Low subcutaneous adiposity associates with higher mortality in female patients with cirrhosis

• Published in: Journal of hepatology 2018-09, Vol.69 (3), p.608-616
• Main Authors: Ebadi, Maryam, Tandon, Puneeta, Moctezuma-Velazquez, Carlos, Ghosh, Sunita, Baracos, Vickie E., Mazurak, Vera C., Montano-Loza, Aldo J.
• Format: Article
• Language: English
• Subjects: Adipose tissue; Body composition; Body mass index; Cirrhosis; Computed tomography; End-stage liver disease; Females; Liver cirrhosis; Liver diseases; Liver transplantation; Mortality; Patients; Skeletal muscle; Survival; Vertebrae
• ISSN: 0168-8278; 1600-0641
• DOI: 10.1016/j.jhep.2018.04.015

[Display omitted] •Sex-related differences in body composition affect the prognosis of cirrhosis.•Low subcutaneous adiposity increases mortality risk in females with cirrhosis.•Skeletal muscle index does not associate with mortality in females with cirrhosis. Two major body compartments, skeletal muscle and adipose tissue, exhibit independent functions. We aimed to explore the prognostic significance of skeletal muscle, visceral and subcutaneous adipose tissue, according to sex, in patients with cirrhosis assessed for liver transplantation (LT). CT images taken at the 3rd lumbar vertebra from 677 patients were quantified for three body composition indexes (cm2/m2), visceral adipose tissue index, subcutaneous adipose tissue index (SATI), and skeletal muscle index (SMI). Cox proportional and competing-risk analysis hazard models were conducted to assess associations between mortality and body composition. The majority of patients were male (67%) with a mean age of 57 ± 7 years, model for end-stage liver disease (MELD) score of 14 ± 8 and mean body mass index of 27 ± 6 kg/m2. Despite similar body mass index between the sexes, male patients had greater SMI (53 ± 12 vs. 45 ± 9 cm2/m2), whereas SATI (67 ± 52 vs. 48 ± 37 cm2/m2) was higher in females (p