J Clin Med Res

Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc

Journal website http://www.jocmr.org

Original Article

Volume 11, Number 10, October 2019, pages 711-719

Efficacy of Physical Activity in Prevention of Muscle Weakness in Patients With Chronic Liver Disease

Figure 1. Flowchart indicating selection of participants and grouping according to age and PA. PA: physical activity.

**Table 1.** Characteristics of Patients With Chronic Liver Disease (N = 183)
Age (years)	69.0 (63.0, 75.0)
Data were expressed as median (interquartile range) or as n (%). ALBI: albumin-bilirubin.
Male	107 (58%)
Body mass index (kg/m²)	23.41 (20.69, 25.23)
Etiology of liver disease
Hepatitis B	46 (25%)
Hepatitis C	69 (38%)
Alcoholic hepatitis	22 (12%)
Nonalcoholic steatohepatitis	23 (13%)
Autoimmune hepatitis	1 (< 1%)
Primary biliary cirrhosis	2 (< 1%)
Others	20 (11%)
Hepatocellular carcinoma	42 (23%)
Sarcopenia	22 (12%)
ALBI grade (1/2/3)	145/37/1
Branched-chain amino acids (intake)	67 (37%)
Living alone (yes)	32 (17%)
Currently smoking (yes)	32 (17%)
Currently drinking (yes)	41 (22%)
Driving of cars (usually)	149 (81%)
Employment status (retired)	94 (51%)
Do home tasks (yes)	100 (55%)
Healthy eating (yes)	157 (86%)
Exercise habits (yes)	133 (73%)
Observation period (days)	119 (96.5, 140)

Table 1. Characteristics of Patients With Chronic Liver Disease (N = 183)

Age (years)

69.0 (63.0, 75.0)

Data were expressed as median (interquartile range) or as n (%). ALBI: albumin-bilirubin.

Male

107 (58%)

Body mass index (kg/m²)

23.41 (20.69, 25.23)

Etiology of liver disease

Hepatitis B

46 (25%)

Hepatitis C

69 (38%)

Alcoholic hepatitis

22 (12%)

Nonalcoholic steatohepatitis

23 (13%)

Autoimmune hepatitis

1 (< 1%)

Primary biliary cirrhosis

2 (< 1%)

Others

20 (11%)

Hepatocellular carcinoma

42 (23%)

Sarcopenia

22 (12%)

ALBI grade (1/2/3)

145/37/1

Branched-chain amino acids (intake)

67 (37%)

Living alone (yes)

32 (17%)

Currently smoking (yes)

32 (17%)

Currently drinking (yes)

41 (22%)

Driving of cars (usually)

149 (81%)

Employment status (retired)

94 (51%)

Do home tasks (yes)

100 (55%)

Healthy eating (yes)

157 (86%)

Exercise habits (yes)

133 (73%)

Observation period (days)

119 (96.5, 140)

**Table 2.** Comparison of Patient’s Characteristics in Young Patients at Baseline
	PA < 23 METs-h/w (n = 20)	PA ≥ 23 METs-h/w (n = 33)	P value
Data were expressed as median (interquartile range), or as n (%). Continuous variables were compared by Mann-Whitney U test. Categorical variables were compared by Fisher’s exact test. PA: physical activity; METS-h/w: metabolic equivalents-hour/week; ALBI: albumin-bilirubin.
Age (years)	60.00 (50.25, 62.00)	56.00 (50.00, 60.00)	0.37
Male (n)	17 (85.0%)	22 (66.7%)	0.20
Body mass index (kg/m²)	22.74 (19.96, 25.69)	23.25 (20.07, 25.47)	0.84
Hepatocellular carcinoma (n)	2 (10.0%)	5 (15.2%)	0.70
Sarcopenia (n)	1 (5.0%)	0	0.38
ALBI grade (1/2/3)	16/4/0	30/3/0	0.41
Hand grip strength (kg)	34.33 (29.99, 37.09)	32.25 (25.90, 39.10)	0.20
Physical activity (METs-h/w)	6.60 (2.47, 14.32)	49.50 (28.00, 118.60)	< 0.01
Sedentary time (h/day)	6.00 (4.00, 10.00)	4.00 (3.00, 6.00)	0.01
Branched-chain amino acids (intake)	4 (20.0%)	6 (18.2%)	> 0.99
Living alone (yes)	3 (15.0%)	6 (18.2%)	> 0.99
Currently smoking (yes)	6 (30.0%)	8 (24.2%)	0.75
Currently drinking (yes)	4 (20.0%)	9 (27.3%)	0.74
Driving of cars (usually)	18 (90.0%)	29 (87.9%)	> 0.99
Employment status (retired)	4 (20.0%)	2 (6.1%)	0.18
Do home tasks (yes)	6 (30.0%)	19 (57.6%)	0.09
Healthy eating (yes)	14 (70.0%)	26 (78.8%)	0.52
Exercise habits (yes)	11 (55.0%)	23 (69.7%)	0.38
Observation period (days)	101.50 (70.00, 135.25)	119.00 (98.00, 151.00)	0.19

