Muscle performance and fatigue in compensated chronic liver disease.

A common and debilitating symptom in patients with chronic liver disease is fatigue (CLD). Muscle dysfunction has been suggested to be a key mechanism of fatigue in CLD. We aimed to evaluate fatigue and the potential association with muscle performance and physical activity in outpatients with CLD. Two-hundred seventy outpatients with CLD were included, (52 ± 15 years, mean ± SD; 151 females) with autoimmune hepatitis ( = 49), primary biliary cholangitis ( = 45), primary sclerosing cholangitis ( = 46), chronic hepatitis B ( = 57) or C ( = 73). Patients with a Child-Pugh >6 were excluded. The questionnaire Fatigue Impact Scale (FIS) was used to evaluate fatigue, and physical activity was evaluated through a self-reported level of physical activity. Muscle function was assessed with four muscle tests, walking speed, handgrip strength, standing heel-rise test (SHT) and 'Timed Up and Go' test (TUG). The median total FIS score was 30 (40% had FIS > 40, considered high-fatigue). Diminished muscle performance was observed in the SHT (% of predicted value: 53 ± 26%) and with maximum grip strength (85 ± 20%). The FIS score was significantly different between groups of CLDs ( = .004). In multivariate analysis the TUG ( = .001), SHT ( = .005), antidepressants ( < .001), and level of physical activity ( = .001) were associated with fatigue ( = 29%). Subjects with higher levels of physical activity had lower FIS ( < .001). In patients with CLD, fatigue was associated with low muscle performance and reduced level of physical activity, which could be a potential therapeutic target.