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Meta-Analysis
. 2017 Oct 24;12(10):e0186990.
doi: 10.1371/journal.pone.0186990. eCollection 2017.

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

Gaeun Kim  1 , Seong Hee Kang  2 , Moon Young Kim  2   3   4 , Soon Koo Baik  2   3   4
Affiliations
Meta-Analysis

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

Gaeun Kim et al. PLoS One. .

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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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. The flow diagram of study selection for the systematic review and meta-analysis.
Fig 2
Fig 2. Forest plot for the mortality in accordance to muscle mass.
Fig 3
Fig 3. Forest plot for the mortality for the sarcopenia group.
(A) The odds ratio (OR) of mortality for the sarcopenia group (B) The hazard ratio (HR) of mortality for the sarcopenia group.
Fig 4
Fig 4. Forest plot for the complications occurrence.
(A) The HR of complications occurrence such as severe infection (B) The HR of complications occurrence such as sepsis or severe infection to sarcopenia.
See this image and copyright information in PMC

References

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