in broader clinical contexts. Full article

Chronic kidney disease (CKD) is a progressive condition linked to sarcopenia, a syndrome characterized by loss of skeletal muscle mass and strength, affecting a quarter of CKD patients globally. Sarcopenia has multiple paths through which it can worsen morbidity and mortality as well as decrease the quality of life in CKD, including systemic inflammation, hormonal imbalances, metabolic changes, and dysbiosis of gut microbiota. There is a regional variation in the criteria set for diagnosis, with two main groups being the European Working Group on Sarcopenia in Older People and the Asian Working Group for Sarcopenia. Management regimes such as nutritional optimization, vitamin D, exercise, correction of metabolic acidosis, and modulation of gut microbiota constitute effective intervention strategies. Emerging therapeutic options include anabolic agents, myostatin inhibitors, and anti-inflammatory treatment options. Future advances such as genomics, proteomics, and personalized medicine will open up new avenues for addressing the complex pathophysiology of sarcopenia. Hence, a comprehensive multidisciplinary approach focused on the specific needs of each patient will be vital in reducing the effects of sarcopenia and improving the situation of people with CKD. Full article

Hip fracture presents high morbidity, mortality, and healthcare costs. Some programs have focused on the effect of progressive strength work on post-hip fracture recovery. Therefore, the objective of this systematic review was to understand the effect of a progressive resistance training program on different variables in adults after hip fracture. This review includes randomized controlled trials that apply progressive strength programs in subjects after a hip fracture. The selected databases are PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), and Ebsco. A total of 7 studies were selected after screening. These studies were published between 2005 and 2022. Most of the research included adults over 65 years of age, showing a mean age of 77.80 years. In the majority of cases, the programs are applied between 3 and 12 months post-fracture. The most commonly applied intervention time is 3 months. The intervention time of the programs typically lasts for 3 months and includes 3–4 lower limb exercises involving, mainly hip and knee movements. All the investigations assess functional capacity and nearly all research the strength. It is shown that the intensity of strength work progresses from 60 to 80% of 1RM. Progressive strength training programs in post-hip fracture patients generally show an improvement in functional capacity, strength, balance, walking speed, flexibility, and cardiorespiratory fitness. However, the effects on independence, quality of life, self-reported physical disability, depression, and cognitive ability do not show conclusive results, and there is little research in this regard. Full article

Background and Objectives: The pathogenesis of metabolic dysfunction-associated steatotic liver disease (MASLD) remains incompletely understood. However, recent studies highlight the interactions between muscle, liver, and adipose tissue. This study aimed to explore the relationships between clinical indicators of MASLD and sarcopenia, cardiorespiratory fitness, fatigue, and mood. Materials and Methods: The study involved 60 participants, including 28 healthy controls and 32 with MASLD, categorized into two disease subgroups: 15 with MASL and 17 with metabolic dysfunction-associated steatohepatitis (MASH). Participants completed an incremental speed shuttle walk test to evaluate cardiorespiratory fitness, a hand-held dynamometer assessment for appendicular muscle strength, and the timed up and go test for physical performance. Physical activity level, fatigue, quality of life, and emotional state were assessed using questionnaires. The test results were compared between groups and with disease characteristics. Results: MASL and MASH groups showed reduced cardiorespiratory fitness (p < 0.001). The knee extensors were significantly weaker in both MASL and MASH groups (p < 0.001 and p = 0.001, respectively). The MASH group reported higher levels of depression and negative health perception (p = 0.006 and p = 0.03, respectively). Muscle strength in patients with MASLD showed a significant negative association with depression (OR = −0.384, 95% CI: −3.10 to −0.74, p = 0.003), intrahepatic triglyceride content (OR = −0.287, 95% CI: −1.31 to −0.11, p = 0.023), and LDL (OR = −0.286, 95% CI: −0.02 to −0.33, p = 0.03). In contrast, a positive association was observed between VO₂ and muscle strength (OR = 0.531, 95% CI 1.27 to 3.47, p < 0.001). Conclusions: This study suggests that muscle strength is linked to key metabolic parameters, such as hepatic fat, LDL levels, and aerobic capacity, that may contribute to the development and progression of MASLD. Interventions aimed at preserving or enhancing muscle strength in MASLD patients may be essential for preventing liver damage and improving metabolic health. Full article