Table 2. Comparison of Patient’s Characteristics in Young Patients at Baseline

PA < 23 METs-h/w (n = 20)

PA ≥ 23 METs-h/w (n = 33)

P value

Data were expressed as median (interquartile range), or as n (%). Continuous variables were compared by Mann-Whitney U test. Categorical variables were compared by Fisher’s exact test. PA: physical activity; METS-h/w: metabolic equivalents-hour/week; ALBI: albumin-bilirubin.

Age (years)

60.00 (50.25, 62.00)

56.00 (50.00, 60.00)

0.37

Male (n)

17 (85.0%)

22 (66.7%)

0.20

Body mass index (kg/m²)

22.74 (19.96, 25.69)

23.25 (20.07, 25.47)

0.84

Hepatocellular carcinoma (n)

2 (10.0%)

5 (15.2%)

0.70

Sarcopenia (n)

1 (5.0%)

0.38

ALBI grade (1/2/3)

16/4/0

30/3/0

0.41

Hand grip strength (kg)

34.33 (29.99, 37.09)

32.25 (25.90, 39.10)

0.20

Physical activity (METs-h/w)

6.60 (2.47, 14.32)

49.50 (28.00, 118.60)

< 0.01

Sedentary time (h/day)

6.00 (4.00, 10.00)

4.00 (3.00, 6.00)

0.01

Branched-chain amino acids (intake)

4 (20.0%)

6 (18.2%)

> 0.99

Living alone (yes)

3 (15.0%)

6 (18.2%)

> 0.99

Currently smoking (yes)

6 (30.0%)

8 (24.2%)

0.75

Currently drinking (yes)

4 (20.0%)

9 (27.3%)

0.74

Driving of cars (usually)

18 (90.0%)

29 (87.9%)

> 0.99

Employment status (retired)

4 (20.0%)

2 (6.1%)

0.18

Do home tasks (yes)

6 (30.0%)

19 (57.6%)

0.09

Healthy eating (yes)

14 (70.0%)

26 (78.8%)

0.52

Exercise habits (yes)

11 (55.0%)

23 (69.7%)

0.38

Observation period (days)

101.50 (70.00, 135.25)

119.00 (98.00, 151.00)

