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Ren W, Zheng J, Yang S, Zhong J, Liu X, Liu X, Feng J, Wei T, Yang Y, Tie C, Hong C, Feng B, Huang R. The relationship between imaging-based body composition abnormalities and long-term mortality in patients with liver cirrhosis. Eur J Radiol 2024; 180:111707. [PMID: 39197272 DOI: 10.1016/j.ejrad.2024.111707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 08/23/2024] [Indexed: 09/01/2024]
Abstract
BACKGROUND Emerging evidence on cirrhosis suggests a close correlation between abnormality in body composition characteristics and poor prognosis. This study aimed to evaluate the impact of dynamic changes in body composition on the prognostic outcomes in patients with cirrhosis. METHODS This retrospective analysis included 158 patients diagnosed as cirrhosis from January 2018 to August 2023. Skeletal muscle mass, muscle quality, visceral and subcutaneous adiposity were evaluated using computed tomography (CT) imaging at the third lumbar vertebra level. Competing risk model was performed four different body composition status (i.e., normal, only sarcopenia, only myosteatosis, and combined status) for liver-related mortality. We also explored the relationship between the dynamic change in body composition and long-term prognosis by applying Gray's test. RESULTS Of the 158 cirrhotic patients (mean [SD] age, 57.1 [12.6] years), sarcopenia was present in 85 (60.1 %) patients, while 22 (13.9 %) patients had sarcopenic obesity and 68 (43.0 %) had myosteatosis. Patients solely diagnosed with sarcopenia exhibited a higher mortality rate compared to those with normal body composition (Gray's test, P=0.006), while patients solely diagnosed with myosteatosis or with a combination of sarcopenia and myosteatosis did not reach statistical significance (Gray's test, P=0.076; P=0.140). Multivariable analysis also revealed that VSR (HR=1.10 [1.01∼1.20]; P=0.028), sarcopenia (HR=2.73 [1.20∼6.22], P=0.017) and myosteatosis (HR=2.39 [1.10∼5.18], P=0.028) were significant independent predictors of liver-related deaths. Otherwise, patients exhibiting aggravating body composition during follow-up period were associated with a significantly higher mortality risk compared to those with normal or remission body composition status (HR=7.63 [1.12∼51.14]; P=0.036). CONCLUSION Progressive alterations in body composition status appears to be associated with liver-related mortality in individuals with liver cirrhosis. Focusing on the management of skeletal muscle, along with visceral and subcutaneous adiposity, may contribute to improving the prognosis of cirrhotic patients.
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Affiliation(s)
- Wenhui Ren
- Department of Clinical Epidemiology, Peking University People's Hospital, No.11 Xizhimen South Street, Beijing 100044, China
| | - Jiarui Zheng
- Peking University Hepatology Institute, Peking University People's Hospital, No.11 Xizhimen South Street, Beijing, 100044, China
| | - Shuo Yang
- Department of Radiology, Peking University People's Hospital, No.11 Xizhimen South Street, Beijing 100044, China
| | - Juan Zhong
- School of Information, Renmin University of China, No. 59 Zhongguancun Avenue, Beijing, 100871, China
| | - Xin Liu
- Department of Gastroenterology, Huaihe Hospital of Henan University, No.115 Ximen Avenue, Kaifeng 475000, China
| | - Xinyue Liu
- Department of Nephrology, Peking University People's Hospital, Beijing 10044, China
| | - Jiajun Feng
- Department of Marketing, School of Business, Renmin University of China, No. 59 Zhongguancun Avenue, Beijing, 100871, China
| | - Tingyang Wei
- School of Basic Medical Sciences, Peking University Health Science Center, No.38 Xueyuan Avenue, Beijing, 10038, China
| | - Yuteng Yang
- School of Basic Medical Sciences, Peking University Health Science Center, No.38 Xueyuan Avenue, Beijing, 10038, China
| | - Changjie Tie
- School of Basic Medical Sciences, Peking University Health Science Center, No.38 Xueyuan Avenue, Beijing, 10038, China
| | - Chengwu Hong
- School of Basic Medical Sciences, Peking University Health Science Center, No.38 Xueyuan Avenue, Beijing, 10038, China
| | - Bo Feng
- Peking University Hepatology Institute, Peking University People's Hospital, No.11 Xizhimen South Street, Beijing, 100044, China
| | - Rui Huang
- Peking University Hepatology Institute, Peking University People's Hospital, No.11 Xizhimen South Street, Beijing, 100044, China.
