Myosteatosis is closely associated with sarcopenia and significantly worse outcomes in patients with cirrhosis
Sarcopenia and myosteatosis are common in patients with cirrhosis. This study aimed to determine the prevalence of these muscle changes, their interrelations and their prognostic impact over a 12-month period. We conducted a prospective multicentre study involving 433 patients. Sarcopenia and myoste...
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| Veröffentlicht in: | Journal of hepatology 2024-10, Vol.81 (4), p.641-650 |
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| creator | Di Cola, Simone D’Amico, Gennaro Caraceni, Paolo Schepis, Filippo Loredana, Simone Lampertico, Pietro Toniutto, Pierluigi Martini, Silvia Maimone, Sergio Colecchia, Antonio Svegliati Barone, Gianluca Alessandria, Carlo Aghemo, Alessio Crocè, Saveria Lory Adinolfi, Luigi Elio Rendina, Maria Lapenna, Lucia Pompili, Enrico Zaccherini, Giacomo Saltini, Dario Iavarone, Massimo Tosetti, Giulia Martelletti, Carolina Nassisi, Veronica Ferrarese, Alberto Giovo, Ilaria Masetti, Chiara Pugliese, Nicola Campigotto, Michele Nevola, Riccardo Merli, Manuela Iannone, Giulia Serri, Paola Bertino, Gaetano Balsano, Clara Iapadre, Nerio Maida, Marcello Sacerdoti, David Natola, Leonardo Antonio Ciacci, Carolina Santonicola, Antonella Cozzolongo, Raffaele Surace, Lorenzo Antonio Fracanzani, Anna Ludovica Cespiati, Annalisa Federico, Alessandro Romeo, Mario Grieco, Antonio Marrone, Giuseppe Vizioli, Luca |
| description | Sarcopenia and myosteatosis are common in patients with cirrhosis. This study aimed to determine the prevalence of these muscle changes, their interrelations and their prognostic impact over a 12-month period.
We conducted a prospective multicentre study involving 433 patients. Sarcopenia and myosteatosis were evaluated using computed tomography scans. The 1-year cumulative incidence of relevant events was assessed by competing risk analysis. We used a Fine-Gray model adjusted for known prognostic factors to evaluate the impact of sarcopenia and myosteatosis on mortality, hospitalization, and liver decompensation.
At enrolment, 166 patients presented with isolated myosteatosis, 36 with isolated sarcopenia, 135 with combined sarcopenia and myosteatosis and 96 patients showed no muscle changes. The 1-year cumulative incidence of death in patients with either sarcopenia and myosteatosis (13.8%) or isolated myosteatosis (13.4%) was over twice that of patients without muscle changes (5.2%) or with isolated sarcopenia (5.6%). The adjusted sub-hazard ratio for death in patients with muscle changes was 1.36 (95% CI 0.99–1.86, p = 0.058). The cumulative incidence of hospitalization was significantly higher in patients with combined sarcopenia and myosteatosis than in patients without muscle changes (adjusted sub-hazard ratio 1.18, 95% CI 1.04–1.35). The cumulative incidence of liver decompensation was greater in patients with combined sarcopenia and myosteatosis (p = 0.018) and those with isolated sarcopenia (p = 0.046) than in patients without muscle changes. Lastly, we found a strong correlation of function tests and frailty scores with the presence of muscle changes.
Myosteatosis, whether alone or combined with sarcopenia, is highly prevalent in patients with cirrhosis and is associated with significantly worse outcomes. The prognostic role of sarcopenia should always be evaluated in relation to the presence of myosteatosis.