0.19

**Table 3.** Comparison of Biochemical Measurements in Young Patients at Baseline
	PA < 23 METs-h/w (n = 20)	PA ≥ 23 METs-h/w (n = 33)	P value
Data were expressed as median (interquartile range). Continuous variables were compared by the Mann-Whitney U test. PA: physical activity; METS-h/w: metabolic equivalents-hour/week; CONUT-score: controlling nutritional status index score; Fib-4 index: fibrosis 4 index.
Serum albumin (g/dL)	4.40 (4.18, 4.53)	4.30 (4.20, 4.50)	0.68
Alkaline phosphatase (U/L)	278.00 (222.50, 296.00)	212.00 (178.00, 284.00)	0.09
Alanine transaminase (U/L)	27.50 (20.00, 47.75)	23.00 (17.00, 32.00)	0.30
Aspartate aminotransferase (U/L)	29.50 (23.75, 34.25)	25.00 (22.00, 36.00)	0.23
Blood urea nitrogen (mg/dL)	14.05 (12.70, 15.28)	14.80 (12.50, 15.70)	0.70
Creatine kinase (U/L)	114.00 (84.75, 167.50)	0.71 (0.59, 0.80)	0.39
Creatinine (mg/dL)	0.78 (0.67, 0.84)	0.71 (0.59, 0.80)	0.11
Cholinesterase (U/L)	339.00 (249.50, 436.75)	340.00 (255.00, 380.00)	0.66
Estimated glomerular filtration rate (mL/min/1.73 m²)	78.53 (73.97, 92.24)	86.22 (73.65, 99.36)	0.22
Hemoglobin (g/dL)	14.10 (13.50, 15.45)	13.90 (13.20, 15.40)	0.59
HemogobinA1c (%)	5.70 (5.55, 5.93)	5.90 (5.50, 6.23)	0.34
Prothrombin time-international normalized ratio	0.99 (0.97, 1.05)	0.98 (0.97, 1.01)	0.53
Total bilirubin (mg/dL)	0.64 (0.54, 0.73)	0.64 (0.48, 0.78)	0.70
Total cholesterol (mg/dL)	163.00 (156.00, 179.50)	177.00 (163.00, 203.00)	0.14
Total protein (g/dL)	7.45 (6.97, 7.73)	7.20 (7.10, 7.60)	0.58
Triglyceride (mg/dL)	83.50 (55.75, 104.00)	94.00 (80.00, 115.00)	0.16
Red blood cell count (× 10⁴/µL)	460.50 (430.75, 488.00)	455.00 (411.00, 497.00)	0.89
White blood cell count (× 10²/µL)	54.50 (47.75, 62.75)	53.00 (42.00, 69.00)	0.77
Total lymphocyte count	1,573.60 (1,192.38, 1,980.75)	1,824.90 (1,167.90, 2,356.00)	0.26
Platelet count (× 10⁴)	20.20 (17.72, 26.02)	21.90 (16.80, 24.50)	0.92
CONUT-score	1.00 (1.00, 2.25)	1.00 (0.00, 2.00)	0.56
Fib-4 index	1.40 (1.16, 1.89)	1.35 (0.96, 2.06)	0.78

Table 3. Comparison of Biochemical Measurements in Young Patients at Baseline

PA < 23 METs-h/w (n = 20)

PA ≥ 23 METs-h/w (n = 33)

P value

Data were expressed as median (interquartile range). Continuous variables were compared by the Mann-Whitney U test. PA: physical activity; METS-h/w: metabolic equivalents-hour/week; CONUT-score: controlling nutritional status index score; Fib-4 index: fibrosis 4 index.

Serum albumin (g/dL)

4.40 (4.18, 4.53)

4.30 (4.20, 4.50)

0.68

Alkaline phosphatase (U/L)

278.00 (222.50, 296.00)

212.00 (178.00, 284.00)

0.09

Alanine transaminase (U/L)

27.50 (20.00, 47.75)

23.00 (17.00, 32.00)

0.30

Aspartate aminotransferase (U/L)

29.50 (23.75, 34.25)

25.00 (22.00, 36.00)

0.23

Blood urea nitrogen (mg/dL)

14.05 (12.70, 15.28)

14.80 (12.50, 15.70)

0.70

Creatine kinase (U/L)

114.00 (84.75, 167.50)

0.71 (0.59, 0.80)

0.39

Creatinine (mg/dL)

0.78 (0.67, 0.84)

0.71 (0.59, 0.80)

0.11

Cholinesterase (U/L)

339.00 (249.50, 436.75)

340.00 (255.00, 380.00)

0.66

Estimated glomerular filtration rate (mL/min/1.73 m²)

78.53 (73.97, 92.24)

86.22 (73.65, 99.36)

0.22

Hemoglobin (g/dL)

14.10 (13.50, 15.45)

13.90 (13.20, 15.40)

0.59

HemogobinA1c (%)

5.70 (5.55, 5.93)

5.90 (5.50, 6.23)

0.34

Prothrombin time-international normalized ratio

0.99 (0.97, 1.05)

