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      Muscle Strength Reduction Less Pronounced In Alcoholic Liver Cirrhosis Patients

      A DGReview of :"Muscle strength, Na,K-pumps, magnesium and potassium in patients with alcoholic liver cirrhosis - relation to spironolactone"
      Journal of Internal Medicine

      07/30/2002
      By David Ball


      The loss of muscle strength associated with alcoholic liver cirrhosis appears to be less pronounced in patients treated with spironolactone.

      A considerable reduction in muscle strength is found in patients with alcoholic liver cirrhosis and their muscle magnesium (Mg) can be seen as an independent predictor of muscle strength.

      "Surprisingly," say researchers from specialist departments at the University of Aarhus, Denmark, "in the spironolactone treated patients, muscle weakness was less pronounced, possibly because of the action of spironolactone on muscle Mg, potassium (K) and sodium (Na), K-pump content."

      In this open cross-sectional study they matched 51 consecutive patients admitted to the Department of Hepatology with 28 healthy controls to evaluate muscle strength in relation to muscle contents of magnesium, potassium and sodium, potassium pump in patients with alcoholic liver cirrhosis.

      Measurements of Mg, K, and Na, K-pumps were obtained in both subject and control groups by biopsies of skeletal muscle. Evaluations were also made of maximum isokinetic knee extension and skeletal muscle mass.

      A substantial reduction in muscle mass, muscle strength, muscle Mg and muscle K was found in the subjects. It was seen to fall along with the increasing severity of the liver disease as shown in the Child-Pugh class.

      Increased muscle strength, muscle Mg and content of Na,K-pumps were found in patients treated with spironolactone for two weeks or more, compared with those subjects who were not.

      Skeletal muscle mass, muscle Mg and daily alcohol consumption were seen in a multivariate analysis of the patient group to be independent predictors of isokinetic muscle strength.
      Journal of Internal Medicine 252 (1), 56-63. "Muscle strength, Na,K-pumps, magnesium and potassium in patients with alcoholic liver cirrhosis - relation to spironolactone"

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