This study investigates the prognostic role of muscle changes in patients with cirrhosis. The novelty of this study is its multicentre, prospective nature and the fact that it distinguishes between the impact of individual muscle changes and their combination on prognosis in cirrhosis. This study highlights the prognostic role of myosteatosis, especially when combined with sarcopenia. On the other hand, the relevance of sarcopenia could be mitigated when considered together with myosteatosis. The implication from these findings is that sarco |
| doi_str_mv | 10.1016/j.jhep.2024.05.020 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_3060384256</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0168827824003556</els_id><sourcerecordid>3060384256</sourcerecordid><originalsourceid>FETCH-LOGICAL-c330t-ec6ce74ee471673f4877d9e23f537afc395c95d6f46584660ae95fa0d8f9d4993</originalsourceid><addsrcrecordid>eNp9kE1v1DAQhi1E1W5L_wAHlCOXhIntOI7EBVV8VCrqBc6WscesV9k4eLxU--_xagtHpJHm8rzvaB7GXvfQ9dCrd7tut8W148BlB0MHHF6wTa8AWlCyf8k2FdKt5qO-YtdEOwAQMMlLdiX0qHnPYcOWr8dEBW1JFKmp4-ZEOB8bS5RctAV98xTLtiGbXVpxibaxi28o_lxiiM4upcJPKRM26VBc2mOtWZrVlohLoXPYxZy3pwuv2EWwM-Ht875h3z99_Hb3pX14_Hx_9-GhdUJAadEph6NElGOvRhGkHkc_IRdhEKMNTkyDmwavglSDlkqBxWkIFrwOk5fTJG7Y23PvmtOvA1Ix-0gO59kumA5kBCgQWvJBVZSfUZcTUcZg1hz3Nh9ND-bk2ezMybM5eTYwmOq5ht489x9-7NH_i_wVW4H3ZwDrl78jZkOuCnHoY0ZXjE_xf_1_AHvJkVY</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3060384256</pqid></control><display><type>article</type><title>Myosteatosis is closely associated with sarcopenia and significantly worse outcomes in patients with cirrhosis</title><source>MEDLINE</source><source>ScienceDirect Journals (5 years ago - present)</source><creator>Di Cola, Simone ; D’Amico, Gennaro ; Caraceni, Paolo ; Schepis, Filippo ; Loredana, Simone ; Lampertico, Pietro ; Toniutto, Pierluigi ; Martini, Silvia ; Maimone, Sergio ; Colecchia, Antonio ; Svegliati Barone, Gianluca ; Alessandria, Carlo ; Aghemo, Alessio ; Crocè, Saveria Lory ; Adinolfi, Luigi Elio ; Rendina, Maria ; Lapenna, Lucia ; Pompili, Enrico ; Zaccherini, Giacomo ; Saltini, Dario ; Iavarone, Massimo ; Tosetti, Giulia ; Martelletti, Carolina ; Nassisi, Veronica ; Ferrarese, Alberto ; Giovo, Ilaria ; Masetti, Chiara ; Pugliese, Nicola ; Campigotto, Michele ; Nevola, Riccardo ; Merli, Manuela ; Iannone, Giulia ; Serri, Paola ; Bertino, Gaetano ; Balsano, Clara ; Iapadre, Nerio ; Maida, Marcello ; Sacerdoti, David ; Natola, Leonardo Antonio ; Ciacci, Carolina ; Santonicola, Antonella ; Cozzolongo, Raffaele ; Surace, Lorenzo Antonio ; Fracanzani, Anna Ludovica ; Cespiati, Annalisa ; Federico, Alessandro ; Romeo, Mario ; Grieco, Antonio ; Marrone, Giuseppe ; Vizioli, Luca</creator><creatorcontrib>Di Cola, Simone ; D’Amico, Gennaro ; Caraceni, Paolo ; Schepis, Filippo ; Loredana, Simone ; Lampertico, Pietro ; Toniutto, Pierluigi ; Martini, Silvia ; Maimone, Sergio ; Colecchia, Antonio ; Svegliati Barone, Gianluca ; Alessandria, Carlo ; Aghemo, Alessio ; Crocè, Saveria Lory ; Adinolfi, Luigi Elio ; Rendina, Maria ; Lapenna, Lucia ; Pompili, Enrico ; Zaccherini, Giacomo ; Saltini, Dario ; Iavarone, Massimo ; Tosetti, Giulia ; Martelletti, Carolina ; Nassisi, Veronica ; Ferrarese, Alberto ; Giovo, Ilaria ; Masetti, Chiara ; Pugliese, Nicola ; Campigotto, Michele ; Nevola, Riccardo ; Merli, Manuela ; Iannone, Giulia ; Serri, Paola ; Bertino, Gaetano ; Balsano, Clara ; Iapadre, Nerio ; Maida, Marcello ; Sacerdoti, David ; Natola, Leonardo Antonio ; Ciacci, Carolina ; Santonicola, Antonella ; Cozzolongo, Raffaele ; Surace, Lorenzo Antonio ; Fracanzani, Anna Ludovica ; Cespiati, Annalisa ; Federico, Alessandro ; Romeo, Mario ; Grieco, Antonio ; Marrone, Giuseppe ; Vizioli, Luca ; for the EpatoSarco working group ; EpatoSarco working group</creatorcontrib><description>Sarcopenia and myosteatosis are common in patients with cirrhosis. This study aimed to determine the prevalence of these muscle changes, their interrelations and their prognostic impact over a 12-month period.