A wide range of factors contribute to the overlap of hyperglycemia—acute or chronic—and sarcopenia, as well as their associated adverse consequences, which can lead to impaired physical function, reduced quality of life, and increased mortality risk. These factors include malnutrition (both overnutrition and undernutrition) and low levels of physical activity. Hyperglycemia and sarcopenia are interconnected through a vicious cycle of events that mutually reinforce and worsen each other. To explore this association, our review compiles evidence on: (i) the impact of hyperglycemia on motor and muscle function, with a focus on the mechanisms underlying biochemical changes in the muscles of individuals with or at risk of diabetes and sarcopenia; (ii) the importance of the clinical assessment and control of sarcopenia under hyperglycemic conditions; and (iii) the potential benefits of medical nutrition therapy and increased physical activity as muscle-targeted treatments for this population. Based on the reviewed evidence, we conclude that a regular intake of key functional nutrients, together with structured and supervised resistance and/or aerobic physical activity, can help maintain euglycemia and improve muscle status in all patients with hyperglycemia and sarcopenia. Full article

Background: Malnutrition and muscle weakness are highly prevalent in critically admitted patients. To overcome sarcopenia and muscle weakness, physical activity and neuromuscular electric stimulation have been introduced with limited efficacy. Thus, several anabolic remedies have been introduced. An adequate increase in protein support according to indirect calorimetry and body composition and methyl hydroxybutyrate (HMB) is emerging. Therefore, we wanted to investigate the impact of HMB-enriched whey formula on the nutritional status, muscle weakness, and clinical course of critically ill patients undergoing nutritional status multimodal assessment and physical rehabilitation. Methods: We consecutively enrolled critically ill adult patients admitted to the intensive care unit (ICU) of “Santa Maria Hospital”, Terni, Italy. All patients underwent preliminary anthropometric, laboratory tests, nutritional (bioimpedance vector analysis and indirect calorimetry), and ultrasound muscle assessment at admission (T0). Laboratory tests monitoring continued throughout the ICU stay. Nutritional and muscle strength assessment was taken weekly throughout the patient’s ICU stay. All patients were enterally administered with a whey protein-enriched formula. Ten days after admission (during the physical rehabilitation period), patients were randomly administered a mixture of essential amino acids and methyl hydroxybutyrate (HMB). Results: We consecutively enrolled 54 ICU patients. At the baseline, survivors (n = 46) were significantly younger than non-survivors. The latter had a worse SAPS II score, nutritional status, and risk, with no significant difference in basal metabolism. Prealbumin values significantly correlated with improved nutritional status and metabolism. Starting from 10 days upon ICU admission, the pennation angle (used as a measure of muscle strength) significantly correlated with the improvement in nutritional status. Whey proteins were well tolerated. Its administration showed a tendency to improve the pennation angle. No specific effect of the mixture containing essential amino acids and methyl hydroxybutyrate was observed. Nutritional status improvement and the rise of basal metabolism were significantly correlated with the extubation time. On the other hand, the reduction in muscle weakness was not significantly correlated with the timing of extubation. Conclusions: Whey protein formula administration can significantly improve nutritional status and basal metabolism in ICU patients. This is reflected in improved muscle strength. Whey protein administration shows a tendency toward a rise in pennation angle. A similar and non-specific trend was observed upon HMB mixture add-one. Further prospective large-scale controlled studies are needed to confirm these promising results. Full article

