Serum Myostatin in Liver Cirrhosis: a Marker beyond Malnutrition

Abstract

Background and study aim: Compensated and decompensated cirrhotic patients are both affected by variable degrees of malnutrition. Myostatin is secreted by muscle cells and adipocytes. It causes inhibition of skeletal muscle growth. The present work aimed to demonstrate the relationship between serum myostatin and the degree of malnutrition and to show its role in prognosis in comparison to the model for end-stage liver diseases (MELD) score. Patients and Methods: We included seventy patients with liver cirrhosis and twenty healthy controls in this study. Assessment of malnutrition was done by subjective global assessment (SGA) in addition to measurements of body mass index (BMI), mid-arm muscle circumference (MAMC), and serum myostatin. Results: Among 70 patients with liver cirrhosis serum myostatin levels were significantly higher in malnourished cirrhotic patients (U=41.5, P=0.001). It was considerably higher in Child C than in Child B or Child A patients (P < 0.05). Roc curve analysis revealed that serum myostatin in liver cirrhotic patients at a cut-off> 6.1 can differentiate malnourished from well-nourished patients with a sensitivity of 98.04% and, a specificity of 84.2%. MELD score and serum myostatin were positively correlated (P < 0.05). Conclusion: High serum myostatin is associated with profound degrees of malnutrition. It is valuable in liver disease prognosis as it is positively correlated with the MELD score.