Evaluation of muscle strength and quality in North African patients with chronic hepatitis B: A pilot case control study

ABSTRACT

Early detection of alteration of muscle strength, quantity, and quality, and sarcopenia is useful in non-cirrhotic chronic hepatitis B (NC-CHB) patients. Studies, which explored the handgrip strength (HGS) are scarce with questionable results, and no previous case-control study explored the presence of sarcopenia.

The aim of this study was to assess the muscle strength [i.e.; HGS absolute (HGS_A), HGS_A/body mass index (BMI)], muscle quantity [i.e.; appendicular skeletal muscle (ASM), ASM/height², ASM/total body weight (TBW), ASM/BMI], and muscle quality [i.e.; HGS_A/total muscle mass (TMM), HGS_A/ASM] of NC-CHB patients.

This was a case-control study. Cases (n = 26) were untreated NC-CHB patients, and controls (n = 28) were ‘apparently’ healthy participants. Muscle mass was estimated via the TMM (kg) and ASM (kg). Muscle strength was evaluated via the HGS data [i.e.; HGS_A (kg), HGS_A/BMI (m²)]. Six variants of HGS_A were determined: highest values for the dominant and non-dominant hands, highest value between the two hands, averages of the three measurements for the two hands, and the average of the highest values of the two hands. Muscle quantity was expressed in three relative variants (ASM/height², ASM/TBW, and ASM/BMI). Muscle quality was evaluated via relative HGS data adjusted by muscle mass (i.e.; HGS_A/TMM, HGS_A/ASM). Probable and confirmed sarcopenia were retained in front of low muscle strength, and low muscle strength and muscle quantity or quality, respectively.

There were no significant differences between controls and NC-CHB patients in values of muscle i) Strength whatever the HGS’ mode of expression (e.g.; HGS_A/BMI: 1.59 ± 0.54 vs. 1.53 ± 0.54 m², p = 0.622, respectively), ii) Quantity (e.g.; ASM/BMI: 0.79 ± 0.24 vs. 0.77 ± 0.23 m², p = 0.883), and iii) Quality (e.g.; HGS_A/ASM: 2.00 ± 0.25 vs. 2.01 ± 0.41, p = 0.952, respectively). One NC-CHB participant had a confirmed sarcopenia.

To conclude, both controls and NC-CHB patients had similar HGS values. Only one NC-CHB patient had a confirmed sarcopenia.

KEYWORDS:

• Chronic liver diseases
• maximal isometric strength
• muscle mass
• sarcopenia
• Tunisia

Abbreviations list

ASM	=	Appendicular skeletal muscle
BIA	=	Bioelectrical impedance meter analysis
BMI	=	Body mass index
CHB	=	Chronic hepatitis B
COVID-19	=	Coronavirus disease-19
HBeAg	=	Hepatitis B viral protein
HBV	=	Hepatitis B virus
HGS	=	Handgrip strength
HGSA	=	HGS expressed as absolute value
METAVIR	=	Meta-analysis of histological data in viral hepatitis
NC-CHB	=	Non-cirrhotic chronic hepatitis B
rHGS	=	Relative handgrip strength
SD	=	Standard deviation
TBW	=	Total body weight
TMM	=	Total muscle mass

Acknowledgments

The authors want to thank: i) Pr. Khalifa LIMEM for his invaluable contribution to the analysis of biochemical markers, ii) Pr. Mondher KORTAS for his appreciated contribution to the analysis of haematological markers, and iii) Pr. Ramzi GHARBI for his precious contribution in the improvement of the quality of the writing in the present article.

Disclosure statement

No potential conflict of interest was reported by the authors.

Data availability statement

Data are available upon a reasonable request from the corresponding author ([email protected]).

Establishment where the work was performed

Department of physiology and functional explorations, department of infectious diseases, laboratories of biochemistry and haematology (Farhat HACHED Hospital, Sousse, Tunisia).

Authors’ contributions

JB: conception and design, analysis and interpretation of the data, drafting of the paper or revising it critically for intellectual content, final approval of the version to be published.

IL: conception and design, analysis and interpretation of the data, drafting of the paper or revising it critically for intellectual content, final approval of the version to be published.

HC: drafting of the paper or revising it critically for intellectual content, final approval of the version to be published.

JBA: drafting of the paper or revising it critically for intellectual content, final approval of the version to be published.

SM: drafting of the paper or revising it critically for intellectual content, final approval of the version to be published.

WM: drafting of the paper or revising it critically for intellectual content, final approval of the version to be published.

AL: conception and design, drafting of the paper or revising it critically for intellectual content, final approval of the version to be published.

HBS: conception and design, analysis and interpretation of the data.

All authors agree to be accountable for all aspects of the work.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/19932820.2023.2204564.

Additional information

Funding

This paper was not funded.