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Jeng WJ, Chien RN, Liaw YF. Reply: New confounders emerging with new evidence regarding reduced HCC and improved survival. Hepatology 2024:01515467-990000000-00904. [PMID: 38836640 DOI: 10.1097/hep.0000000000000955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2024] [Accepted: 05/16/2024] [Indexed: 06/06/2024]
Affiliation(s)
- Wen-Juei Jeng
- College of Medicine, Chang Gung University, Taipei, Taiwan
- Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
| | - Rong-Nan Chien
- College of Medicine, Chang Gung University, Taipei, Taiwan
- Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
- Liver Research Unit, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Yun-Fan Liaw
- College of Medicine, Chang Gung University, Taipei, Taiwan
- Liver Research Unit, Chang Gung Memorial Hospital, Taoyuan, Taiwan
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Hu Y, Li Z, Li Q, Jin X, Di C, He W, Cheng X. Letter to the Editor: New confounders emerging with new evidence regarding reduced HCC and improved survival. Hepatology 2024:01515467-990000000-00899. [PMID: 38836625 DOI: 10.1097/hep.0000000000000954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Accepted: 05/03/2024] [Indexed: 06/06/2024]
Affiliation(s)
- Yue Hu
- Department of Paediatric Genetics, Endocrinology and Metabolism, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Zheng Li
- Department of Radiation Oncology, Division of Thoracic Tumor Multimodality Treatment, Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Qiang Li
- Biomedical Center, Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou, China
| | - Xiaodong Jin
- Biomedical Center, Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou, China
| | - Cuixia Di
- Biomedical Center, Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou, China
| | - Weilan He
- Department of Paediatric Genetics, Endocrinology and Metabolism, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Xinran Cheng
- Department of Paediatric Genetics, Endocrinology and Metabolism, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
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Jeng WJ, Chien RN, Liaw YF. Reply: Halting antiviral therapy in patients with cirrhosis and chronic hepatitis B: A dangerous game? Hepatology 2024; 79:E134-E135. [PMID: 38150032 DOI: 10.1097/hep.0000000000000737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 11/29/2023] [Indexed: 12/28/2023]
Affiliation(s)
- Wen-Juei Jeng
- College of Medicine, Chang Gung University, Taipei, Taiwan
- Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
| | - Rong-Nan Chien
- College of Medicine, Chang Gung University, Taipei, Taiwan
- Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
- Liver Research Unit, Chang Gung Memorial Hospital, Taiwan
| | - Yun-Fan Liaw
- College of Medicine, Chang Gung University, Taipei, Taiwan
- Liver Research Unit, Chang Gung Memorial Hospital, Taiwan
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Chen J, Tu T, Cohen C, Wang S, Hsu YC, Gish RG. Letter to the Editor: Halting antiviral therapy in patients with cirrhosis and chronic hepatitis B: A dangerous game? Hepatology 2024; 79:E132-E133. [PMID: 38150019 DOI: 10.1097/hep.0000000000000732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 11/08/2023] [Indexed: 12/28/2023]
Affiliation(s)
- Jacki Chen
- Taiwan Hepatitis Information & Care Association, Kaohsiung, Taiwan
- Department of Pharmacology, Robert Wood Johnson Medical School, Rutgers University, Piscataway, New Jersey, USA
| | - Thomas Tu
- Storr Liver Centre, The Westmead Institute for Medical Research, The University of Sydney at Westmead Hospital, Westmead, New South Wales, Australia
| | - Chari Cohen
- Hepatitis B Foundation, Doylestown, Pennsylvania, USA
| | - Su Wang
- Hepatitis B Foundation, Doylestown, Pennsylvania, USA
- Center for Asian Health, Cooperman Barnabas Medical Center, RWJBarnabas-Rutgers Medical Group, Livingston, New Jersey, USA
| | - Yao-Chun Hsu
- Division of Gastroenterology and Hepatology, E-Da Hospital, Kaohsiung, Taiwan
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Robert G Gish
- Hepatitis B Foundation, Doylestown, Pennsylvania, USA
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, La Jolla, California, USA
- Reno School of Medicine, University of Nevada, Reno, Nevada, USA