0.98 (0.97, 1.01)

0.53

Total bilirubin (mg/dL)

0.64 (0.54, 0.73)

0.64 (0.48, 0.78)

0.70

Total cholesterol (mg/dL)

163.00 (156.00, 179.50)

177.00 (163.00, 203.00)

0.14

Total protein (g/dL)

7.45 (6.97, 7.73)

7.20 (7.10, 7.60)

0.58

Triglyceride (mg/dL)

83.50 (55.75, 104.00)

94.00 (80.00, 115.00)

0.16

Red blood cell count (× 10⁴/µL)

460.50 (430.75, 488.00)

455.00 (411.00, 497.00)

0.89

White blood cell count (× 10²/µL)

54.50 (47.75, 62.75)

53.00 (42.00, 69.00)

0.77

Total lymphocyte count

1,573.60 (1,192.38, 1,980.75)

1,824.90 (1,167.90, 2,356.00)

0.26

Platelet count (× 10⁴)

20.20 (17.72, 26.02)

21.90 (16.80, 24.50)

0.92

CONUT-score

1.00 (1.00, 2.25)

1.00 (0.00, 2.00)

0.56

Fib-4 index

1.40 (1.16, 1.89)

1.35 (0.96, 2.06)

0.78

**Table 4.** Comparison of Changes in Hand Grip Strength From the Baseline to the Endpoint in Young Patients
	PA < 23 METs-h/w (n = 20)	PA ≥ 23 METs-h/w (n = 33)	P value
Data were expressed as median (interquartile range). Variables were compared by the Mann-Whitney U test. PA: physical activity; METS-h/w: metabolic equivalents-hour/week.
Changes in hand grip strength (kg)	-0.02 (-1.83, 1.47)	0.25 (-2.45, 2.05)	0.96
Rate of change (%)	-0.06 (-5.85, 4.43)	0.69 (-6.76, 6.39)	0.99

Table 4. Comparison of Changes in Hand Grip Strength From the Baseline to the Endpoint in Young Patients

PA < 23 METs-h/w (n = 20)

PA ≥ 23 METs-h/w (n = 33)

P value

Data were expressed as median (interquartile range). Variables were compared by the Mann-Whitney U test. PA: physical activity; METS-h/w: metabolic equivalents-hour/week.

Changes in hand grip strength (kg)

-0.02 (-1.83, 1.47)

0.25 (-2.45, 2.05)

0.96

Rate of change (%)

-0.06 (-5.85, 4.43)

0.69 (-6.76, 6.39)

0.99

**Table 5.** Comparison of Patient’s Characteristics in Elder Patients at Baseline
	PA < 10 METs-h/w (n = 47)	PA ≥ 10 METs-h/w (n = 83)	P value
Data were expressed as median (interquartile range), or as n (%). Continuous variables were compared by Mann-Whitney U test. Categorical variables were compared by Fisher’s exact test. PA: physical activity; METS-h/w: metabolic equivalents-hour/week; ALBI: albumin-bilirubin.
Age (years)	73.00 (68.50, 78.00)	71.00 (68.00, 77.00)	0.32
Male (n)	22 (46.8%)	46 (55.4%)	0.37
Body mass index (kg/m²)	22.91 (20.41, 24.75)	23.44 (21.09, 25.24)	0.34
Hepatocellular carcinoma (n)	14 (29.8%)	21 (25.3%)	0.68
Sarcopenia (n)	15 (31.9%)	6 (7.2%)	< 0.01
ALBI grade (1/2/3)	34/12/1	65/18/0	0.42
Hand grip strength (kg)	22.95 (17.82, 31.00)	27.05 (21.80, 33.73)	< 0.01
Physical activity (METS-h/w)	4.40 (1.65, 6.60)	25.10 (15.62, 49.70)	< 0.01
Sedentary time (h/day)	7.00 (5.00, 10.00)	5.00 (3.00, 6.00)	< 0.01
Branched-chain amino acids (intake)	19 (40.4%)	38 (45.8%)	0.59
Living alone (yes)	13 (27.7%)	10 (12.0%)	0.03
Currently smoking (yes)	5 (10.6%)	13 (15.7%)	0.60
Currently drinking (yes)	9 (19.1%)	19 (22.9%)	0.66
Driving of cars (usually)	35 (74.5%)	67 (80.7%)	0.51
Employment status (retired)	37 (78.7%)	51 (61.4%)	0.05
Do home tasks (yes)	30 (63.8%)	45 (54.2%)	0.36
Healthy eating (yes)	42 (89.4%)	75 (90.4%)	> 0.99
Exercise habits (yes)	26 (55.3%)	73 (88.0%)	< 0.01
Observation period (days)	126.00 (105.00, 147.00)	112.00 (91.00, 140.00)	0.05

