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Journal of Hepatology
Article . 2022
Data sources: NARCIS
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Journal of Hepatology
Article
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Article . 2022
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Effect of sarcopenia on survival in patients with cirrhosis: A meta-analysis

A meta-analysis
Authors: Xinxing Tantai; Yi Liu; Yee Hui Yeo; Michael Praktiknjo; Ezequiel Mauro; Yuhei Hamaguchi; Cornelius Engelmann; +25 Authors

Effect of sarcopenia on survival in patients with cirrhosis: A meta-analysis

Abstract

BACKGROUND & AIMS: The association between sarcopenia and prognosis in patients with cirrhosis remains to be determined. In this study, we aimed to quantify the association between sarcopenia and the risk of mortality in patients with cirrhosis, stratified by sex, underlying liver disease etiology, and severity of hepatic dysfunction.METHODS: PubMed, Web of Science, EMBASE, and major scientific conference sessions were searched without language restriction through 13 January 2021 with an additional manual search of bibliographies of relevant articles. Cohort studies of ≥100 patients with cirrhosis and ≥12 months of follow-up that evaluated the association between sarcopenia, muscle mass and the risk of mortality were included.RESULTS: Twenty-two studies involving 6,965 patients with cirrhosis were included. The pooled prevalence of sarcopenia in patients with cirrhosis was 37.5% overall (95% CI 32.4%-42.8%), and was higher in male patients, those with alcohol-associated liver disease, those with Child-Pugh grade C cirrhosis, and when sarcopenia was defined by L3-SMI (third lumbar-skeletal muscle index). Sarcopenia was associated with an increased risk of mortality in patients with cirrhosis (adjusted hazard ratio [aHR] 2.30, 95% CI 2.01-2.63), with similar findings in a sensitivity analysis of patients with cirrhosis without hepatocellular carcinoma (aHR 2.35, 95% CI 1.95-2.83) and in subgroups stratified by sex, liver disease etiology, and severity of hepatic dysfunction. The association between quantitative muscle mass index and mortality further supports the association between sarcopenia and poor prognosis (aHR 0.95, 95% CI 0.93-0.98). There was no significant heterogeneity in any of our analyses.CONCLUSIONS: Sarcopenia was highly and independently associated with higher risk of mortality in patients with cirrhosis.LAY SUMMARY: The prevalence of sarcopenia and its association with death in patients with cirrhosis remain unclear. This meta-analysis indicated that sarcopenia affected about one-third of patients with cirrhosis and up to 50% of patients with alcohol-related liver disease or Child-Pugh class C cirrhosis. Sarcopenia was independently associated with an ∼2-fold higher risk of mortality in patients with cirrhosis. The mortality rate increased with greater severity or longer durations of sarcopenia. Increasing awareness about the importance of sarcopenia in patients with cirrhosis among stakeholders must be prioritized.

Countries
Netherlands, Spain, Denmark
Subjects by Vocabulary

Microsoft Academic Graph classification: medicine.medical_specialty Cirrhosis medicine.medical_treatment Liver transplantation Liver disease Model for End-Stage Liver Disease Internal medicine medicine Risk of mortality business.industry Mortality rate medicine.disease Newcastle–Ottawa scale Sarcopenia business

Medical Subject Headings: musculoskeletal system human activities

Keywords

Liver Cirrhosis, Sarcopenia, Cirrosi hepàtica, sarcopenia, Liver Cirrhosis/complications, Muscular Diseases, Risk Factors, Humans, skeletal muscle index, Malalties musculars, Hepatology, cirrhosis, Prognosis, alcohol-associated liver disease, Survival Analysis, Hepatic cirrhosis, Sarcopenia/complications, prognosis

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    84
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    This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
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    influence
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    visibility views 97
    download downloads 61
  • citations
    This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
    84
    popularity
    This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
    Top 1%
    influence
    This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
    Top 10%
    impulse
    This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
    Top 1%
    Powered byBIP!BIP!
  • 97
    views
    61
    downloads
    Powered byOpenAIRE UsageCounts
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visibility
download
citations
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
views
OpenAIRE UsageCountsViews provided by UsageCounts
downloads
OpenAIRE UsageCountsDownloads provided by UsageCounts
84
Top 1%
Top 10%
Top 1%
97
61
Funded by
EC| DECISION
Project
DECISION
DECOMPENSATED CIRRHOSIS: IDENTIFICATION OF NEW COMBINATORIAL THERAPIES BASED ON SYSTEMS APPROACHES
  • Funder: European Commission (EC)
  • Project Code: 847949
  • Funding stream: H2020 | RIA
Validated by funder
,
EC| MICROB-PREDICT
Project
MICROB-PREDICT
MICROBiome-based biomarkers to PREDICT decompensation of liver cirrhosis and treatment response
  • Funder: European Commission (EC)
  • Project Code: 825694
  • Funding stream: H2020 | RIA
Validated by funder | sysimport:crosswalk:repository
,
EC| GALAXY
Project
GALAXY
GALAXY: Gut-and-liver axis in alcoholic liver fibrosis
  • Funder: European Commission (EC)
  • Project Code: 668031
  • Funding stream: H2020 | RIA
Validated by funder | sysimport:crosswalk:repository
,
EC| LIVERHOPE
Project
LIVERHOPE
SIMVASTATIN AND RIFAXIMIN AS NEW THERAPY FOR PATIENTS WITH DECOMPENSATED CIRRHOSIS
  • Funder: European Commission (EC)
  • Project Code: 731875
  • Funding stream: H2020 | RIA
Validated by funder | sysimport:crosswalk:repository
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