We conducted a prospective multicentre study involving 433 patients. Sarcopenia and myosteatosis were evaluated using computed tomography scans. The 1-year cumulative incidence of relevant events was assessed by competing risk analysis. We used a Fine-Gray model adjusted for known prognostic factors to evaluate the impact of sarcopenia and myosteatosis on mortality, hospitalization, and liver decompensation.
At enrolment, 166 patients presented with isolated myosteatosis, 36 with isolated sarcopenia, 135 with combined sarcopenia and myosteatosis and 96 patients showed no muscle changes. The 1-year cumulative incidence of death in patients with either sarcopenia and myosteatosis (13.8%) or isolated myosteatosis (13.4%) was over twice that of patients without muscle changes (5.2%) or with isolated sarcopenia (5.6%). The adjusted sub-hazard ratio for death in patients with muscle changes was 1.36 (95% CI 0.99–1.86, p = 0.058). The cumulative incidence of hospitalization was significantly higher in patients with combined sarcopenia and myosteatosis than in patients without muscle changes (adjusted sub-hazard ratio 1.18, 95% CI 1.04–1.35). The cumulative incidence of liver decompensation was greater in patients with combined sarcopenia and myosteatosis (p = 0.018) and those with isolated sarcopenia (p = 0.046) than in patients without muscle changes. Lastly, we found a strong correlation of function tests and frailty scores with the presence of muscle changes.
Myosteatosis, whether alone or combined with sarcopenia, is highly prevalent in patients with cirrhosis and is associated with significantly worse outcomes. The prognostic role of sarcopenia should always be evaluated in relation to the presence of myosteatosis.
This study investigates the prognostic role of muscle changes in patients with cirrhosis. The novelty of this study is its multicentre, prospective nature and the fact that it distinguishes between the impact of individual muscle changes and their combination on prognosis in cirrhosis. This study highlights the prognostic role of myosteatosis, especially when combined with sarcopenia. On the other hand, the relevance of sarcopenia could be mitigated when considered together with myosteatosis. The implication from these findings is that sarcopenia should never be evaluated individually and that myosteatosis may play a dominant role in the prognosis of patients with cirrhosis.
[Display omitted]
•Sarcopenia is closely associated with myosteatosis in patients with cirrhosis.•The combination of sarcopenia and myosteatosis is an independent predictor of worse outcomes.•Isolated myosteatosis is a risk factor for decline in muscle function and is associated with patient survival.•Muscle function tests are clinical surrogates for sarcopenia and myosteatosis.</description><identifier>ISSN: 0168-8278</identifier><identifier>ISSN: 1600-0641</identifier><identifier>EISSN: 1600-0641</identifier><identifier>DOI: 10.1016/j.jhep.2024.05.020</identifier><identifier>PMID: 38782120</identifier><language>eng</language><publisher>Netherlands: Elsevier B.V</publisher><subject>Aged ; cirrhosis ; decompensation ; Female ; Hospitalization - statistics & numerical data ; Humans ; Incidence ; Liver Cirrhosis - complications ; Male ; Middle Aged ; muscle function ; myosteatosis ; Prevalence ; Prognosis ; Prospective Studies ; sarcopenia ; Sarcopenia - complications ; Sarcopenia - diagnosis ; Sarcopenia - epidemiology ; Sarcopenia - etiology ; survival ; Tomography, X-Ray Computed - methods</subject><ispartof>Journal of hepatology, 2024-10, Vol.81 (4), p.641-650</ispartof><rights>2024 The Authors</rights><rights>Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c330t-ec6ce74ee471673f4877d9e23f537afc395c95d6f46584660ae95fa0d8f9d4993</citedby><cites>FETCH-LOGICAL-c330t-ec6ce74ee471673f4877d9e23f537afc395c95d6f46584660ae95fa0d8f9d4993</cites><orcidid>0000-0002-7426-1145 ; 0000-0002-3248-2038 ; 0000-0003-2467-7027 ; 0000-0002-6368-2964 ; 