Table 5. Comparison of Patient’s Characteristics in Elder Patients at Baseline

PA < 10 METs-h/w (n = 47)

PA ≥ 10 METs-h/w (n = 83)

P value

Age (years)

73.00 (68.50, 78.00)

71.00 (68.00, 77.00)

0.32

Male (n)

22 (46.8%)

46 (55.4%)

0.37

Body mass index (kg/m²)

22.91 (20.41, 24.75)

23.44 (21.09, 25.24)

0.34

Hepatocellular carcinoma (n)

14 (29.8%)

21 (25.3%)

0.68

Sarcopenia (n)

15 (31.9%)

6 (7.2%)

< 0.01

ALBI grade (1/2/3)

34/12/1

65/18/0

0.42

Hand grip strength (kg)

22.95 (17.82, 31.00)

27.05 (21.80, 33.73)

< 0.01

Physical activity (METS-h/w)

4.40 (1.65, 6.60)

25.10 (15.62, 49.70)

< 0.01

Sedentary time (h/day)

7.00 (5.00, 10.00)

5.00 (3.00, 6.00)

< 0.01

Branched-chain amino acids (intake)

19 (40.4%)

38 (45.8%)

0.59

Living alone (yes)

13 (27.7%)

10 (12.0%)

0.03

Currently smoking (yes)

5 (10.6%)

13 (15.7%)

0.60

Currently drinking (yes)

9 (19.1%)

19 (22.9%)

0.66

Driving of cars (usually)

35 (74.5%)

67 (80.7%)

0.51

Employment status (retired)

37 (78.7%)

51 (61.4%)

0.05

Do home tasks (yes)

30 (63.8%)

45 (54.2%)

0.36

Healthy eating (yes)

42 (89.4%)

75 (90.4%)

> 0.99

Exercise habits (yes)

26 (55.3%)

73 (88.0%)

< 0.01

Observation period (days)

126.00 (105.00, 147.00)

112.00 (91.00, 140.00)

