Measure Components Abnormal TestResult Range Considerationsfor Patients withCirrhosis Psoas muscle area / Skeletal muscle index Cross-sectional imaging (CT or MRI) at specified level (e.g., L4) Varies per study Radiation Exposure Bioimpedance Analysis Estimates amount of fat vs lean body mass < 90% of the standard skeletal muscle Limited accuracy in patients with significant ascites Dual X-ray Absorptiometry Estimates skeletal muscle mass < 10th percentile based on age and gender Radiation Exposure Hand grip Strength Hand grip strength from dominant hand < 5th percentile based on age and gender Limited in those with severe hepatic encephalopathy, interobserver variability Anthropometry 1.Triceps skin-fold Thickness < 5th percentile Interobserver Variability 2.Mid-arm muscle Circumference < 5th percentile 3.BMI < 20 kg/m2 4.Weight loss ≥ 5% - 10% Subjective Global Assessment Muscle wasting, fat loss, dietary intake, functional capacity Severe muscle wasting and subcutaneous fat loss, inadequate dietary intake > 5 wk, minimal functional capacity Interobserver variability

Table 1: Evaluation of nutritional status - sarcopenia in patients with cirrhosis.