0000-0001-9094-765X ; 0000-0002-6414-4404 ; 0000-0002-0823-1642 ; 0000-0001-5376-9575 ; 0000-0002-1439-056X ; 0000-0002-0885-0793 ; 0000-0002-4702-3539 ; 0000-0002-4992-9289 ; 0009-0007-3054-7575 ; 0000-0002-2970-9019 ; 0000-0003-3320-3878 ; 0000-0002-9615-7031 ; 0000-0001-5468-694X ; 0000-0001-6466-1412 ; 0000-0002-3219-6963 ; 0000-0003-3173-9767 ; 0000-0002-2566-3041 ; 0000-0003-1003-8179</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0168827824003556$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38782120$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Di Cola, Simone</creatorcontrib><creatorcontrib>D’Amico, Gennaro</creatorcontrib><creatorcontrib>Caraceni, Paolo</creatorcontrib><creatorcontrib>Schepis, Filippo</creatorcontrib><creatorcontrib>Loredana, Simone</creatorcontrib><creatorcontrib>Lampertico, Pietro</creatorcontrib><creatorcontrib>Toniutto, Pierluigi</creatorcontrib><creatorcontrib>Martini, Silvia</creatorcontrib><creatorcontrib>Maimone, Sergio</creatorcontrib><creatorcontrib>Colecchia, Antonio</creatorcontrib><creatorcontrib>Svegliati Barone, Gianluca</creatorcontrib><creatorcontrib>Alessandria, Carlo</creatorcontrib><creatorcontrib>Aghemo, Alessio</creatorcontrib><creatorcontrib>Crocè, Saveria Lory</creatorcontrib><creatorcontrib>Adinolfi, Luigi Elio</creatorcontrib><creatorcontrib>Rendina, Maria</creatorcontrib><creatorcontrib>Lapenna, Lucia</creatorcontrib><creatorcontrib>Pompili, Enrico</creatorcontrib><creatorcontrib>Zaccherini, Giacomo</creatorcontrib><creatorcontrib>Saltini, Dario</creatorcontrib><creatorcontrib>Iavarone, Massimo</creatorcontrib><creatorcontrib>Tosetti, Giulia</creatorcontrib><creatorcontrib>Martelletti, Carolina</creatorcontrib><creatorcontrib>Nassisi, Veronica</creatorcontrib><creatorcontrib>Ferrarese, Alberto</creatorcontrib><creatorcontrib>Giovo, Ilaria</creatorcontrib><creatorcontrib>Masetti, Chiara</creatorcontrib><creatorcontrib>Pugliese, Nicola</creatorcontrib><creatorcontrib>Campigotto, Michele</creatorcontrib><creatorcontrib>Nevola, Riccardo</creatorcontrib><creatorcontrib>Merli, Manuela</creatorcontrib><creatorcontrib>Iannone, Giulia</creatorcontrib><creatorcontrib>Serri, Paola</creatorcontrib><creatorcontrib>Bertino, Gaetano</creatorcontrib><creatorcontrib>Balsano, Clara</creatorcontrib><creatorcontrib>Iapadre, Nerio</creatorcontrib><creatorcontrib>Maida, Marcello</creatorcontrib><creatorcontrib>Sacerdoti, David</creatorcontrib><creatorcontrib>Natola, Leonardo Antonio</creatorcontrib><creatorcontrib>Ciacci, Carolina</creatorcontrib><creatorcontrib>Santonicola, Antonella</creatorcontrib><creatorcontrib>Cozzolongo, Raffaele</creatorcontrib><creatorcontrib>Surace, Lorenzo Antonio</creatorcontrib><creatorcontrib>Fracanzani, Anna Ludovica</creatorcontrib><creatorcontrib>Cespiati, Annalisa</creatorcontrib><creatorcontrib>Federico, Alessandro</creatorcontrib><creatorcontrib>Romeo, Mario</creatorcontrib><creatorcontrib>Grieco, Antonio</creatorcontrib><creatorcontrib>Marrone, Giuseppe</creatorcontrib><creatorcontrib>Vizioli, Luca</creatorcontrib><creatorcontrib>for the EpatoSarco working group</creatorcontrib><creatorcontrib>EpatoSarco working group</creatorcontrib><title>Myosteatosis is closely associated with sarcopenia and significantly worse outcomes in patients with cirrhosis</title><title>Journal of hepatology</title><addtitle>J Hepatol</addtitle><description>Sarcopenia and myosteatosis are common in patients with cirrhosis. This study aimed to determine the prevalence of these muscle changes, their interrelations and their prognostic impact over a 12-month period.
We conducted a prospective multicentre study involving 433 patients. Sarcopenia and myosteatosis were evaluated using computed tomography scans. The 1-year cumulative incidence of relevant events was assessed by competing risk analysis. We used a Fine-Gray model adjusted for known prognostic factors to evaluate the impact of sarcopenia and myosteatosis on mortality, hospitalization, and liver decompensation.
