Prognostic value of sarcopenia in patients with liver cirrhosis: A systematic review and meta-analysis

Gaeun Kim, Seong Hee Kang, Moon Young Kim, Soon Koo Baik

Research output: Contribution to journalArticle

36 Citations (Scopus)

Abstract

Background: Sarcopenia is a common syndrome in chronic diseases such as liver cirrhosis. The association between sarcopenia and outcomes, such as complications and survival has recently been described in various patient groups. However, study results remain inconclusive. Therefore, the aim of this study was to systematically review the impact of sarcopenia on outcome in patients with cirrhosis. Methods and findings: We conducted a systematic review (SR) and meta-analysis (MA) on the impact of sarcopenia on outcome in liver cirrhosis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Of the 312 studies identified, 20 were eligible according to our inclusion criteria. Most of the studies used CT to diagnose sarcopenia. Two studies used bioelectrical impedance analysis (BIA), 10 studies used skeletal muscle index (SMI) and 8 studies used total psoas muscle area (TPA). Seven studies included Asian participants and the remaining 13 studies included Western participants. The prevalence rate of sarcopenia among participants was mean 48.1%, and appeared more among men with a rate of 61.6% whereas the rate was 36% for women. With respect to clinical outcomes, patients with sarcopenia had poorer survival rates and an increased risk of complications such as infection compared to those without sarcopenia. According to the analysis of race subgroup, Asians had a HR 2.45 (95% confidence interval (CI) = 1.44–4.16, P = 0.001) of mortality whereas Westerners had a HR 1.45 (95% CI = 1.002–2.09, P<0.05). Conclusions: Based on this SR and MA, the presence of sarcopenia is related to a poor prognosis and occurrence of cirrhotic complications and could be used for risk assessment. Moreover, Asian participants had higher mortality related to sarcopenia compared to the Western participants.

Original languageEnglish
Article numbere0186990
JournalPloS one
Volume12
Issue number10
DOIs
Publication statusPublished - 2017 Oct

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sarcopenia
Sarcopenia
liver cirrhosis
systematic review
meta-analysis
Liver Cirrhosis
Liver
Meta-Analysis
Muscle
Acoustic impedance
Risk assessment
confidence interval
Confidence Intervals
Psoas Muscles
psoas muscles
bioelectrical impedance
Mortality
Electric Impedance
chronic diseases
prognosis

All Science Journal Classification (ASJC) codes

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

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title = "Prognostic value of sarcopenia in patients with liver cirrhosis: A systematic review and meta-analysis",
abstract = "Background: Sarcopenia is a common syndrome in chronic diseases such as liver cirrhosis. The association between sarcopenia and outcomes, such as complications and survival has recently been described in various patient groups. However, study results remain inconclusive. Therefore, the aim of this study was to systematically review the impact of sarcopenia on outcome in patients with cirrhosis. Methods and findings: We conducted a systematic review (SR) and meta-analysis (MA) on the impact of sarcopenia on outcome in liver cirrhosis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Of the 312 studies identified, 20 were eligible according to our inclusion criteria. Most of the studies used CT to diagnose sarcopenia. Two studies used bioelectrical impedance analysis (BIA), 10 studies used skeletal muscle index (SMI) and 8 studies used total psoas muscle area (TPA). Seven studies included Asian participants and the remaining 13 studies included Western participants. The prevalence rate of sarcopenia among participants was mean 48.1{\%}, and appeared more among men with a rate of 61.6{\%} whereas the rate was 36{\%} for women. With respect to clinical outcomes, patients with sarcopenia had poorer survival rates and an increased risk of complications such as infection compared to those without sarcopenia. According to the analysis of race subgroup, Asians had a HR 2.45 (95{\%} confidence interval (CI) = 1.44–4.16, P = 0.001) of mortality whereas Westerners had a HR 1.45 (95{\%} CI = 1.002–2.09, P<0.05). Conclusions: Based on this SR and MA, the presence of sarcopenia is related to a poor prognosis and occurrence of cirrhotic complications and could be used for risk assessment. Moreover, Asian participants had higher mortality related to sarcopenia compared to the Western participants.",
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Prognostic value of sarcopenia in patients with liver cirrhosis : A systematic review and meta-analysis. / Kim, Gaeun; Kang, Seong Hee; Kim, Moon Young; Baik, Soon Koo.

In: PloS one, Vol. 12, No. 10, e0186990, 10.2017.

Research output: Contribution to journalArticle

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