Cachexia occurs in late stages of liver cirrhosis, and a low-fat
mass is potentially
associated with poor outcome. This study compared different computed
tomography (CT)–derived
fat parameters with respect to its prognostic impact
on the development of complications and death before and after liver
transplantation. Between 2001 and 2014, 612 patients with liver cirrhosis
without hepatocellular carcinoma listed for liver transplantation met the inclusion
criteria, including abdominal CT scan (±200 days to listing). A total
of 109 patients without cirrhosis served as controls. The subcutaneous fat
index (SCFI), the paraspinal muscle fat index, and the visceral fat index were
assessed at L3/L4 level and normalized to the height (cm2/m2). Data were collected
and analyzed retrospectively. Low SCFI was associated with a higher
rate of ascites and increased C-reactive
protein levels (p < 0.001). In addition,
multivariate Cox regression analysis adjusting for sex, age, body mass index
(BMI), and Model for End-Stage
Liver Disease showed that decreasing SCFI
was also associated with an increased risk of cirrhosis-related
complications
(p = 0.003) and death on the transplant wait list (p = 0.013). Increased paraspinal
and visceral fat were not only positively correlated with creatinine
levels (p < 0.001), BMI, and metabolic comorbidities (all p < 0.001) before
transplantation, but also predictive for 1-year
mortality after transplantation.
Conclusion: The distribution of body fat is a major determinant for complications
and outcome in cirrhosis before and after liver transplantation.
| Identifer | oai:union.ndltd.org:DRESDEN/oai:qucosa:de:qucosa:88868 |
| Date | 05 January 2024 |
| Creators | Engelmann, Cornelius, Aehling, Niklas F., Schob, Stefan, Nonnenmacher, Ines, Handmann, Luise, Macnaughtan, Jane, Herber, Adam, Surov, Alexey, Kaiser, Thorsten, Denecke, Timm, Jalan, Rajiv, Seehofer, Daniel, Moche, MIchael, Berg, Thomas |
| Publisher | Wiley |
| Source Sets | Hochschulschriftenserver (HSSS) der SLUB Dresden |
| Language | English |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, doc-type:article, info:eu-repo/semantics/article, doc-type:Text |
| Rights | info:eu-repo/semantics/openAccess |
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