Background/Objectives: Carbohydrate and protein restriction are associated with sarcopenia and osteopenia, but the underlying mechanisms remain unclear. We aimed to determine whether mild protein restriction affects muscle and bone function in wild-type (WT) and homozygous carbohydrate response element binding protein (Chrebp) knockout (KO) mice. Methods: Eighteen-week-old male wild-type and homozygous carbohydrate response element binding protein (Chrebp) knockout (KO) mice were fed a control diet (20% protein) or a low-protein diet (15% protein) for 12 weeks. We estimated the muscle weight and limb grip strength as well as the bone mineral density, bone structure, and bone morphometry. Results: Chrebp deletion and a low-protein diet additively decreased body weight (WT control–KO low-protein: mean difference with 95% CI, 8.7 [6.3, 11.0], p < 0.0001) and epidydimal fat weight (1.0 [0.7, 1.2], p < 0.0001). Chrebp deletion and a low-protein diet additively decreased tibialis anterior muscle weight (0.03 [0.01, 0.05], p = 0.002) and limb grip strength (63.9 [37.4, 90.5], p < 0.0001) due to a decrease in insulin/insulin-like growth factor 1 mRNA and an increase in myostatin mRNA. In contrast, Chrebp deletion increased bone mineral density (BMD) (WT control–KO control: –6.1 [–1.0, –2.3], p = 0.0009), stiffness (–21.4 [–38.8, –4.1], p = 0.011), cancellous bone BV/TV (–6.517 [–10.99, –2.040], p = 0.003), and the number of trabeculae (–1.1 [–1.8, –0.5], p = 0.0008). However, in KO mice, protein restriction additively decreased BMD (KO control–KO low-protein: 8.1 [4.3, 11.9], p < 0.0001), bone stiffness (38.0 [21.3, 54.7], p < 0.0001), cancellous bone BV/TV (7.7 [3.3, 12.2], p = 0.006), and the number of trabeculae (1.2 [0.6, 1.9], p = 0.0004). The effects of mild protein restriction on bone formation parameters (osteoid volume (WT control–WT low-protein: –1.7 [–2.7, –0.7], p = 0.001) and the osteoid surface (–11.2 [–20.8, –1.5], p = 0.02) were observed only in wild-type (WT) mice. The levels of bone resorption markers, such as the number of osteoclasts on the surface, the number of osteoclasts, and surface erosion, did not differ between the groups. Conclusions: Both Chrebp deletion and protein restriction led to a decrease in muscle and bone function; therefore, an adequate intake of carbohydrates and proteins is important for maintaining muscle and bone mass and function. Further studies will be needed to elucidate the mechanisms by which ChREBP deletion and a low-protein diet cause osteosarcopenia. Full article

Background: Sarcopenia associated with aging severely affects the quality of life of the elderly; diets have been shown to elicit an inflammatory response in the body, and diets that promote inflammation may lead to damage to muscles. The Dietary Inflammatory Index (DII) has been developed to quantify the inflammatory potential of individual diets. Therefore, this study aimed to investigate the association between the DII, sarcopenia and its components in elderly Chinese people. Methods: In this study, data were obtained from the China Nutrition Improvement Strategies and Applications for the Elderly Research Programme. An assessment of sarcopenia was carried out according to the Asian Working Group on Sarcopenia’s (AWGS2019) criteria. The DII was calculated using food intake data obtained using the FFQ method, and then the quartile method was used to categorize the subjects into four groups. Multifactor logistic regression was conducted to examine the associations between DII, sarcopenia and its components. Results: This study included 993 subjects over the age of 65, and the prevalence of sarcopenia was 20.2%. The mean DII score of the study population was 0.99 ± 0.1. After adjusting for the confounders age, gender, marital status, and educational level, the risk of sarcopenia was 1.66 times higher in group Q4 than in group Q1 (p-trend < 0.05). However, this relationship is not statistically significant when other more confounding factors are added. Nevertheless, when further analyzing the relationship between DII and sarcopenia components, it was found that after adjusting the model, a higher DII was associated with a risk of muscle strength loss (OR = 1.65, p-trend < 0.05). Conclusions: Higher DII scores increase the risk of muscle strength loss in older adults. By guiding older adults to adopt a more anti-inflammatory diet, muscle health can be improved in terms of increased muscle strength. Further cohort or interventional studies are necessary to validate our findings. Full article

