Zhoukou Central Hospital Affiliated to Xinxiang Medical University, Zhoukou City, Henan Province, China.
Ward 1, Department of Gastroenterology, Zhoukou Central Hospital, Zhoukou City, Henan Province, China.
PLoS One. 2024 Sep 12;19(9):e0310017. doi: 10.1371/journal.pone.0310017. eCollection 2024.
This study aimed to examine the potential correlation between myosteatosis and the prognosis of patients diagnosed with liver cirrhosis by a meta-analysis.
Cohort studies of relevance were acquired through comprehensive searches of the Medline, Web of Science, and Embase databases. To account for heterogeneity, a random-effects model was employed to combine the findings.
The meta-analysis included 10 retrospective and four prospective cohort studies, encompassing a total of 4287 patients diagnosed with cirrhosis. The pooled findings indicated a notable decline in transplant-free survival (TFS) among individuals with liver cirrhosis and myosteatosis compared to those without this condition (risk ratio: 1.94; 95% confidence interval: 1.61 to 2.34, p < 0.001; I2 = 49%). The predefined subgroup analyses demonstrated consistent findings across various categories, including Asian and non-Asian studies, prospective and retrospective cohort studies, patients with cirrhosis overall and those who underwent transjugular intrahepatic portosystemic shunt, studies with different follow-up durations (< or ≥ 24 months), studies employing univariate and multivariate analyses, and studies with and without an adjustment for sarcopenia (p > 0.05 for all subgroup differences). Additionally, Egger's regression test indicated the presence of significant publication bias (p = 0.044). However, trim-and-fill analysis by including three hypothesized studies showed consistent results.
The presence of myosteatosis in individuals diagnosed with liver cirrhosis may potentially be linked to a poor TFS prognosis. Further investigations are required to ascertain whether enhancing myosteatosis could potentially yield a survival advantage for this particular patient population.
本研究旨在通过荟萃分析探讨肌内脂肪与肝硬化患者预后的潜在相关性。
通过全面检索 Medline、Web of Science 和 Embase 数据库，获取相关队列研究。为了考虑异质性，采用随机效应模型对研究结果进行合并。
荟萃分析纳入了 10 项回顾性队列研究和 4 项前瞻性队列研究，共纳入 4287 例诊断为肝硬化的患者。汇总结果表明，与无肌内脂肪的肝硬化患者相比，有肌内脂肪的肝硬化患者的无移植生存（TFS）显著下降（风险比：1.94；95%置信区间：1.61 至 2.34，p<0.001；I2=49%）。预先设定的亚组分析显示，在不同类别中均得到一致的发现，包括亚洲和非亚洲研究、前瞻性和回顾性队列研究、总体肝硬化患者和接受经颈静脉肝内门体分流术的患者、随访时间不同（<24 个月和≥24 个月）的研究、采用单因素和多因素分析的研究，以及考虑和不考虑肌肉减少症调整的研究（所有亚组差异的 p>0.05）。此外，Egger 回归检验表明存在显著的发表偏倚（p=0.044）。然而，通过包含三个假设研究的修剪和填充分析显示了一致的结果。
肝硬化患者存在肌内脂肪可能与较差的 TFS 预后相关。需要进一步的研究来确定是否增强肌内脂肪可能为这一特定患者群体带来生存优势。
