Effect of Body Mass Index on the Prognosis of Liver Cirrhosis

Yin, Yue; Li, Yiling; Shao, Lichun; Yuan, Shanshan; Liu, Bang; Lin, Su; Yang, Yida; Tang, Shanhong; Meng, Fanping; Wu, Yue; Chen, Yu; Li, Bimin; Zhu, Qiang; Qi, Xingshun

doi:10.3389/fnut.2021.700132

Cited by 18 publications

(11 citation statements)

References 50 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A high BMI is a significant risk factor for LBP in patients with liver cirrhosis. Obesity is a common public health problem [ 46 ] and a significant risk factor for LBP [ 47 ]. Obesity is considered a risk factor for liver disease [ 48 ].…”

Section: Discussionmentioning

confidence: 99%

Low back pain in patients hospitalised with liver cirrhosis- a retrospective study

Bednár

Líška

Gurín

et al. 2023

BMC Musculoskelet Disord

View full text Add to dashboard Cite

Background Lower back pain is a common issue, but little is known about the prevalence of pain in patients with liver cirrhosis during hospitalisation. Therefore, the objective of this study was to determine lower back pain in patients with liver cirrhosis. Methods The sample consisted of patients with liver cirrhosis (n = 79; men n = 55; women n = 24; mean age = 55.79 ± 12.52 years). The hospitalised patients were mobile. The presence and intensity of pain were assessed in the lumbar spine during hospitalisation. The presence of pain was assessed using the visual analogue pain scale (0–10). The range of motion of the lower spine was assessed using the Schober and Stibor tests. Frailty was measured by Liver Frailty Index (LFI). The condition of liver disease was evaluated using The Model For the End-Stage Liver Disease (MELD) and Child–Pugh score (CPS) and ascites classification. Student’s t test and Mann–Whitney test were used for analysis of the difference of group. Analysis of variance (ANOVA) with the Tukey post hoc test was used to test differences between categories of liver frailty index. The Kruskal–Wallis test was used to test pain distribution. Statistical significance was determined at the α-0.05 significance level. Result The prevalence of pain in patients with liver cirrhosis was 13.92% (n = 11), and the mean intensity of pain according to the visual analogue scale was 3.73 (± 1.90). Lower back pain was present in patients with ascites (15.91%; n = 7) and without ascites (11.43%; n = 4). The prevalence of lower back pain was not statistically significant between patients with and without ascites (p = 0,426). The base of Schober’s assessment mean score was 3.74 cm (± 1.81), and based on Stibor’s assessment mean score was 5.84 cm (± 2.23). Conclusion Lower back pain in patients with liver cirrhosis is a problem that requires attention. Restricted spinal mobility has been reported in patients with back pain, according to Stibor, compared to patients without pain. There was no difference in the incidence of pain in patients with and without ascites.

show abstract

Section: Discussionmentioning

confidence: 99%

Low back pain in patients hospitalised with liver cirrhosis- a retrospective study

Bednár

Líška

Gurín

et al. 2023

BMC Musculoskelet Disord

View full text Add to dashboard Cite

show abstract

“…Existing evidence on the impact of BMI reduction on the outcomes in patients with CLD is controversial 32,33 . BMI is convenient and widely accepted, yet it is unable to comprehensively measure body composition as it poorly indicates the actual percentage or distribution of muscle and adipose tissue 34,35 .…”

Section: Discussionmentioning

confidence: 99%

Imaging-Based Diagnosis of Sarcopenia for Transplant-Free Survival in Primary Sclerosing Cholangitis