0.05

**Table 6.** Comparison of Biochemical Measurements in Elder Patients at Baseline
	PA < 10 METs-h/w (n = 47)	PA ≥ 10 METs-h/w (n = 83)	P value
Data were expressed as median (interquartile range). Continuous variables were compared by Mann-Whitney U test. CONUT-score: controlling nutritional status index score; Fib-4 index: fibrosis 4 index. PA: physical activity; METS-h/w: metabolic equivalents-hour/week.
Serum albumin (g/dL)	4.10 (3.75, 4.30)	4.20 (3.90, 4.40)	0.20
Alkaline phosphatase (U/L)	246.00 (206.00, 323.00)	247.00 (196.50, 327.50)	0.97
Alanine transaminase (U/L)	14.00 (11.00, 19.50)	17.00 (13.50, 21.50)	0.08
Aspartate aminotransferase (U/L)	23.00 (19.50, 28.00)	25.00 (21.00, 31.00)	0.23
Blood urea nitrogen (mg/dL)	17.30 (13.85, 19.65)	15.50 (13.30, 18.10)	0.05
Creatine kinase (U/L)	90.00 (71.50, 124.50)	107.00 (76.50, 156.00)	0.048
Creatinine (mg/dL)	0.73 (0.57, 0.89)	0.71 (0.62, 0.81)	0.70
Cholinesterase (U/L)	270.00 (212.50, 326.00)	288.00 (243.00, 340.75)	0.29
Estimated glomerular filtration rate (mL/min/1.73m²)	68.79 (58.30, 85.77)	71.78 (65.50, 81.37)	0.36
Hemoglobin (g/dL)	13.30 (12.15, 14.75)	13.20 (12.20, 14.15)	0.46
HemogobinA1c (%)	5.90 (5.50, 6.30)	5.80 (5.60, 6.10)	0.12
Prothrombin time-international normalized ratio	0.98 (0.97, 1.07)	1.00 (0.97, 1.05)	0.46
Total bilirubin (mg/dL)	0.58 (0.46, 0.74)	0.66 (0.50, 0.88)	0.12
Total cholesterol (mg/dL)	180.00 (163.00, 200.00)	178.00 (159.50, 199.50)	0.67
Total protein (g/dL)	7.50 (7.00, 7.60)	7.30 (7.10, 7.75)	0.81
Triglyceride (mg/dL)	111.00 (74.50, 139.50)	92.00 (68.00, 129.00)	0.18
Red blood cell count (× 10⁴/µL)	432.00 (394.00, 478.00)	421.00 (395.50, 458.00)	0.37
White blood cell count (× 10²/µL)	52.00 (39.50, 63.00)	54.00 (42.50, 64.00)	0.66
Total lymphocyte count	1,348.10 (1,091.10, 1,754.40)	1,510.50 (1,176.10, 2,008.85)	0.13
Platelet count (× 10⁴)	19.10 (14.00, 23.10)	19.10 (14.85, 23.60)	0.91
CONUT-score	2.00 (1.00, 3.00)	1.00 (1.00, 2.00)	0.26
Fib-4 index	2.48 (1.95, 3.60)	2.44 (1.85, 3.04)	0.76

Table 6. Comparison of Biochemical Measurements in Elder Patients at Baseline

PA < 10 METs-h/w (n = 47)

PA ≥ 10 METs-h/w (n = 83)

P value

Data were expressed as median (interquartile range). Continuous variables were compared by Mann-Whitney U test. CONUT-score: controlling nutritional status index score; Fib-4 index: fibrosis 4 index. PA: physical activity; METS-h/w: metabolic equivalents-hour/week.

Serum albumin (g/dL)

4.10 (3.75, 4.30)

4.20 (3.90, 4.40)

0.20

Alkaline phosphatase (U/L)

246.00 (206.00, 323.00)

247.00 (196.50, 327.50)

0.97

Alanine transaminase (U/L)

14.00 (11.00, 19.50)

17.00 (13.50, 21.50)

0.08

Aspartate aminotransferase (U/L)

23.00 (19.50, 28.00)

25.00 (21.00, 31.00)

0.23

Blood urea nitrogen (mg/dL)

17.30 (13.85, 19.65)

15.50 (13.30, 18.10)

0.05

Creatine kinase (U/L)

90.00 (71.50, 124.50)

107.00 (76.50, 156.00)

0.048

Creatinine (mg/dL)

0.73 (0.57, 0.89)

0.71 (0.62, 0.81)

0.70

Cholinesterase (U/L)

270.00 (212.50, 326.00)

288.00 (243.00, 340.75)

0.29

Estimated glomerular filtration rate (mL/min/1.73m²)

68.79 (58.30, 85.77)

71.78 (65.50, 81.37)

0.36

Hemoglobin (g/dL)

13.30 (12.15, 14.75)

13.20 (12.20, 14.15)

0.46

HemogobinA1c (%)

5.90 (5.50, 6.30)

5.80 (5.60, 6.10)

0.12

Prothrombin time-international normalized ratio

0.98 (0.97, 1.07)

1.00 (0.97, 1.05)

0.46

Total bilirubin (mg/dL)

0.58 (0.46, 0.74)

0.66 (0.50, 0.88)

0.12

Total cholesterol (mg/dL)

180.00 (163.00, 200.00)

178.00 (159.50, 199.50)

0.67

Total protein (g/dL)

7.50 (7.00, 7.60)

7.30 (7.10, 7.75)

0.81

Triglyceride (mg/dL)

111.00 (74.50, 139.50)

92.00 (68.00, 129.00)

0.18

Red blood cell count (× 10⁴/µL)