At enrolment, 166 patients presented with isolated myosteatosis, 36 with isolated sarcopenia, 135 with combined sarcopenia and myosteatosis and 96 patients showed no muscle changes. The 1-year cumulative incidence of death in patients with either sarcopenia and myosteatosis (13.8%) or isolated myosteatosis (13.4%) was over twice that of patients without muscle changes (5.2%) or with isolated sarcopenia (5.6%). The adjusted sub-hazard ratio for death in patients with muscle changes was 1.36 (95% CI 0.99–1.86, p = 0.058). The cumulative incidence of hospitalization was significantly higher in patients with combined sarcopenia and myosteatosis than in patients without muscle changes (adjusted sub-hazard ratio 1.18, 95% CI 1.04–1.35). The cumulative incidence of liver decompensation was greater in patients with combined sarcopenia and myosteatosis (p = 0.018) and those with isolated sarcopenia (p = 0.046) than in patients without muscle changes. Lastly, we found a strong correlation of function tests and frailty scores with the presence of muscle changes.
Myosteatosis, whether alone or combined with sarcopenia, is highly prevalent in patients with cirrhosis and is associated with significantly worse outcomes. The prognostic role of sarcopenia should always be evaluated in relation to the presence of myosteatosis.
This study investigates the prognostic role of muscle changes in patients with cirrhosis. The novelty of this study is its multicentre, prospective nature and the fact that it distinguishes between the impact of individual muscle changes and their combination on prognosis in cirrhosis. This study highlights the prognostic role of myosteatosis, especially when combined with sarcopenia. On the other hand, the relevance of sarcopenia could be mitigated when considered together with myosteatosis. The implication from these findings is that sarcopenia should never be evaluated individually and that myosteatosis may play a dominant role in the prognosis of patients with cirrhosis.
[Display omitted]
•Sarcopenia is closely associated with myosteatosis in patients with cirrhosis.•The combination of sarcopenia and myosteatosis is an independent predictor of worse outcomes.•Isolated myosteatosis is a risk factor for decline in muscle function and is associated with patient survival.•Muscle function tests are clinical surrogates for sarcopenia and myosteatosis.</description><subject>Aged</subject><subject>cirrhosis</subject><subject>decompensation</subject><subject>Female</subject><subject>Hospitalization - statistics & numerical data</subject><subject>Humans</subject><subject>Incidence</subject><subject>Liver Cirrhosis - complications</subject><subject>Male</subject><subject>Middle Aged</subject><subject>muscle function</subject><subject>myosteatosis</subject><subject>Prevalence</subject><subject>Prognosis</subject><subject>Prospective Studies</subject><subject>sarcopenia</subject><subject>Sarcopenia - complications</subject><subject>Sarcopenia - diagnosis</subject><subject>Sarcopenia - epidemiology</subject><subject>Sarcopenia - etiology</subject><subject>survival</subject><subject>Tomography, X-Ray Computed - methods</subject><issn>0168-8278</issn><issn>1600-0641</issn><issn>1600-0641</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE1v1DAQhi1E1W5L_wAHlCOXhIntOI7EBVV8VCrqBc6WscesV9k4eLxU--_xagtHpJHm8rzvaB7GXvfQ9dCrd7tut8W148BlB0MHHF6wTa8AWlCyf8k2FdKt5qO-YtdEOwAQMMlLdiX0qHnPYcOWr8dEBW1JFKmp4-ZEOB8bS5RctAV98xTLtiGbXVpxibaxi28o_lxiiM4upcJPKRM26VBc2mOtWZrVlohLoXPYxZy3pwuv2EWwM-Ht875h3z99_Hb3pX14_Hx_9-GhdUJAadEph6NElGOvRhGkHkc_IRdhEKMNTkyDmwavglSDlkqBxWkIFrwOk5fTJG7Y23PvmtOvA1Ix-0gO59kumA5kBCgQWvJBVZSfUZcTUcZg1hz3Nh9ND-bk2ezMybM5eTYwmOq5ht489x9-7NH_i_wVW4H3ZwDrl78jZkOuCnHoY0ZXjE_xf_1_AHvJkVY</recordid><startdate>202410</startdate><enddate>202410</enddate><creator>Di