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Sarcopenic obesity and myosteratosis are associated with higher mortality in patients with cirrhosis Open Access


Author or creator
Montano-Loza, A. J.
Angulo, P. Meza-Junco, J.
Prado, C. M.
Sawyer, M. B.
Beaumont, C.
Esfandiari, N.
Ma, M.
Baracos, V. E.
Additional contributors
Muscle Depletion
Lumbar Skeletal Muscle Index
Muscle Attenuation Index
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Journal Article (Published)
Background and aimsObesity is frequently associated with cirrhosis, and cirrhotic patients may develop simultaneous lossof skeletal muscle and gain of adipose tissue, culminating in the condition of sarcopenic obesity. Additionally, muscle depletionis characterized by both a reduction in muscle size and increased proportion of muscular fat, termed myosteatosis. In thisstudy, we aimed to establish the frequency and clinical significance of sarcopenia, sarcopenic obesity and myosteatosis in cir-rhotic patients.MethodsWe analysed 678 patients with cirrhosis. Sarcopenia, sarcopenic obesity and myosteatosis were analysed by CTscan using the third lumbar vertebrae skeletal muscle and attenuation indexes, using previously validated gender-and bodymass index-specific cutoffs.ResultsPatients were predominately men (n= 457, 67%), and cirrhosis aetiology was hepatitis C virus in 269 patients (40%),alcohol in 153 (23%), non-alcoholic steatohepatitis/cryptogenic in 96 (14%), autoimmune liver disease in 55 (8%), hepatitis Bvirus in 43 (6%), and others in 5 patients (1%). Sarcopenia was present in 292 (43%), 135 had sarcopenic obesity (20%) and 353had myosteatosis (52%). Patients with sarcopenia (22 ± 3 vs. 95 ± 22 months,P<0.001), sarcopenic obesity (22 ± 3 vs. 95± 22 months,P<0.001), and myosteatosis (28 ± 5 vs. 95 ± 22 months,P<0.001) had worse median survival than patients with-out muscular abnormalities. By multivariate Cox regression analysis, both sarcopenia [hazard ratio (HR) 2.00, 95% confidenceinterval (CI) 1.44–2.77,P<0.001], and myosteatosis (HR 1.42, 95% CI 1.02–1.07,P= 0.04) were associated with mortality.ConclusionsSarcopenia, sarcopenic obesity and myosteatosis are often present in patients with cirrhosis, and sarcopeniaand myosteatosis are independently associated with a higher long-term mortality in cirrhosis
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Montano-Loza, A. J., Angulo, P. Meza-Junco, J., Prado, C. M., Sawyer, M. B., Beaumont, C., Esfandiari, N., Ma, M., & Baracos, V. E. (2016). Sarcopenic obesity and myosteratosis are associated with higher mortality in patients with cirrhosis. Journal of Cachexia, Sarcopenia and Muscle, 7(2), 126-135.


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File title: Sarcopenic obesity and myosteatosis are associated with higher mortality in patients with cirrhosis
File author: Aldo J. Montano-Loza, Paul Angulo, Judith Meza-Junco, Carla M. M. Prado, Michael B. Sawyer, Crystal Beaumont, Nina Esfandiari, Mang Ma, Vickie E. Baracos
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