Body fat composition determines outcomes before and after liver transplantation in patients with cirrhosis
Abstract Cachexia occurs in late stages of liver cirrhosis, and a low‐fat mass is potentially associated with poor outcome. This study compared different computed tomography (CT)–derived fat parameters with respect to its prognostic impact on the development of complications and death before and aft...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Health/LWW
2022-08-01
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| Series: | Hepatology Communications |
| Online Access: | https://doi.org/10.1002/hep4.1946 |
| _version_ | 1828044538989510656 |
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| author | Cornelius Engelmann Niklas F. Aehling Stefan Schob Ines Nonnenmacher Luise Handmann Jane Macnaughtan Adam Herber Alexey Surov Thorsten Kaiser Timm Denecke Rajiv Jalan Daniel Seehofer Michael Moche Thomas Berg |
| author_facet | Cornelius Engelmann Niklas F. Aehling Stefan Schob Ines Nonnenmacher Luise Handmann Jane Macnaughtan Adam Herber Alexey Surov Thorsten Kaiser Timm Denecke Rajiv Jalan Daniel Seehofer Michael Moche Thomas Berg |
| author_sort | Cornelius Engelmann |
| collection | DOAJ |
| description | Abstract Cachexia occurs in late stages of liver cirrhosis, and a low‐fat mass is potentially associated with poor outcome. This study compared different computed tomography (CT)–derived fat parameters with respect to its prognostic impact on the development of complications and death before and after liver transplantation. Between 2001 and 2014, 612 patients with liver cirrhosis without hepatocellular carcinoma listed for liver transplantation met the inclusion criteria, including abdominal CT scan (±200 days to listing). A total of 109 patients without cirrhosis served as controls. The subcutaneous fat index (SCFI), the paraspinal muscle fat index, and the visceral fat index were assessed at L3/L4 level and normalized to the height (cm2/m2). Data were collected and analyzed retrospectively. Low SCFI was associated with a higher rate of ascites and increased C‐reactive protein levels (p < 0.001). In addition, multivariate Cox regression analysis adjusting for sex, age, body mass index (BMI), and Model for End‐Stage Liver Disease showed that decreasing SCFI was also associated with an increased risk of cirrhosis‐related complications (p = 0.003) and death on the transplant wait list (p = 0.013). Increased paraspinal and visceral fat were not only positively correlated with creatinine levels (p < 0.001), BMI, and metabolic comorbidities (all p < 0.001) before transplantation, but also predictive for 1‐year mortality after transplantation. Conclusion: The distribution of body fat is a major determinant for complications and outcome in cirrhosis before and after liver transplantation. |
| first_indexed | 2024-04-10T17:57:47Z |
| format | Article |
| id | doaj.art-dfc0f48b1d484bf482596c9d72133b40 |
| institution | Directory Open Access Journal |
| issn | 2471-254X |
| language | English |
| last_indexed | 2024-04-10T17:57:47Z |
| publishDate | 2022-08-01 |
| publisher | Wolters Kluwer Health/LWW |
| record_format | Article |
| series | Hepatology Communications |
| spelling | doaj.art-dfc0f48b1d484bf482596c9d72133b402023-02-02T17:26:08ZengWolters Kluwer Health/LWWHepatology Communications2471-254X2022-08-01682198220910.1002/hep4.1946Body fat composition determines outcomes before and after liver transplantation in patients with cirrhosisCornelius Engelmann0Niklas F. Aehling1Stefan Schob2Ines Nonnenmacher3Luise Handmann4Jane Macnaughtan5Adam Herber6Alexey Surov7Thorsten Kaiser8Timm Denecke9Rajiv Jalan10Daniel Seehofer11Michael Moche12Thomas Berg13Division of Hepatology Department of Medicine II Leipzig University Medical Center Leipzig GermanyDivision of Hepatology Department of Medicine II Leipzig University Medical Center Leipzig GermanyDepartment for Neuroradiology University Hospital Leipzig Leipzig GermanyDivision of Hepatology Department of Medicine II Leipzig University Medical Center Leipzig GermanyDivision of Hepatology Department of Medicine II Leipzig University Medical Center Leipzig GermanyLiver Failure Group Institute for Liver and Digestive Health University College London Royal Free Campus London UKDivision of Hepatology Department of Medicine II Leipzig University Medical Center Leipzig GermanyDepartment of Diagnostic and Interventional Radiology University Hospital Leipzig Leipzig GermanyInstitute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics University Hospital Leipzig Leipzig GermanyDepartment of Diagnostic and Interventional Radiology University Hospital Leipzig Leipzig GermanyLiver Failure Group Institute for Liver and Digestive Health University College London Royal Free Campus London UKDepartment of Visceral Vascular Thoracic and Transplant Surgery University Hospital Leipzig Leipzig GermanyDepartment of Diagnostic and Interventional Radiology University Hospital Leipzig Leipzig GermanyDivision of Hepatology Department of Medicine II Leipzig University Medical Center Leipzig GermanyAbstract Cachexia occurs in late stages of liver cirrhosis, and a low‐fat mass is potentially associated with poor outcome. This study compared different computed tomography (CT)–derived fat parameters with respect to its prognostic impact on the development of complications and death before and after liver transplantation. Between 2001 and 2014, 612 patients with liver cirrhosis without hepatocellular carcinoma listed for liver transplantation met the inclusion criteria, including abdominal CT scan (±200 days to listing). A total of 109 patients without cirrhosis served as controls. The subcutaneous fat index (SCFI), the paraspinal muscle fat index, and the visceral fat index were assessed at L3/L4 level and normalized to the height (cm2/m2). Data were collected and analyzed retrospectively. Low SCFI was associated with a higher rate of ascites and increased C‐reactive protein levels (p < 0.001). In addition, multivariate Cox regression analysis adjusting for sex, age, body mass index (BMI), and Model for End‐Stage Liver Disease showed that decreasing SCFI was also associated with an increased risk of cirrhosis‐related complications (p = 0.003) and death on the transplant wait list (p = 0.013). Increased paraspinal and visceral fat were not only positively correlated with creatinine levels (p < 0.001), BMI, and metabolic comorbidities (all p < 0.001) before transplantation, but also predictive for 1‐year mortality after transplantation. Conclusion: The distribution of body fat is a major determinant for complications and outcome in cirrhosis before and after liver transplantation.https://doi.org/10.1002/hep4.1946 |
| spellingShingle | Cornelius Engelmann Niklas F. Aehling Stefan Schob Ines Nonnenmacher Luise Handmann Jane Macnaughtan Adam Herber Alexey Surov Thorsten Kaiser Timm Denecke Rajiv Jalan Daniel Seehofer Michael Moche Thomas Berg Body fat composition determines outcomes before and after liver transplantation in patients with cirrhosis Hepatology Communications |
| title | Body fat composition determines outcomes before and after liver transplantation in patients with cirrhosis |
| title_full | Body fat composition determines outcomes before and after liver transplantation in patients with cirrhosis |
| title_fullStr | Body fat composition determines outcomes before and after liver transplantation in patients with cirrhosis |
| title_full_unstemmed | Body fat composition determines outcomes before and after liver transplantation in patients with cirrhosis |
| title_short | Body fat composition determines outcomes before and after liver transplantation in patients with cirrhosis |
| title_sort | body fat composition determines outcomes before and after liver transplantation in patients with cirrhosis |
| url | https://doi.org/10.1002/hep4.1946 |
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