The association between sarcopenia and decorin, an exercise-induced myokine, in patients with chronic liver disease

Background : Sarcopenia frequently occurs in patients with chronic liver disease (CLD). The skeletal muscles secrete myokines, including myostatin, irisin, and decorin, which regulate skeletal muscle mass. This study aimed to investigate the association between myokine levels and muscle mass and to identify independent factors for muscle mass in patients with CLD. Methods : Thirty-nine patients with CLD were enrolled in this study (mean age, 75 years [41-84], female/male, 19/20) and were classified into muscle atrophy or non-atrophy groups according to the Japan Society of Hepatology guidelines. Serum levels of myostatin, irisin, and decorin were measured by ELISA/EIA. Independent factors associated with skeletal muscle index (SMI) were investigated. Profiles associated with non-atrophic muscle were determined by a decision-tree analysis. Results : There were no significant differences in body mass index (BMI) or blood ammonia or myostatin levels between the muscle atrophy and non-atrophy groups. However, serum decorin and irisin levels were significantly higher in the non-atrophy group than the atrophy group (11,888±5,418 vs. 5,642±1,978 pg/mL, P=0.0394; 35.1±1.9 vs. 31.1±8.3 ng/mL, P=0.0109). BMI and serum decorin level were identified as independent factors associated with SMI (P=0.0121, P=0.0483). In the decision-tree analysis, serum decorin level was identified as the first divergence variable for non-atrophic muscle. Of the patients with ≥10,226.8 pg/mL of decorin, 75% were in the non-atrophy group. Conclusions : Serum decorin level was significantly associated with skeletal muscle mass and was an independent factor for skeletal muscle non-atrophy in patients with CLD. Decorin may be an important myokine regulating sarcopenia in patients with CLD.