Keshoofi,

Schindler,

Rennebaum

et al. 2023

Preprint

View full text Add to dashboard Cite

Background Imaging-based assessment of sarcopenia is a well-validated prognostic tool for patients with chronic liver disease. However, little is known about its value in patients with primary sclerosing cholangitis (PSC). This cross-sectional study aimed to investigate the predictive value of the cross-sectional imaging-based skeletal muscle index (SMI) for transplant-free survival (TFS) in patients with PSC. Methods A total of 95 patients with PSC who underwent abdominal cross-sectional imaging between 2008 and 2022 were included in this retrospective study. SMI was measured at the third lumbar vertebra level (L3-SMI). The cut-off values to define sarcopenia were < 50 cm²/m² in male patients and < 39 cm²/m² in female patients. The primary outcome of this study was TFS, which was defined as survival without liver transplantation or death from any cause. Results Our study indicates that L3-SMI sarcopenia impairs TFS in patients with PSC (5-year TFS: 33.9% vs. 83.3%, p = 0.001, log-rank test). L3-SMI sarcopenia was independently associated with reduced TFS via multivariate Cox regression analysis (HR = 2.749; p = 0.028). Body mass index reduction > 10% at 12 months, which is used as MELD standard exception (SE) criterion in Eurotransplant (in Germany only until September 2023), was not significantly associated with TFS in the multivariate Cox regression analysis (HR = 1.417; p = 0.330). Substitution of BMI reduction with L3-SMI in the German SE criteria improved the predictive accuracy of TFS compared to the established SE criteria (multivariable Cox regression analysis: HR = 4.007, p < 0.001 vs. HR = 1.691, p = 0.141). Conclusion Imaging-based diagnosis of sarcopenia via L3-SMI is associated with a low TFS in patients with PSC and may provide additional benefits as a prognostic factor in patient selection for liver transplantation.

show abstract

“…We retrospectively reviewed the medical records from our prospectively established database, 36 37 in which a total of 558 patients with a diagnosis of liver cirrhosis and without a definite diagnosis of malignancy were consecutively admitted to the Department of Gastroenterology and underwent contrast-enhanced abdominal CT/MRI scans between December 2014 and September 2021. Exclusion criteria were as follows: (1) contrast-enhanced CT or MRI images were not well-preserved; (2) patients had history of splenectomy, splenic arterial embolization, or transjugular intrahepatic portosystemic shunt (TIPS); (3) patients presented with acute or progressive abdominal pain related to the development of mesenteric vein thrombosis during hospitalization; and (4) patients received anticoagulant therapy, thrombolytic therapy, or TIPS for any indication during hospitalization or follow-up.…”

Section: Methodsmentioning

confidence: 99%

Impact of Asymptomatic Superior Mesenteric Vein Thrombosis on the Outcomes of Patients with Liver Cirrhosis

et al. 2022

Self Cite

View full text Add to dashboard Cite

Background The impact of asymptomatic superior mesenteric vein (SMV) thrombosis on the outcomes of cirrhotic patients remains uncertain. Methods Nonmalignant cirrhotic patients who were consecutively admitted between December 2014 and September 2021 and underwent contrast-enhanced computed tomography/magnetic resonance imaging scans were screened. Portal venous system thrombosis (PVST) was identified. Death and hepatic decompensation were the outcomes of interest. Nelson–Aalen cumulative risk curve analysis and competing risk regression analysis were performed to evaluate the impact of asymptomatic SMV thrombosis and portal vein thrombosis (PVT) on the outcomes. Results Overall, 475 patients were included, of whom 67 (14.1%) had asymptomatic SMV thrombosis, 95 (20%) had PVT, and 344 (72.4%) did not have any PVST. Nelson–Aalen cumulative risk curve analyses showed that the cumulative incidences of death (p = 0.653) and hepatic decompensation (p = 0.630) were not significantly different between patients with asymptomatic SMV thrombosis and those without PVST, but the cumulative incidences of death (p = 0.021) and hepatic decompensation (p = 0.004) were significantly higher in patients with PVT than those without PVST. Competing risk regression analyses demonstrated that asymptomatic SMV thrombosis was not a significant risk factor for death (subdistribution hazard ratio [sHR] = 0.89, p = 0.65) or hepatic decompensation (sHR = 1.09, p = 0.63), but PVT was a significant risk factor for death (sHR = 1.56, p = 0.02) and hepatic decompensation (sHR = 1.50, p = 0.006). These statistical results remained in competing risk regression analyses after adjusting for age, sex, and Child–Pugh score. Conclusions Asymptomatic SMV thrombosis may not influence the outcomes of cirrhotic patients. The timing of intervention for asymptomatic SMV thrombosis in liver cirrhosis should be further explored.

show abstract

Effect of Body Mass Index on the Prognosis of Liver Cirrhosis

Cited by 18 publications

References 50 publications

Low back pain in patients hospitalised with liver cirrhosis- a retrospective study

Low back pain in patients hospitalised with liver cirrhosis- a retrospective study

Imaging-Based Diagnosis of Sarcopenia for Transplant-Free Survival in Primary Sclerosing Cholangitis

Impact of Asymptomatic Superior Mesenteric Vein Thrombosis on the Outcomes of Patients with Liver Cirrhosis

Contact Info

Product

Resources

About