Risk factors for sarcopenia in cirrhotic patients under evaluation for liver transplantation.

Introduction and Objectives

Liver cirrhosis is the sixth cause of death in Mexico and is also associated with a significant reduction in quality of life. Malnutrition is common in patients in the final stage of the disease and its presence has been associated with worse clinical outcomes.

Objectives

determine the prognostic factors of sarcopenia in cirrhotic patients in a protocol of

liver transplant.

Materials and Patients

Type of study: Retrospective, cross-sectional, analytical, single center. Patients over 18 years of age were included in the evaluation for liver transplantation within the transplant clinic of the Gastroenterology department of the UMAE Centro Médico Nacional Siglo XXI: Study period: January 1, 2022, to June 1, 2023. Statistical analysis It was carried out with dispersion measures for continuous variables and with proportions for categorical variables. Mean and standard deviation or median and interquartile range were used according to the distribution of the variables for normal Student T distribution and for free Mann Whitney U distribution. Dichotomous variables and determining risk were analyzed with the Chi-square test.

Results

63 patients with liver cirrhosis on a liver transplant protocol were included, with a predominance of female sex (74.6%), whose most frequent etiology was steatotic liver disease associated with metabolic dysfunction (MASLD) (27%), mostly Child- Pugh Functional Class. Pugh B (32%). Median MELD 3.0 was 17(14-22); The most frequent decompensations were ascites in 46 (73%), followed by hepatic encephalopathy in 31 (49%) and variceal hemorrhage in 27 patients (42.9%). Mortality in the evaluated group was 14%, and 3 of them had sarcopenia, which represents 33%. A prevalence of sarcopenia was found in 55.6% of the patients evaluated. In the risk analysis, age > 60 years had an OR of 5.46 95% CI (1.6-17.6)

Conclusions

The risk factor for sarcopenia in patients being evaluated for liver transplantation is age >60 years. Other factors that can influence the development of sarcopenia must be established.

Ethical statement: Risk-free research and approved by the ethics committee.

Declaration of interests: None.

Funding: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Table 1.

Characteristics of patients undergoing evaluation for liver transplantation. n= 63.

Age, median	52.2 + 11.7
Gender
Women, No. (%)	47 (74.6)
Men, No. (%)	16 (25.4)
Sarcopenia, No.(%)	35 (55.6)
Etiology
MASLD, No. (%)	17 (27)
BPC, No. (%)	14 (22)
VHC, No. (%)	7 (11.1)
Overlap Syndrome, No. (%)	7 (11.1)
AIH, No. (%)	6 (9.5)
Other etiology, No. %	12 (20)
Child-Pugh-Turcotte
A No. (%)	7 (11.1)
B No. (%)	32 (50.8)
C No. (%)	24 (38)
MELD Na, median, percentile	16 (11 - 20)
MELD 3.0 median, percentile	17 (14 - 22)
Diabetes, No. (%)	16 (25.4)
Systemic arterial hypertension, No. (%)	9 (14.3)
Acute decompensation
Hepatic encephalopathy, No. (%)	31 (49.2)
Spontaneous bacterial peritonitis, No. (%)	5 (7.9)
Ascites, No. (%)	46 (73)
Hemorrhage, No. (%)	27 (42.9)
Thyroid disease, No. (%)	17 (27)
Death, No. (%)	9 (14)
Transplant, No. (%)	4 (6.3)
Body Mass Index, median, percentile	26.17 (23.2 - 29.6)