الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Cirrhosis is the final stage of different chronic liver diseases characterized by hepatic cell degeneration and regeneration with fibrosis and nodular formation. Compensated cirrhosis often only slightly worsens patients′ general condition. However, morbidity and mortality are increasing rapidly if decompensating of liver cirrhosis occurs. Although the most commonly known complications in cirrhotic patients are ascites, variceal bleeding, hepatic encephalopathy, and hepatocellular carcinoma, severe muscle wasting or sarcopenia is considered one of frequent unseen complication which negatively impact survival and quality of life. Balance between protein synthesis and protein breakdown plays important role in maintaining muscle mass. As cirrhotic patients have poor hepatic glycogen reserves due to the impaired synthetic capacity of hepatic cells, this leads to increase the utilization of amino acids as an energy source that accelerate the breakdown of skeletal muscle resulting in sarcopenia . Sarcopenia, as defined by muscle loss and dysfunction, is a common feature of all chronic inflammatory diseases and involve impairment of contractile, metabolic and endocrinal functions of the skeletal muscle. It is also a crucial nutritional issue that is widely spread among patient with cirrhosis with prevalence 40% to 70%. Different screening procedures are used to identify sarcopenia earlier and to allow proper interventions. Mild degree of muscle loss possibly occurs in all cirrhotic patients but the severity of sarcopenia measured by anthropometric assessment getting worse with increasing severity of liver disease measured by Child’s score . Sarcopenic obesity was first defined by Baumgartner as the co-existence of sarcopenia and obesity, as measured by dual-energy X-ray absorptiometry, describing an interplay between obesity and sarcopenia related to physical activity decline and reduced energy expenditure.
The rapidly increasing prevalence and poor clinical consequences of Sa-O are recognized as an important public health problem in the aging population. The main alterations in body composition due to aging include an increase in body fat and a decrease in SMM, which are not accompanied by much change in BMI . The aim of this study is to assess sarcopenic obesity among patients with liver cirrhosis and it is relation to liver disease progression.
This cross-sectional study was be carried out on 150 cirrhotic patients with liver cirrhosis attending hepatology and gastroenterology unit(outpatient clinic and inpatient ward). at Ain Shams University Hospital for 6 months.