Some adipose-related parameters exhibit distinct prognostic value in patients with cirrhosis. However, the magnitude and direction of the association between individual adipose parameter and mortality in patients with cirrhosis are unclear. This study aimed to evaluate the association between individual adipose parameter and mortality in patients with cirrhosis using the meta-analysis method. The PubMed, Embase, Web of Science, China Biological Medicine, WanFang, and China National Knowledge Infrastructure databases were searched from inception through December 15, 2023, to identify eligible studies. The impact of each adipose parameter on mortality was assessed by the pooled unadjusted or adjusted hazard ratio (HR) with 95% confidence intervals (CIs) using the random effects model. A total of 33 studies involving 9626 patients were included in our analysis, with 11 adipose parameters evaluated. The pooled prevalence of sarcopenic obesity (SO) and myosteatosis in patients with cirrhosis was 15.5% and 34.4%, respectively. In adjusted analysis, each unit increase in subcutaneous adipose tissue index (SATI) (HR: 0.99, 95% CI: 0.98-1.00) or muscle attenuation (MA) (HR: 0.94, 95% CI: 0.90-0.98) and each unit decrease in visceral-to-subcutaneous adipose tissue ratio (VSR) (HR: 1.92, 95% CI: 1.45-2.54) showed an independent association with a decreased risk of mortality. However, concurrent myosteatosis (HR: 1.88, 95% CI: 1.48-2.40) or SO (HR: 2.77, 95% CI: 1.95-3.93) significantly increased the risk of mortality in patients with cirrhosis. Decreased SATI or MA, increased VSR, and concurrent myosteatosis or SO were independently associated with a higher risk of mortality in patients with cirrhosis.

Background: Previous studies have shown inconsistent findings regarding the association of alcohol consumption with sarcopenia. Therefore, this study comprehensively investigated the association of alcohol consumption with sarcopenia in a nationally representative sample of US adults.Methods: This population-based study included adults aged 18 years and older from the National Health and Nutrition Examination Survey (NHANES) III. Alcohol exposure was defined as daily alcohol intake, alcohol drinking history, number of drinking days per week, and frequency of binge drinking days per month. Weighted logistic regressions were used to determine associations.Results: Four cohorts were selected from the NHANES III: cohort 1 (n = 7,592), cohort 2 (n = 12,060), cohort 3 (n = 7,608), and cohort 4 (n = 7,649), corresponding to alcohol exposure categories of daily alcohol intake, drinking history, number of drinking days per week, and frequency of binge drinking days per month. In the full model, the risk of sarcopenia was significantly associated with mild (odds ratio [OR]: 1.65; 95% confidence interval [CI]: 1.08–2.51), moderate (OR: 2.04; 95% CI: 1.12–3.71), and heavy drinkers (OR: 2.42; 95% CI: 1.17–4.97) compared to nondrinkers. There was an association between the development of sarcopenia and current drinkers (OR: 1.69; 95% CI: 1.12–2.56) but not former drinkers (OR: 1.21; 95% CI: 0.88–1.66). Compared to nondrinkers, an increased risk of developing sarcopenia was observed in participants who consumed alcohol 2 days (OR: 2.36; 95% CI: 1.40–3.99) or > 2 days (OR: 1.84; 95% CI: 1.10–3.07) per week, and those who engaged in binge drinking for ≤1 day per month (OR: 1.68; 95% CI: 1.09–2.60) or > 1 day per month (OR: 2.10; 95% CI: 1.10–4.01). Sensitivity analyses based on different definitions of sarcopenia yielded similar results. Stratified analyses revealed that these associations were present in females but not males.Conclusion: Alcohol intake was associated with an increased risk of sarcopenia in all individuals, with this association being primarily observed in females rather than males.

Muscle quality index (MQI) is a novel indicator reflecting the quality of skeletal muscles. The association between MQI and the development of advanced fibrosis in patients with nonalcoholic fatty liver disease (NAFLD) is unknown. We investigated the association of low MQI with advanced fibrosis among adults with NAFLD using a nationally representative sample of the US population. Adults with NAFLD who participated in the National Health and Nutrition Examination Survey (NHANES) 2011–2014 were included. Sex-specific standard was used to define low and extremely low MQI. Univariate and multivariate logistic regressions were used to assess the association between MQI level and advanced fibrosis. In the study, 3758 participants with NAFLD were included. The prevalence of low and extremely low MQI was 11.7% (95% CI 10.4–13.0%) and 2.2% (95% CI 1.6–2.8%), respectively. Among these participants, 96 were assessed to have advanced fibrosis. Individuals with low [(odds ratio (OR) 2.45, 95% confidence interval (CI) 1.22–4.91)] and extremely low MQI (OR 10.48, 95% CI 3.20–34.27) were associated with advanced fibrosis in multivariable analysis. A linear trend relationship was also observed between MQI level and the risk of advanced fibrosis (P_trend = 0.001). Subgroup and sensitivity analyses yielded similar results to the main analyses. Decreased MQI is highly prevalent, and is associated with an increased risk of advanced fibrosis in adult US population with NAFLD.

Validating the prognostic value of muscle changes in patients with cirrhosis undergoing transjugular intrahepatic portosystemic shunt

Reassessing the impact of post-transjugular intrahepatic portosystemic shunt hepatic encephalopathy on mortality in patients with cirrhosis