Cola, Simone</creator><creator>D’Amico, Gennaro</creator><creator>Caraceni, 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is closely associated with sarcopenia and significantly worse outcomes in patients with cirrhosis</title><author>Di Cola, Simone ; D’Amico, Gennaro ; Caraceni, Paolo ; Schepis, Filippo ; Loredana, Simone ; Lampertico, Pietro ; Toniutto, Pierluigi ; Martini, Silvia ; Maimone, Sergio ; Colecchia, Antonio ; Svegliati Barone, Gianluca ; Alessandria, Carlo ; Aghemo, Alessio ; Crocè, Saveria Lory ; Adinolfi, Luigi Elio ; Rendina, Maria ; Lapenna, Lucia ; Pompili, Enrico ; Zaccherini, Giacomo ; Saltini, Dario ; Iavarone, Massimo ; Tosetti, Giulia ; Martelletti, Carolina ; Nassisi, Veronica ; Ferrarese, Alberto ; Giovo, Ilaria ; Masetti, Chiara ; Pugliese, Nicola ; Campigotto, Michele ; Nevola, Riccardo ; Merli, Manuela ; Iannone, Giulia ; Serri, Paola ; Bertino, Gaetano ; Balsano, Clara ; Iapadre, Nerio ; Maida, Marcello ; Sacerdoti, David ; Natola, Leonardo Antonio ; Ciacci, Carolina ; Santonicola, Antonella ; Cozzolongo, Raffaele ; Surace, Lorenzo Antonio ; Fracanzani, Anna Ludovica ; Cespiati, Annalisa ; Federico, Alessandro ; Romeo, Mario ; Grieco, Antonio ; Marrone, Giuseppe ; Vizioli, Luca</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c330t-ec6ce74ee471673f4877d9e23f537afc395c95d6f46584660ae95fa0d8f9d4993</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Aged</topic><topic>cirrhosis</topic><topic>decompensation</topic><topic>Female</topic><topic>Hospitalization - statistics & numerical data</topic><topic>Humans</topic><topic>Incidence</topic><topic>Liver Cirrhosis - complications</topic><topic>Male</topic><topic>Middle Aged</topic><topic>muscle function</topic><topic>myosteatosis</topic><topic>Prevalence</topic><topic>Prognosis</topic><topic>Prospective Studies</topic><topic>sarcopenia</topic><topic>Sarcopenia - complications</topic><topic>Sarcopenia - diagnosis</topic><topic>Sarcopenia - epidemiology</topic><topic>Sarcopenia - etiology</topic><topic>survival</topic><topic>Tomography, X-Ray Computed - methods</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Di Cola, Simone</creatorcontrib><creatorcontrib>D’Amico, Gennaro</creatorcontrib><creatorcontrib>Caraceni, Paolo</creatorcontrib><creatorcontrib>Schepis, Filippo</creatorcontrib><creatorcontrib>Loredana, Simone</creatorcontrib><creatorcontrib>Lampertico, Pietro</creatorcontrib><creatorcontrib>Toniutto, Pierluigi</creatorcontrib><creatorcontrib>Martini, Silvia</creatorcontrib><creatorcontrib>Maimone, Sergio</creatorcontrib><creatorcontrib>Colecchia, Antonio</creatorcontrib><creatorcontrib>Svegliati Barone, Gianluca</creatorcontrib><creatorcontrib>Alessandria, Carlo</creatorcontrib><creatorcontrib>Aghemo, Alessio</creatorcontrib><creatorcontrib>Crocè, Saveria Lory</creatorcontrib><creatorcontrib>Adinolfi, Luigi Elio</creatorcontrib><creatorcontrib>Rendina, Maria</creatorcontrib><creatorcontrib>Lapenna, Lucia</creatorcontrib><creatorcontrib>Pompili, Enrico</creatorcontrib><creatorcontrib>Zaccherini, Giacomo</creatorcontrib><creatorcontrib>Saltini, Dario</creatorcontrib><creatorcontrib>Iavarone, Massimo</creatorcontrib><creatorcontrib>Tosetti, Giulia</creatorcontrib><creatorcontrib>Martelletti, Carolina</creatorcontrib><creatorcontrib>Nassisi, Veronica</creatorcontrib><creatorcontrib>Ferrarese, Alberto</creatorcontrib><creatorcontrib>Giovo, Ilaria</creatorcontrib><creatorcontrib>Masetti, Chiara</creatorcontrib><creatorcontrib>Pugliese, Nicola</creatorcontrib><creatorcontrib>Campigotto, Michele</creatorcontrib><creatorcontrib>Nevola, Riccardo</creatorcontrib><creatorcontrib>Merli, Manuela</creatorcontrib><creatorcontrib>Iannone, Giulia</creatorcontrib><creatorcontrib>Serri, Paola</creatorcontrib><creatorcontrib>Bertino, Gaetano</creatorcontrib><creatorcontrib>Balsano, Clara</creatorcontrib><creatorcontrib>Iapadre, Nerio</creatorcontrib><creatorcontrib>Maida, Marcello</creatorcontrib><creatorcontrib>Sacerdoti, David</creatorcontrib><creatorcontrib>Natola, Leonardo