Low adipose tissue index as an indicator of hepatic encephalopathy in cirrhotic patients following transjugular intrahepatic portosystemic shunt

Wang, Chuhan; Teng, Yue; Gao, Jin; Zhang, Zichen; Li, Yonggang

doi:10.1007/s00261-023-03813-4

Cited by 4 publications

(5 citation statements)

References 41 publications

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“…The possible key role of adipose tissue on the pathogenesis of hepatic encephalopathy is further suggested by the results of the study conducted by Wang who showed that females with low SATI (<70.05 cm 2 /m 2 ) (OR 10.55; 95% CI 2.36-46.23; p = 0.002) and male patients with low VATI (<53.52 cm 2 /m 2 ) (OR 6.44; 95% CI 1.72-23.59; p = 0.006) had a higher risk of post-TIPS HE. In fact, SATI and VATI were confirmed to be predictors of hepatic encephalopathy after TIPS in a multivariate analysis [52].…”

Section: Effect Of Tips On Adipose Tissuementioning

confidence: 84%

Transjugular Intrahepatic Portosystemic Shunt Placement: Effects on Nutritional Status in Cirrhotic Patients

de Felice,

Ridola,

Riggio

et al. 2023

JCM

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Malnutrition is a tangible complication of cirrhosis with portal hypertension with a prevalence of up to 50%. In particular, sarcopenia and myosteatosis, defined as the alteration in muscle quantity and quality, have a negative impact on the main complications of liver disease and are associated with higher mortality in patients with cirrhosis. Recently, alterations in adipose tissue have also been described in cirrhotic patients and they seem to influence the course of liver disease. Several pieces of evidence indicate that a transjugular intrahepatic portosystemic shunt (TIPS), placed for the treatment of refractory portal hypertension, can lead to a modification of body composition consisting in the improvement of the skeletal muscle index, myosteatosis, and an increase in subcutaneous fat. These modifications of the nutritional status, even more pronounced in sarcopenic patients before TIPS, have been associated with an amelioration of cognitive impairment after TIPS as well as with an increase in the survival rate. The aim of this paper is to provide an overview of the effects of TIPS placement on nutritional status in cirrhosis focusing on its pathophysiological mechanisms and its relationship with liver-related outcomes.

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Section: Effect Of Tips On Adipose Tissuementioning

confidence: 84%

Transjugular Intrahepatic Portosystemic Shunt Placement: Effects on Nutritional Status in Cirrhotic Patients

de Felice,

Ridola,

Riggio

et al. 2023

JCM

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“…Accurate prediction and assessment of patient outcomes after TIPS, particularly in terms of early mortality and liver function, as well as identification of individuals at increased risk of HE, can lead to timely and targeted interventions. These can significantly improve patient outcomes and mitigate the broader social and economic impact [13] , [42] . This review aims to summarize the use and limitations of HE assessment tools currently used in clinical practice, with a particular focus on the nuances of HE after TIPS and the special considerations required for its assessment.…”

Section: Background Of the Studymentioning

confidence: 99%

“… Absence of multiple measures to establish causality. Wang et al 2023 [42] Single-institution retrospective study 191 patients Quantification of body composition by CT in cirrhotic patients using multivariate LR and nomogram analysis Evaluation of the predictive value of CT-measured body composition for post-TIPS HE in cirrhotic patients. Visceral fat area index (VFAI) in male patients and subcutaneous fat area index (SFAI) in female patients were significant predictors of HE after TIPS procedures.…”

Section: Advances In the Application Of Ai To The Evaluation Of Hementioning

confidence: 99%

“…The results suggest that body composition can be used not only for non-invasive nutritional assessment, but also for predicting the risk of HE in cirrhotic patients after TIPS. The study showed that body composition metrics can be used non-invasively, which goes beyond nutritional assessment and can also serve as predictive indicators for the risk of HE in individuals with cirrhosis after TIPS [42] . Ince et al used patient clinical profiles coupled with laboratory and imaging data to develop three ML models based on support vector machines (SVM), LR and CatBoost algorithms.…”

Section: Advances In the Application Of Ai To The Evaluation Of Hementioning

confidence: 99%

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Hepatic encephalopathy post-TIPS: Current status and prospects in predictive assessment

Xu,

Yang,

Tan

et al. 2024

Computational and Structural Biotechnology Journal

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“…In other studies, adiposity is used as a marker of nutritional status. Here, male patients with a low volume of visceral fat and female patients with a low volume of subcutaneous fat pre-TIPS had a higher risk of post-TIPS HE, and patients that increased their body fat fraction after TIPS had a lower risk of developing post-TIPS HE [ 75 , 78 ].…”

Section: Risk Factorsmentioning

confidence: 99%

Post-Transjugular Intrahepatic Portosystemic Shunt (TIPS) Hepatic Encephalopathy—A Review of the Past Decade’s Literature Focusing on Incidence, Risk Factors, and Prophylaxis

Friis,

Thomsen,

Laleman

et al. 2023

JCM

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Transjugular intrahepatic portosystemic shunt (TIPS) is an established treatment for portal hypertension and its’ complications in liver cirrhosis, yet the development of hepatic encephalopathy (HE) remains a significant concern. This review covers the reported incidence, risk factors, and management strategies for post-TIPS HE over the past decade. Incidence varies widely (7–61%), with factors like age, liver function, hyponatremia, and spontaneous portosystemic shunts influencing risk. Procedural aspects, including TIPS timing, indication, and stent characteristics, also contribute. Pharmacological prophylaxis with lactulose and rifaximin shows promise, but current evidence is inconclusive. Procedural preventive measures, such as shunt embolization and monitoring portal pressure gradients, are explored. Treatment involves pharmacological options like lactulose and rifaximin, and procedural interventions like stent diameter reduction. Ongoing studies on novel predictive markers and emerging treatments, such as faecal microbiota transplant, reflect the evolving landscape in post-TIPS HE management. This concise review provides clinicians with insights into the multifaceted nature of post-TIPS HE, aiding in improved risk assessment, prophylaxis, and management for patients undergoing TIPS procedures.

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Low adipose tissue index as an indicator of hepatic encephalopathy in cirrhotic patients following transjugular intrahepatic portosystemic shunt

Cited by 4 publications

References 41 publications

Transjugular Intrahepatic Portosystemic Shunt Placement: Effects on Nutritional Status in Cirrhotic Patients

Transjugular Intrahepatic Portosystemic Shunt Placement: Effects on Nutritional Status in Cirrhotic Patients

Hepatic encephalopathy post-TIPS: Current status and prospects in predictive assessment

Post-Transjugular Intrahepatic Portosystemic Shunt (TIPS) Hepatic Encephalopathy—A Review of the Past Decade’s Literature Focusing on Incidence, Risk Factors, and Prophylaxis

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