432.00 (394.00, 478.00)

421.00 (395.50, 458.00)

0.37

White blood cell count (× 10²/µL)

52.00 (39.50, 63.00)

54.00 (42.50, 64.00)

0.66

Total lymphocyte count

1,348.10 (1,091.10, 1,754.40)

1,510.50 (1,176.10, 2,008.85)

0.13

Platelet count (× 10⁴)

19.10 (14.00, 23.10)

19.10 (14.85, 23.60)

0.91

CONUT-score

2.00 (1.00, 3.00)

1.00 (1.00, 2.00)

0.26

Fib-4 index

2.48 (1.95, 3.60)

2.44 (1.85, 3.04)

0.76

**Table 7.** Comparison of Changes in Hand Grip Strength From Baseline to Endpoint in Elder Patients
	Low PA (n = 47)	High PA (n = 83)	P value
Data were expressed as median (interquartile range). Variables were compared by Mann-Whitney U test. PA: physical activity.
Changes in hand grip strength (kg)	-1.00 (-2.27, 0.55)	0.10 (-1.40, 1.10)	0.02
Rate of change (%)	-5.24 (-8.59, 2.94)	0.44 (-4.17, 4.66)	0.03

Table 7. Comparison of Changes in Hand Grip Strength From Baseline to Endpoint in Elder Patients

Low PA (n = 47)

High PA (n = 83)

P value

Data were expressed as median (interquartile range). Variables were compared by Mann-Whitney U test. PA: physical activity.

Changes in hand grip strength (kg)

-1.00 (-2.27, 0.55)

0.10 (-1.40, 1.10)

0.02

Rate of change (%)

-5.24 (-8.59, 2.94)

0.44 (-4.17, 4.66)

0.03

**Table 8.** Logistic Regression Analysis of Variables Associated With Prevention of Decreased HGS
Variables	Univariate analysis	Multivariate analysis
Data were analyzed by logistic regression analysis model. HGS: hand grip strength; OR: odds ratio; CI: confidence interval; ALBI: albumin-bilirubin; METs: metabolic equivalents-hour/week.
Age (< 65/≥ 65)	1.15	0.58 - 2.31	0.74	1.09	0.55 - 2.17	0.80
Sex (male/female)	1.11	0.59 - 2.09	0.77	0.95	0.52 - 1.76	0.89
ALBI grade (1/2 or 3)	0.89	0.41 - 1.93	0.86	0.78	0.34 - 1.79	0.55
Branched-amino acids supplementation (yes/no)	1.03	0.54 - 1.97	> 0.99	1.09	0.53 - 2.24	0.82
Hepatocellular carcinoma (absence/presence)	1.12	0.53 - 2.36	0.86	0.86	0.41 - 1.79	0.69
Physical activity (≥ 10METs-h/w/< 10METs-h/w)	1.85	0.95 - 3.66	0.06	1.91	1.00 - 3.62	0.049

Table 8. Logistic Regression Analysis of Variables Associated With Prevention of Decreased HGS

Variables

Univariate analysis

Multivariate analysis

95% CI

P value

95% CI

P value

Data were analyzed by logistic regression analysis model. HGS: hand grip strength; OR: odds ratio; CI: confidence interval; ALBI: albumin-bilirubin; METs: metabolic equivalents-hour/week.

Age (< 65/≥ 65)

1.15

0.58 - 2.31

0.74

1.09

0.55 - 2.17

0.80

Sex (male/female)

1.11

0.59 - 2.09

0.77

0.95

0.52 - 1.76

0.89

ALBI grade (1/2 or 3)

0.89

0.41 - 1.93

0.86

0.78

0.34 - 1.79

0.55

Branched-amino acids supplementation (yes/no)

1.03

0.54 - 1.97

> 0.99

1.09

0.53 - 2.24

0.82

Hepatocellular carcinoma (absence/presence)

1.12

0.53 - 2.36

0.86

0.41 - 1.79

0.69

Physical activity (≥ 10METs-h/w/< 10METs-h/w)

1.85

0.95 - 3.66

0.06

1.91

1.00 - 3.62

0.049