Visceral Adiposity Associates With Malnutrition Risk Determined by Royal Free Hospital-Nutritional Prioritizing Tool in Cirrhosis

Abstract

Mounting evidence has suggested the clinical significance of body composition abnormalities in the context of cirrhosis. Herein, we aimed to investigate the association between visceral adiposity and malnutrition risk in 176 hospitalized patients with cirrhosis. The adiposity parameters were obtained by computed tomography (CT) as follows: total adipose tissue index (TATI), visceral adipose tissue index (VATI), subcutaneous adipose tissue index (SATI), and visceral to subcutaneous adipose tissue area ratio (VSR). Malnutrition risk was screened using Royal Free Hospital-Nutritional Prioritizing Tool (RFH-NPT). Visceral adiposity was determined given a higher VSR based on our previously established cutoffs. Multivariate analysis implicated that male gender (OR = 2.884, 95% CI: 1.360–6.115, p = 0.006), BMI (OR = 0.879, 95% CI: 0.812–0.951, P = 0.001), albumin (OR = 0.934, 95% CI: 0.882–0.989, P = 0.019), and visceral adiposity (OR = 3.413, 95% CI: 1.344–8.670, P = 0.010) were independent risk factors of malnutrition risk. No significant difference was observed regarding TATI, SATI, and VATI among patients with low or moderate and high risk of malnutrition. In contrast, the proportion of male patients embracing visceral adiposity was higher in high malnutrition risk group compared with that in low or moderate group (47.27 vs. 17.86%, p = 0.009). Moreover, this disparity was of borderline statistical significance in women (19.05 vs. 5.88%, p = 0.061). Assessing adipose tissue distribution might potentiate the estimation of malnutrition risk in cirrhotics. It is pivotal to recognize visceral adiposity and develop targeted therapeutic strategies.

Comparison of the GLIM criteria with specific screening tool for diagnosing malnutrition in hospitalized patients with cirrhosis: A descriptive cross‐sectional study

“…Notably, we suppose two issues—that is, etiology of cirrhosis and fluid accumulation—partly account for this ambiguity and discordance. Keeping this in mind, RFH‐NPT is emerging as a metric aimed at screening malnutrition risk, whose validity and reliability has been reported across several investigations and associated with a wide array of adverse events 30–32 . In this sample, RFH‐NPT identified 70.8% of participants as being at moderate‐high risk, and as a consequence, approximately one‐third of the population was confirmed as having GLIM criteria–defined malnutrition.…”

Relationship between lipid profiles and reduced handgrip strength (dynapenia) in hospitalized patients with cirrhosis

“…Mounting evidence has proved the clinical relevance of cross-sectional imaging-based body composition abnormalities including skeletal muscle and adipose tissue in cirrhosis [17–20]. Unlike the geriatric literature, computed tomography represents the gold standard for the evaluation of muscle mass in the context of cirrhosis.…”

“…This novel finding may confer clinical implications because the measurement of serum lipid profiles is regular, simple, and easy to perform which would facilitate the routine use of TC in every healthcare or hospital setting. Mounting evidence has proved the clinical relevance of cross-sectional imaging-based body composition abnormalities including skeletal muscle and adipose tissue in cirrhosis [17][18][19][20]. Unlike the geriatric literature, computed tomography represents the gold standard for the evaluation of muscle mass in the context of cirrhosis.…”

Handgrip strength is a substitutive metric to the GLIM criteria–defined malnutrition and predicts long‐term mortality among hospitalized patients with cirrhosis

“…A detailed depiction of CT-based quantification of muscle mass can be found in our previous report. 15 The participants underwent abdominal CT scans for a spectrum of indications such as disease progression monitor, disease severity stratification, and malignant transformation surveillance. All CT images were obtained using a 64-row spectral CT scanner (Discovery 750 HD; General Electric Company).…”