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Hepatology International

18-06-2023 | Sarcopenia | Original Article

Skeletal muscle alterations indicate poor prognosis in cirrhotic patients: a multicenter cohort study in China

Authors: Xin Zeng, Zhi-Wen Shi, Jia-Jun Yu, Li-Fen Wang, Chun-Yan Sun, Yuan-Yuan Luo, Pei-Mei Shi, Yong Lin, Yue-Xiang Chen, Jia Guo, Chun-Qing Zhang, Wei-Fen Xie

Published in: Hepatology International

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Abstract

Introduction

We aimed to determine the diagnostic criteria of myosteatosis in a Chinese population and investigate the effect of skeletal muscle abnormalities on the outcomes of cirrhotic patients.

Methods

Totally 911 volunteers were recruited to determine the diagnostic criteria and impact factors of myosteatosis, and 480 cirrhotic patients were enrolled to verify the value of muscle alterations for prognosis prediction and establish new noninvasive prognostic strategies.

Results

Multivariate analysis showed age, sex, weight, waist circumference, and biceps circumference had a remarkable influence on the L3 skeletal muscle density (L3-SMD). Based on the cut-off of a mean − 1.28 × SD among adults aged < 60 years, the diagnostic criteria for myosteatosis was L3-SMD < 38.93 Hu in males and L3-SMD < 32.82 Hu in females. Myosteatosis rather than sarcopenia has a close correlation with portal hypertension. The concurrence of sarcopenia and myosteatosis not only is associated with poor liver function but also evidently reduced the overall and liver transplantation-free survival of cirrhotic patients (p < 0.001). According to the stepwise Cox regression hazard model analysis, we established nomograms including TBil, albumin, history of HE, ascites grade, sarcopenia, and myosteatosis for easily determining survival probabilities in cirrhotic patients. The AUC is 0.874 (95% CI 0.800–0.949) for 6-month survival, 0.831 (95% CI 0.764–0.898) for 1-year survival, and 0.813 (95% CI 0.756–0.871) for 2-year survival prediction, respectively.

Conclusions

This study provides evidence of the significant correlation between skeletal muscle alterations and poor outcomes of cirrhosis, and establishes valid and convenient nomograms incorporating musculoskeletal disorders for the prognostic prediction of liver cirrhosis. Further large-scale prospective studies are necessary to verify the value of the nomograms.
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Metadata
Title
Skeletal muscle alterations indicate poor prognosis in cirrhotic patients: a multicenter cohort study in China
Authors
Xin Zeng
Zhi-Wen Shi
Jia-Jun Yu
Li-Fen Wang
Chun-Yan Sun
Yuan-Yuan Luo
Pei-Mei Shi
Yong Lin
Yue-Xiang Chen
Jia Guo
Chun-Qing Zhang
Wei-Fen Xie
Publication date
18-06-2023
Publisher
Springer India
Published in
Hepatology International
Print ISSN: 1936-0533
Electronic ISSN: 1936-0541
DOI
https://doi.org/10.1007/s12072-023-10497-x
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