Background: As individuals age, there is a gradual loss of muscle mass and strength, which not only impairs physical functionality but also heightens the risk of falls and diminishes independence among older adults. Probiotics have emerged as a focus of recent research due to their potential role in enhancing muscle health via the gut–muscle axis. This study evaluates the effects of live and heat-treated Lacticaseibacillus paracasei PS23 (PS23) supplementation on muscle strength and mass in the elderly. Methods: This study recruited 119 participants, aged 65–85 years, and randomly assigned them to receive a placebo (0 × 10¹⁰ CFU/day), L-PS23 (live PS23, 2 × 10¹⁰ CFU/day), or HT-PS23 (heat-treated PS23, 2 × 10¹⁰ cells/day) for a duration of 12 weeks. Assessments of blood pressure, body composition, muscle strength, functional physical fitness, and biochemical parameters were conducted at baseline, 6 weeks, and 12 weeks. Results: Among the 100 subjects who completed the trial, supplementation with both L-PS23 and HT-PS23 significantly enhanced lower limb muscle strength and endurance compared to the placebo (p < 0.05), although no significant differences were observed in muscle mass or upper limb muscle strength across the groups. Additionally, while most muscle anabolism-related markers showed no significant changes, both supplements effectively decreased inflammatory markers related to aging—C-reactive protein (CRP: L-PS23, p = 0.016; HT-PS23, p = 0.013) and interleukin-6 (IL-6: L-PS23, p = 0.003; HT-PS23, p < 0.001)—and increased interleukin-10 levels (L-PS23, p = 0.014; HT-PS23, p = 0.005). Notably, only the HT-PS23 group demonstrated a significant increase in testosterone levels (p = 0.029). Conclusions: 12 weeks of supplementation with L-PS23 and HT-PS23 improved lower limb muscle strength and endurance but did not significantly enhance muscle mass in older adults. Both supplements also proved effective in reducing inflammatory markers and elevating testosterone levels. HT-PS23, administered as a heat-treated probiotic, provided more pronounced benefits to the elderly compared with its probiotic counterpart, L-PS23. Full article

(1) Background: Commonly used anthropometric indices have limitations that discriminate their relevance. The subject of this research was to evaluate the health risks associated with body composition using the new weight-adjusted waist index (WWI). (2) Materials and Methods: The research group consisted of two hundred and thirty-nine Caucasian women. Body composition was analyzed by the MF-BIA method using InBody 970. The WWI was calculated as waist circumference divided by the square root of weight. Biochemical parameters (lipid profile, glucose, hs-CRP and uric acid) were analyzed using a Biolis 24i Premium biochemical analyser. One-factor variance analysis, a post-hoc test, Pearson correlation analysis and WWI quartiles were used for the statistical evaluation. (3) Results: The results showed significant differences between WWI quartiles. Compared to the lowest quartile, participants in the highest quartile groups had the highest values of body weight (58.49 vs. 87.17 kg; p < 0.001), waist circumference (WC) (76.47 vs. 109.45 cm; p < 0.001), body mass index (BMI) (20.65 vs. 32.06 kg/m²; p < 0.001), waist-to-hip ratio (WHR) (0.84 vs. 1.03; p < 0.001), waist-to-height ratio (WHtR) (0.46 vs. 0.66; p < 0.001), fat-free mass (FFM) (44.97 vs. 49.12 kg; p < 0.001), fat mass (FM) (13.52 vs. 38.05 kg; p < 0.001) and visceral fat area (VFA) (56.94 vs. 150.62 cm²; p < 0.001), confirming a higher risk of obesity. The women in the highest quartile had significantly higher values of total cholesterol (TC), triglycerides (TG), glucose (GLU), uric acid (UA), high-sensitivity C-reactive protein (hs-CRP) and systolic and diastolic blood pressure (BP). The correlations showed a strong positive relationship of the WWI with WC (r = 0.924), VFA (r = 0.907) and FM (r = 0.901) and a strong negative relationship with %FFM (r = −0.9) and %SMM (skeletal muscle mass) (r = −0.887). The correlation analysis also confirmed a strong positive association with WHR (r = 0.964), WHtR (r = 0.944), FMI (r = 0.902) and BMI (r = 0.863). (4) Conclusions: Our results confirmed that the WWI is a useful tool for assessing fat and muscle components, as well as for assessing health risks. Full article

