KE-VIN CHANGChen J.-D.WEI-TING WUKUO-CHIN HUANGLin H.-Y.DER-SHENG HAN2020-03-312020-03-3120190929-6646https://www.scopus.com/inward/record.uri?eid=2-s2.0-85054086952&doi=10.1016%2fj.jfma.2018.09.011&partnerID=40&md5=aea5f589e4d1981bba52e34b2abf906ahttps://scholars.lib.ntu.edu.tw/handle/123456789/481817Background/purpose: Hepatic encephalopathy (HE), a major neuropsychiatric complication in advanced liver disease, is associated with poor prognosis. Sarcopenia, characterized by a decline in muscle mass, strength, and physical performance, is prevalent in liver cirrhosis. This study aims to explore whether sarcopenia is associated with HE in cirrhotic patients. Methods: PubMed and EMBASE were searched for relevant cohort and case-control studies investigating the association between sarcopenia and HE up to July 2018. Data of patients' characteristics, definition of low muscle mass, and protocols of grading/diagnosing HE were retrieved. The primary outcome was estimated by a pooled odds ratio (OR) and its 95% confidence interval (CI), using a random effect model. Results: The meta-analysis enrolled 6 studies, comprising 1795 patients. Sarcopenia was positively associated with the presence of HE (OR 2.74 with a 95% CI, 1.87 to 4.01). The association was less likely to be influenced by differences in research designs, focused study outcomes, muscle mass measurements, and protocols of grading/diagnosing HE. There was lack of evidence supporting higher serum ammonia levels in patients with sarcopenia. Conclusion: In patients with liver cirrhosis, there is a significant association between sarcopenia and HE. A greater number of prospective studies are necessary to clarify whether the association remains even after adjusting relevant confounders and to suggest effective prevention of HE in patients with coexisting sarcopenia. ? 2018[SDGs]SDG3ammonia; ammonia; ammonia blood level; Article; case control study; clinical protocol; cohort analysis; disease association; Embase; hepatic encephalopathy; human; liver cirrhosis; Medline; methodology; muscle mass; outcome assessment; prospective study; risk assessment; sarcopenia; statistical bias; systematic review; blood; complication; hepatic encephalopathy; liver; liver cirrhosis; meta analysis; metabolism; sarcopenia; skeletal muscle; Ammonia; Hepatic Encephalopathy; Humans; Liver; Liver Cirrhosis; Muscle, Skeletal; Sarcopeniajournal article10.1016/j.jfma.2018.09.011302790302-s2.0-85054086952