Association of Myosteatosis with Short-term Outcomes in Patients with Acute-on-chronic Liver Failure

Overview

Journal Sci Rep

Specialty Science

Date 2024 Jun 13

PMID 38871846

Authors

Nan Geng

Ming Kong

Jiateng Zhang

Huina Chen

Manman Xu

Wenyan Song

Yu Chen

Zhongping Duan

Affiliations

Soon will be listed here.

Abstract

Sarcopenia (low muscle mass, i.e., quantity) is associated with poor clinical outcomes in patients with acute-on-chronic liver failure (ACLF). In this study, we aimed to illustrate the clinical prognostic value of myosteatosis (muscle fat infiltration) for short-term mortality in patients with ACLF. We retrospectively enrolled consecutive patients with ACLF between January 2019 and January 2022. Computed tomography-based body composition analysis was performed at the third lumbar vertebral level to determine skeletal muscle radiation attenuation. Fine and Gray's competing risk regression model, with liver transplantation as a competing risk, was used to assess the factors associated with 90-day mortality. A total of 431 patients with ACLF were included. Myosteatosis and sarcopenia were observed in 261 (60.6%) and 87 (20.2%) patients, respectively. Competitive risk regression showed that age (HR 1.021, 95% CI 1.000-1.043, P = 0.042), APASL ACLF Research Consortium (AARC) score (HR 1.498, 95% CI 1.312-1.710, P < 0.001), and sarcopenia (HR 1.802, 95% CI 1.062-3.060, P = 0.029) were independently associated with increased 90-day mortality. Subgroup analysis of male patients with HBV-ACLF revealed that myosteatosis (HR 2.119, 95% CI 1.101-4.078, P = 0.025) was promising prognostic factors for 90-day mortality after being adjusted for ascites, acute kidney injury, AARC score, and sarcopenia. Myosteatosis is predictive of short-term outcomes in male patients with HBV-ACLF. Our results emphasise the importance of focusing on muscle fat infiltration in patients with HBV-ACLF. Further studies are warranted to investigate the underlying mechanisms and potential therapies for myosteatosis.

Citing Articles

Acute-on-chronic liver failure (ACLF): the 'Kyoto Consensus'-steps from Asia.

Choudhury A, Kulkarni A, Arora V, Soin A, Dokmeci A, Chowdhury A Hepatol Int. 2025; 19(1):1-69.

PMID: 39961976 PMC: 11846769. DOI: 10.1007/s12072-024-10773-4.

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