Work

#146 - Covert Hepatic Encephalopathy in Cirrhotic Patients With Sarcopenia

Year: 2026

Type: article

Abstract: Introduction and Objectives Covert hepatic encephalopathy (CHE) and sarcopenia are subclinical disorders that worsen the prognosis of liver cirrhosis from its early stages. Their bidirectional association has been poorly explored in Latin American populations. To quantify the bidirectional association between sarcopenia and CHE, and to identify the independent predictors of their coexistence in patients with compensated cirrhosis. Materials and Methods An observational, analytical, and cross-sectional study (n=132) was conducted in patients with compensated cirrhosis. Sarcopenia was evaluated using the simplified EWGSOP2 criteria (SARC-F questionnaire, five-times chair stand test, and calf circumference). CHE was determined using the Psychometric Hepatic Encephalopathy Score (PHES) battery or the EncephalApp Stroop Test. Logistic regression models were used to determine adjusted associations. Results Sarcopenia prevalence was 14.4% (95% CI: 8.8–21.6%), CHE was 31.1% (95% CI: 23.3–39.7%), and coexistence was 10.6% (95% CI: 5.9–17.1%). The bidirectional association remained independent after adjusting for age, albumin, platelets, hemoglobin, and etiology: sarcopenia-CHE OR: 6.18 (95% CI: 1.53–24.98; p=0.011); CHE-sarcopenia OR: 5.92 (95% CI: 1.46–24.01; p=0.013). Factors associated with coexistence were albumin (OR: 0.88; 95% CI: 0.83–0.94), age (OR: 1.07; 95% CI: 1.01–1.13), and platelet count (OR: 0.99; 95% CI: 0.98–0.99). Conclusions A robust bidirectional association exists between sarcopenia and CHE in compensated cirrhosis, with a magnitude superior to that reported internationally. Hypoalbuminemia, advanced age, and thrombocytopenia predict their coexistence, which provides a rationale for an integrated clinical approach.

Source: Annals of Hepatology

DOI: 10.1016/j.aohep.2026.102392