Work

Mean liver density independently predicts therapeutic response and liver-related mortality in patients with primary biliary cholangitis

Year: 2024

Type: article

Abstract: Background: Sarcopenia, myosteatosis, and sarcopenic obesity are known to adversely affect nutritional status and quality of life in cirrhotic patients. However, there is limited research on these conditions in individuals with primary biliary cholangitis (PBC). This study aims to identify risk factors for sarcopenia, myosteatosis, and sarcopenic obesity in PBC patients and to investigate their association with therapeutic outcomes and liver-related mortality. Furthermore, this research aims to uncover novel imaging-based risk factors that may influence biochemical response rates and mortality risk. Methods: In this retrospective study, patients with PBC were enrolled. Sarcopenia and myosteatosis were defined using the third lumbar vertebra (L3) skeletal muscle index (SMI) and skeletal muscle density (SMD) obtained from computed tomography (CT) imaging. The prognosis of PBC patients can be accurately evaluated using the PARIS I criteria. Results: The study included 117 PBC patients, of whom 73 (62.4%) exhibited sarcopenia and 51 (43.6%) presented with myosteatosis. Seventeen (14.5%) patients were with sarcopenic obesity. The rate of biochemical response was 38.5%. During a mean follow-up period of 68 months, seven patients died. Patients with sarcopenia were older, with a lower body mass index (BMI) and a higher prevalence of myosteatosis, as well as lower visceral adipose tissue index (VATI) and subcutaneous adipose tissue index (SATI) levels (P<0.05). Patients with myosteatosis were older and had higher levels of albumin, SATI, and VATI (P<0.05). They also had a higher prevalence of sarcopenia and sarcopenia obesity (P<0.05). Multivariate analysis revealed that neither sarcopenia nor myosteatosis impacted the biochemical response rates or liver-related mortality in PBC patients. Conversely, mean liver density was identified as a significant risk factor for biochemical response and liver-related mortality (P<0.05). Conclusions: Mean liver density is an independent predictor for biochemical response and liver-related mortality in patients with PBC.

Source: Quantitative Imaging in Medicine and Surgery

DOI: 10.21037/qims-24-553