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. 2024 Jun 13;14(1):13609.
doi: 10.1038/s41598-024-64420-x.

Association of myosteatosis with short-term outcomes in patients with acute-on-chronic liver failure

Nan Geng #  1 , Ming Kong #  2   3 , Jiateng Zhang #  2   3 , Huina Chen  4   5 , Manman Xu  2   3 , Wenyan Song  6 , Yu Chen  7   8 , Zhongping Duan  9   10
Affiliations

Association of myosteatosis with short-term outcomes in patients with acute-on-chronic liver failure

Nan Geng et al. Sci Rep. .

Abstract

Sarcopenia (low muscle mass, i.e., quantity) is associated with poor clinical outcomes in patients with acute-on-chronic liver failure (ACLF). In this study, we aimed to illustrate the clinical prognostic value of myosteatosis (muscle fat infiltration) for short-term mortality in patients with ACLF. We retrospectively enrolled consecutive patients with ACLF between January 2019 and January 2022. Computed tomography-based body composition analysis was performed at the third lumbar vertebral level to determine skeletal muscle radiation attenuation. Fine and Gray's competing risk regression model, with liver transplantation as a competing risk, was used to assess the factors associated with 90-day mortality. A total of 431 patients with ACLF were included. Myosteatosis and sarcopenia were observed in 261 (60.6%) and 87 (20.2%) patients, respectively. Competitive risk regression showed that age (HR 1.021, 95% CI 1.000-1.043, P = 0.042), APASL ACLF Research Consortium (AARC) score (HR 1.498, 95% CI 1.312-1.710, P < 0.001), and sarcopenia (HR 1.802, 95% CI 1.062-3.060, P = 0.029) were independently associated with increased 90-day mortality. Subgroup analysis of male patients with HBV-ACLF revealed that myosteatosis (HR 2.119, 95% CI 1.101-4.078, P = 0.025) was promising prognostic factors for 90-day mortality after being adjusted for ascites, acute kidney injury, AARC score, and sarcopenia. Myosteatosis is predictive of short-term outcomes in male patients with HBV-ACLF. Our results emphasise the importance of focusing on muscle fat infiltration in patients with HBV-ACLF. Further studies are warranted to investigate the underlying mechanisms and potential therapies for myosteatosis.

Keywords: APASL ACLF Research Consortium; Acute on chronic liver failure; Muscle quality; Sarcopenia; Skeletal muscle radiation attenuation.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Flow diagram for enrolment in the study.
Figure 2
Figure 2
The 90-day cumulative mortality in the groups with and without myosteatosis (A), and the groups with co-existing sarcopenia and myosteatosis in male patients with HBV-ACLF (B).
See this image and copyright information in PMC

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