Antonio</creatorcontrib><creatorcontrib>Ciacci, Carolina</creatorcontrib><creatorcontrib>Santonicola, Antonella</creatorcontrib><creatorcontrib>Cozzolongo, Raffaele</creatorcontrib><creatorcontrib>Surace, Lorenzo Antonio</creatorcontrib><creatorcontrib>Fracanzani, Anna Ludovica</creatorcontrib><creatorcontrib>Cespiati, Annalisa</creatorcontrib><creatorcontrib>Federico, Alessandro</creatorcontrib><creatorcontrib>Romeo, Mario</creatorcontrib><creatorcontrib>Grieco, Antonio</creatorcontrib><creatorcontrib>Marrone, Giuseppe</creatorcontrib><creatorcontrib>Vizioli, Luca</creatorcontrib><creatorcontrib>for the EpatoSarco working group</creatorcontrib><creatorcontrib>EpatoSarco working group</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of hepatology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Di Cola, Simone</au><au>D’Amico, Gennaro</au><au>Caraceni, Paolo</au><au>Schepis, Filippo</au><au>Loredana, Simone</au><au>Lampertico, Pietro</au><au>Toniutto, Pierluigi</au><au>Martini, Silvia</au><au>Maimone, Sergio</au><au>Colecchia, Antonio</au><au>Svegliati Barone, Gianluca</au><au>Alessandria, Carlo</au><au>Aghemo, Alessio</au><au>Crocè, Saveria Lory</au><au>Adinolfi, Luigi Elio</au><au>Rendina, Maria</au><au>Lapenna, Lucia</au><au>Pompili, Enrico</au><au>Zaccherini, Giacomo</au><au>Saltini, Dario</au><au>Iavarone, Massimo</au><au>Tosetti, Giulia</au><au>Martelletti, Carolina</au><au>Nassisi, Veronica</au><au>Ferrarese, Alberto</au><au>Giovo, Ilaria</au><au>Masetti, Chiara</au><au>Pugliese, Nicola</au><au>Campigotto, Michele</au><au>Nevola, Riccardo</au><au>Merli, Manuela</au><au>Iannone, Giulia</au><au>Serri, Paola</au><au>Bertino, Gaetano</au><au>Balsano, Clara</au><au>Iapadre, Nerio</au><au>Maida, Marcello</au><au>Sacerdoti, David</au><au>Natola, Leonardo Antonio</au><au>Ciacci, Carolina</au><au>Santonicola, Antonella</au><au>Cozzolongo, Raffaele</au><au>Surace, Lorenzo Antonio</au><au>Fracanzani, Anna Ludovica</au><au>Cespiati, Annalisa</au><au>Federico, Alessandro</au><au>Romeo, Mario</au><au>Grieco, Antonio</au><au>Marrone, Giuseppe</au><au>Vizioli, Luca</au><aucorp>for the EpatoSarco working group</aucorp><aucorp>EpatoSarco working group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Myosteatosis is closely associated with sarcopenia and significantly worse outcomes in patients with cirrhosis</atitle><jtitle>Journal of hepatology</jtitle><addtitle>J Hepatol</addtitle><date>2024-10</date><risdate>2024</risdate><volume>81</volume><issue>4</issue><spage>641</spage><epage>650</epage><pages>641-650</pages><issn>0168-8278</issn><issn>1600-0641</issn><eissn>1600-0641</eissn><abstract>Sarcopenia and myosteatosis are common in patients with cirrhosis. This study aimed to determine the prevalence of these muscle changes, their interrelations and their prognostic impact over a 12-month period.
We conducted a prospective multicentre study involving 433 patients. Sarcopenia and myosteatosis were evaluated using computed tomography scans. The 1-year cumulative incidence of relevant events was assessed by competing risk analysis. We used a Fine-Gray model adjusted for known prognostic factors to evaluate the impact of sarcopenia and myosteatosis on mortality, hospitalization, and liver decompensation.