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Liaw YF. Letter regarding "Hepatitis B core-related antigen dynamics and risk of subsequent clinical relapses after nucleos(t)ide analog cessation". Clin Mol Hepatol 2024; 30:269-271. [PMID: 38295765 PMCID: PMC11016499 DOI: 10.3350/cmh.2024.0064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 01/29/2024] [Accepted: 01/31/2024] [Indexed: 04/13/2024] Open
Affiliation(s)
- Yun-Fan Liaw
- Liver Research Unit, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taipei, Taiwan
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Deng R, Wang Z, Liu Y, Sun J. Letter to the Editor: Cautious interpretation of the association between finite treatment and better prognosis in initially HBeAg-negative hepatitis B patients with cirrhosis. Hepatology 2024; 79:E107-E108. [PMID: 37906598 DOI: 10.1097/hep.0000000000000654] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Accepted: 09/18/2023] [Indexed: 11/02/2023]
Affiliation(s)
- Rui Deng
- State Key Laboratory of Organ Failure Research, Key Laboratory of Infectious Diseases Research in South China, Ministry of Education, Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Guangdong Provincial Clinical Research Center for Viral Hepatitis, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China
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Jeng WJ, Chien RN, Liaw YF. Reply: Cautious interpretation of the association between finite treatment and better prognosis in initially HBeAg-negative hepatitis B patients with cirrhosis. Hepatology 2024; 79:E109-E110. [PMID: 37906680 DOI: 10.1097/hep.0000000000000662] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 10/12/2023] [Indexed: 11/02/2023]
Affiliation(s)
- Wen-Juei Jeng
- College of Medicine, Chang Gung University, Taipei, Taiwan
- Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
| | - Rong-Nan Chien
- College of Medicine, Chang Gung University, Taipei, Taiwan
- Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
- Liver Research Unit, Chang Gung Memorial Hospital, Taiwan
| | - Yun-Fan Liaw
- College of Medicine, Chang Gung University, Taipei, Taiwan
- Liver Research Unit, Chang Gung Memorial Hospital, Taiwan
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Dongelmans EJ, Sonneveld MJ, Janssen HLA. Letter to the Editor: Benefits of stopping therapy in patients with cirrhotic hepatitis B, true effect or residual confounding? Hepatology 2024; 79:E95-E96. [PMID: 37862458 DOI: 10.1097/hep.0000000000000639] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 09/14/2023] [Indexed: 10/22/2023]
Affiliation(s)
- Edo J Dongelmans
- Department of Gastroenterology and Hepatology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Milan J Sonneveld
- Department of Gastroenterology and Hepatology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Harry L A Janssen
- Department of Gastroenterology and Hepatology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Toronto Centre for Liver Disease, Toronto General Hospital, University Health Network, Toronto, Canada
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Liaw YF, Jeng WJ, Chien RN. Reply: Benefits of stopping therapy in patients with cirrhotic hepatitis B, true effect, or residual confounding? Hepatology 2024; 79:E97-E98. [PMID: 37862454 DOI: 10.1097/hep.0000000000000641] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 09/20/2023] [Indexed: 10/22/2023]
Affiliation(s)
- Yun-Fan Liaw
- Department of Medicine, College of Medicine, Chang Gung University, Taipei, Taiwan
- Liver Research Unit, Chang Gung Memorial Hospital, Taiwan
| | - Wen-Juei Jeng
- Department of Medicine, College of Medicine, Chang Gung University, Taipei, Taiwan
- Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
| | - Rong-Nan Chien
- Department of Medicine, College of Medicine, Chang Gung University, Taipei, Taiwan
- Liver Research Unit, Chang Gung Memorial Hospital, Taiwan
- Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
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Papatheodoridi M, Papatheodoridis G. Finite therapy of chronic hepatitis B infection: Pros. Clin Liver Dis (Hoboken) 2024; 23:e0148. [PMID: 38707241 PMCID: PMC11068136 DOI: 10.1097/cld.0000000000000148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Accepted: 01/09/2024] [Indexed: 05/07/2024] Open
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