Objectives: This study aimed to explore the independent and joint associations of daily sitting time and leisure-time physical activity (LTPA) with sarcopenia among older adults. Methods: The participants were 847 community-dwelling adults aged 60 or older from Beijing and Shanghai, China. Sarcopenia was diagnosed based on the criteria established by the Asian Working Group for Sarcopenia (2019). Daily sitting time and LTPA were self-reported using the Physical Activity Scale for the Elderly (PASE). Logistics regression models were used to explore the associations between daily sitting time, LTPA, and sarcopenia. To examine joint associations, participants were classified based on daily sitting time and LTPA levels. Final models were adjusted for sociodemographic variables, lifestyle factors, and chronic conditions. Results: Prolonged sitting time and insufficient LTPA were independently associated with higher odds of sarcopenia. Among insufficiently active participants, sitting for 1–2 h, 2–4 h, and more than 4 h per day was associated with 5.52-fold (95% CI: 1.13–26.83), 6.69-fold (95% CI: 1.33–33.59), and 12.82-fold (95% CI: 2.75–59.85) increased odds of sarcopenia, respectively, compared to sitting for less than 1 h. For those meeting the physical activity guideline (≥150 min of LTPA per week), only sitting for more than 4 h per day was significantly associated with higher odds of sarcopenia (OR: 7.25, 95% CI: 1.99–26.36). Conclusions: Prolonged sedentary behavior was associated with increased odds of sarcopenia. The higher odds of sarcopenia associated with more than 4 h daily sitting may not be offset by achieving the recommended levels of physical activity. Full article

Myokine is a general term for hormones, peptides, and other substances secreted by skeletal muscle. Myokine has attracted much attention in recent years as a key substance for understanding the mechanism of “exercise and health”. Skeletal muscle accounts for about 40% of the total human weight and is now recognized as an endocrine organ that produces myokines, which have physiological activity. Representative myokines include IL-6, myostatin, irisin, brain-derived neurotropic factor, fibroblast growth factor-21, and decorin. On the other hand, sarcopenia, defined by quantitative and qualitative loss of skeletal muscle, is a condition that has received much attention in recent years because of its close correlation with prognosis. In patients with chronic liver disease (CLD), sarcopenia is a common complication. Mechanisms underlying sarcopenia in CLD patients have been reported to involve protein-energy malnutrition, which is characteristic of patients with cirrhosis, signaling involved in protein synthesis and degradation, myokines such as myostatin and decorin, the ubiquitin-proteasome pathway, sex hormones such as testosterone, dysbiosis, and insulin resistance, etc., in addition to aging. Each of these pathological conditions is thought to be intricately related to each other, leading to sarcopenia. This review will summarize the relationship between CLD and myokines. Full article

Background/Objectives: Sarcopenia is an important clinical feature of patients with chronic liver disease (CLD). However, special devices are required to determine skeletal muscle mass. We evaluated the usefulness of body surface area (BSA) for estimating muscle mass and diagnosing sarcopenia in patients with CLD. Methods: We retrospectively studied 1889 Japanese patients with CLD who underwent bioimpedance analysis (BIA) (training cohort, n = 983; validation cohort, n = 906). The optimal cutoff values for predicting low skeletal muscle mass index (SMI) were determined using ROC analysis. We also assessed 1229 patients whose BSA and grip strength (GS) data were obtained on the same day and evaluated the diagnostic performance of the determined cutoff values of BSA for the diagnosis of sarcopenia. Results: In the training cohort, a strong correlation was observed between the SMI and BSA (r = 0.883, p < 0.0001). The cutoff values of BSA for predicting low SMI were 1.68 m² for men and 1.48 m² for women. Regarding the presence of low SMI, 776 (78.9%) and 730 (80.5%) patients were correctly diagnosed in the training and validation cohorts, respectively. The sensitivity and specificity of the combination of BSA and GS for sarcopenia were 82.7% and 97.1%, respectively, and 1175 patients (95.6%) were correctly diagnosed. Conclusions: BSA was highly correlated with SMI, suggesting that BSA could facilitate noninvasive estimation of low skeletal muscle mass in patients with CLD. Full article