Wen Zhang, Tuo Shuyue, Ran Qiuju, Yuan Jia, Li Yong, Zhang Ying, Chang Danyan, Li Chan, Dai Shejiao, Wang Jinhai, Tantai Xinxing
Department of Gastroenterology, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.
Clinical Research Center for Gastrointestinal Diseases of Shaanxi Province, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.
Ann Med. 2025 Dec;57(1):2473627. doi: 10.1080/07853890.2025.2473627. Epub 2025 Mar 4.
Some adipose-related parameters exhibit distinct prognostic value in patients with cirrhosis. However, the magnitude and direction of the association between individual adipose parameter and mortality in patients with cirrhosis are unclear.
This study aimed to evaluate the association between individual adipose parameter and mortality in patients with cirrhosis using the meta-analysis method.
The PubMed, Embase, Web of Science, China Biological Medicine, WanFang, and China National Knowledge Infrastructure databases were searched from inception through December 15, 2023, to identify eligible studies. The impact of each adipose parameter on mortality was assessed by the pooled unadjusted or adjusted hazard ratio (HR) with 95% confidence intervals (CIs) using the random effects model.
A total of 33 studies involving 9626 patients were included in our analysis, with 11 adipose parameters evaluated. The pooled prevalence of sarcopenic obesity (SO) and myosteatosis in patients with cirrhosis was 15.5% and 34.4%, respectively. In adjusted analysis, each unit increase in subcutaneous adipose tissue index (SATI) (HR: 0.99, 95% CI: 0.98-1.00) or muscle attenuation (MA) (HR: 0.94, 95% CI: 0.90-0.98) and each unit decrease in visceral-to-subcutaneous adipose tissue ratio (VSR) (HR: 1.92, 95% CI: 1.45-2.54) showed an independent association with a decreased risk of mortality. However, concurrent myosteatosis (HR: 1.88, 95% CI: 1.48-2.40) or SO (HR: 2.77, 95% CI: 1.95-3.93) significantly increased the risk of mortality in patients with cirrhosis.
Decreased SATI or MA, increased VSR, and concurrent myosteatosis or SO were independently associated with a higher risk of mortality in patients with cirrhosis.
一些与脂肪相关的参数在肝硬化患者中具有明显的预后价值。然而，个体脂肪参数与肝硬化患者死亡率之间关联的程度和方向尚不清楚。
本研究旨在采用荟萃分析方法评估个体脂肪参数与肝硬化患者死亡率之间的关联。
检索了PubMed、Embase、Web of Science、中国生物医学数据库、万方数据库和中国知网数据库，检索时间从建库至2023年12月15日，以确定符合条件的研究。使用随机效应模型，通过合并未调整或调整后的风险比（HR）及95%置信区间（CI）评估每个脂肪参数对死亡率的影响。
我们的分析共纳入33项研究，涉及9626例患者，评估了11个脂肪参数。肝硬化患者中肌肉减少性肥胖（SO）和肌脂肪变性的合并患病率分别为15.5%和34.4%。在调整分析中，皮下脂肪组织指数（SATI）每增加一个单位（HR：0.99，95%CI：0.98 - 1.00）或肌肉衰减（MA）每增加一个单位（HR：0.94，95%CI：0.90 - 0.98）以及内脏与皮下脂肪组织比值（VSR）每降低一个单位（HR：1.92，95%CI：1.45 - 2.54）均显示与死亡率降低风险独立相关。然而，并发肌脂肪变性（HR：1.88，95%CI：1.48 - 2.40）或SO（HR：2.77，95%CI：1.95 - 3.93）会显著增加肝硬化患者的死亡风险。
SATI或MA降低、VSR升高以及并发肌脂肪变性或SO与肝硬化患者更高的死亡风险独立相关。