At enrolment, 166 patients presented with isolated myosteatosis, 36 with isolated sarcopenia, 135 with combined sarcopenia and myosteatosis and 96 patients showed no muscle changes. The 1-year cumulative incidence of death in patients with either sarcopenia and myosteatosis (13.8%) or isolated myosteatosis (13.4%) was over twice that of patients without muscle changes (5.2%) or with isolated sarcopenia (5.6%). The adjusted sub-hazard ratio for death in patients with muscle changes was 1.36 (95% CI 0.99–1.86, p = 0.058). The cumulative incidence of hospitalization was significantly higher in patients with combined sarcopenia and myosteatosis than in patients without muscle changes (adjusted sub-hazard ratio 1.18, 95% CI 1.04–1.35). The cumulative incidence of liver decompensation was greater in patients with combined sarcopenia and myosteatosis (p = 0.018) and those with isolated sarcopenia (p = 0.046) than in patients without muscle changes. Lastly, we found a strong correlation of function tests and frailty scores with the presence of muscle changes.
Myosteatosis, whether alone or combined with sarcopenia, is highly prevalent in patients with cirrhosis and is associated with significantly worse outcomes. The prognostic role of sarcopenia should always be evaluated in relation to the presence of myosteatosis.
This study investigates the prognostic role of muscle changes in patients with cirrhosis. The novelty of this study is its multicentre, prospective nature and the fact that it distinguishes between the impact of individual muscle changes and their combination on prognosis in cirrhosis. This study highlights the prognostic role of myosteatosis, especially when combined with sarcopenia. On the other hand, the relevance of sarcopenia could be mitigated when considered together with myosteatosis. The implication from these findings is that sarcopenia should never be evaluated individually and that myosteatosis may play a dominant role in the prognosis of patients with cirrhosis.
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•Sarcopenia is closely associated with myosteatosis in patients with cirrhosis.•The combination of sarcopenia and myosteatosis is an independent predictor of worse outcomes.•Isolated myosteatosis is a risk factor for decline in muscle function and is associated with patient survival.•Muscle function tests are clinical surrogates for sarcopenia and myosteatosis.</abstract><cop>Netherlands</cop><pub>Elsevier B.V</pub><pmid>38782120</pmid><doi>10.1016/j.jhep.2024.05.020</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-7426-1145</orcidid><orcidid>https://orcid.org/0000-0002-3248-2038</orcidid><orcidid>https://orcid.org/0000-0003-2467-7027</orcidid><orcidid>https://orcid.org/0000-0002-6368-2964</orcidid><orcidid>https://orcid.org/0000-0001-9094-765X</orcidid><orcidid>https://orcid.org/0000-0002-6414-4404</orcidid><orcidid>https://orcid.org/0000-0002-0823-1642</orcidid><orcidid>https://orcid.org/0000-0001-5376-9575</orcidid><orcidid>https://orcid.org/0000-0002-1439-056X</orcidid><orcidid>https://orcid.org/0000-0002-0885-0793</orcidid><orcidid>https://orcid.org/0000-0002-4702-3539</orcidid><orcidid>https://orcid.org/0000-0002-4992-9289</orcidid><orcidid>https://orcid.org/0009-0007-3054-7575</orcidid><orcidid>https://orcid.org/0000-0002-2970-9019</orcidid><orcidid>https://orcid.org/0000-0003-3320-3878</orcidid><orcidid>https://orcid.org/0000-0002-9615-7031</orcidid><orcidid>https://orcid.org/0000-0001-5468-694X</orcidid><orcidid>https://orcid.org/0000-0001-6466-1412</orcidid><orcidid>https://orcid.org/0000-0002-3219-6963</orcidid><orcidid>https://orcid.org/0000-0003-3173-9767</orcidid><orcidid>https://orcid.org/0000-0002-2566-3041</orcidid><orcidid>https://orcid.org/0000-0003-1003-8179</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0168-8278 |
| ispartof | Journal of hepatology, 2024-10, Vol.81 (4), p.641-650 |
| issn | 0168-8278 1600-0641 1600-0641 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_3060384256 |
| source | MEDLINE; ScienceDirect Journals (5 years ago - present) |
| subjects | Aged cirrhosis decompensation Female Hospitalization - statistics & numerical data Humans Incidence Liver Cirrhosis - complications Male Middle Aged muscle function myosteatosis Prevalence Prognosis Prospective Studies sarcopenia Sarcopenia - complications Sarcopenia - diagnosis Sarcopenia - epidemiology Sarcopenia - etiology survival Tomography, X-Ray Computed - methods |
| title | Myosteatosis is closely associated with sarcopenia and significantly worse outcomes in patients with cirrhosis |
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