Interventions to improve sarcopenia in cirrhosis: A systematic review

Table 4 Trans jugular intrahepatic portosystemic shunt to improve sarcopenia in cirrhosis

Ref.	Study participants characteristics	Study design	Sample size	Intervention	Follow up, mean ± SD	Diagnosis of sarcopenia	Results
Plauth et al[48], 2004	mean age: 60; gender: 13/8; mean BMI: 22.3; decompensated; setting: Germany	Quasi experimental (pre-post intervention study)	21	TIPS	12 mo	Anthropometry, BIA, REE by indirect calorimeter and TBP	Increased muscle mass; no change in REE and fat mass
Tsein et al[49], 2013	mean age: 55.5; gender: 59/30; mean BMI: 29; CTP score: 9; setting: USA	Case control; Cases: 57; Controls: 32	57	TIPS	13.5 ± 11.9 mo	Unenhanced CT axial scan	Total psoas and paraspinal muscle area increased significantly after TIPS; post TIPS visceral fat volume decreased significantly
Montomoli et al[50], 2010	mean age: 47.8-54.9; gender: 14/7; mean BMI: 26.2; MELD: 18; setting: Denmark	Quasi experimental (pre-post intervention study)	21	TIPS	52 wk	Anthropometry: body composition parameters such as dry lean mass and fat mass	Patient with normal weight has increased in dry lean mass. No changes in the fat mass

TBP: Total body protein; REE: Resting energy expenditure; FFA: Free fatty acid; CT: Computed tomography; TIPS: Trans jugular intrahepatic portosystemic shunt; BMI: Body mass index.