Characterization of the gut‐liver‐muscle axis in cirrhotic patients with sarcopenia

Background & Aim Sarcopenia is frequent in cirrhosis and associated with unfavourable outcomes. The role of the gut-liver-muscle axis this setting has been poorly investigated. aim study was to identify gut microbiota, metabolic inflammatory signatures sarcopenia cirrhotic patients. Methods Fifty patients assessed for presence by quantification muscle mass strength were compared age- sex-matched controls. A multiomic analysis, including microbiota composition metabolomics, serum myokines systemic intestinal mediators, performed. Results sarcopenic poor bacteria physical function (Methanobrevibacter, Prevotella Akkermansia), enriched Eggerthella, a microbial marker frailty. abundance potentially pathogenic bacteria, such as Klebsiella, also increased, detriment autochthonous ones. elevated levels pro-inflammatory mediators fibroblast growth factor 21 (FGF21) Gut pathways involved amino acid, protein branched-chain acid metabolism up-regulated, addition ethanol, trimethylamine dimethylamine production. Correlation networks clusters variables identified, one centred on Klebsiella/ethanol/FGF21/Eggerthella/Prevotella. Conclusions Alterations are cirrhosis. Detrimental but compensatory functions complex network.