Myosteatosis independently predicts transplant-free survival in patients with primary sclerosing cholangitis.

Intramuscular fat fraction Liver transplantation Myosteatosis PSC Primary sclerosing cholangitis Sarcopenia

Journal

Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver
ISSN: 1878-3562
Titre abrégé: Dig Liver Dis
Pays: Netherlands
ID NLM: 100958385

Informations de publication

Date de publication:
11 2023
Historique:
received: 01 04 2023
revised: 10 07 2023
accepted: 01 08 2023
medline: 30 10 2023
pubmed: 17 8 2023
entrez: 16 8 2023
Statut: ppublish

Résumé

Primary Sclerosing Cholangitis (PSC) is a progressive cholestatic liver disease with liver transplantation (LT) as the only curative therapy. Some regions use body-weight-loss as standard-exception criteria for organ allocation but data on the impact of body composition on survival of patients with PSC is scarce. Abdominal MRI of PSC patients were quantitatively analyzed for intramuscular fat fraction (IMFF) as surrogate of myosteatosis. Clinical and laboratory data were retrieved from patient records. Primary outcome was transplant-free survival (TFS). 116 PSC patients were included. Median age was 38 (18-71) years with 74 (64%) male patients. 15 (13%) patients had significant weigh loss. IMFF was significantly associated with survival. Multivariate regression analysis showed IMFF ≥ 15% as independent predictor for TFS (p = 0.032, HR 3.215 CI 1.104-9.366), but not significant weight loss (p = 0.618). IMFF is independently associated with TFS in patients with PSC and may identify patients with more urgent need for LT. NCT03584204.

Sections du résumé

BACKGROUND
Primary Sclerosing Cholangitis (PSC) is a progressive cholestatic liver disease with liver transplantation (LT) as the only curative therapy. Some regions use body-weight-loss as standard-exception criteria for organ allocation but data on the impact of body composition on survival of patients with PSC is scarce.
METHODS
Abdominal MRI of PSC patients were quantitatively analyzed for intramuscular fat fraction (IMFF) as surrogate of myosteatosis. Clinical and laboratory data were retrieved from patient records. Primary outcome was transplant-free survival (TFS).
RESULTS
116 PSC patients were included. Median age was 38 (18-71) years with 74 (64%) male patients. 15 (13%) patients had significant weigh loss. IMFF was significantly associated with survival. Multivariate regression analysis showed IMFF ≥ 15% as independent predictor for TFS (p = 0.032, HR 3.215 CI 1.104-9.366), but not significant weight loss (p = 0.618).
CONCLUSION
IMFF is independently associated with TFS in patients with PSC and may identify patients with more urgent need for LT. NCT03584204.

Identifiants

pubmed: 37586906
pii: S1590-8658(23)00845-9
doi: 10.1016/j.dld.2023.08.037
pii:
doi:

Banques de données

ClinicalTrials.gov
['NCT03584204']

Types de publication

Clinical Study Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1543-1547

Informations de copyright

Copyright © 2023 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest No conflict of competing interest exists.

Auteurs

Michael Praktiknjo (M)

Department of Internal Medicine B, University Hospital Münster, Germany; Department of Internal Medicine I, University Hospital Bonn, Germany. Electronic address: michael.praktiknjo@ukmuenster.de.

Taotao Zhou (T)

Department of Internal Medicine I, University Hospital Bonn, Germany.

Maximiliane Krüsken (M)

Department of Internal Medicine I, University Hospital Bonn, Germany.

Torid Jacob (T)

Department of Internal Medicine B, University Hospital Münster, Germany.

Alois M Sprinkart (AM)

Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Germany.

Sebastian Nowak (S)

Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Germany.

Markus Kimmann (M)

Department of Internal Medicine B, University Hospital Münster, Germany.

Leona Dold (L)

Department of Internal Medicine I, University Hospital Bonn, Germany.

Johannes Chang (J)

Department of Internal Medicine I, University Hospital Bonn, Germany.

Christian Jansen (C)

Department of Internal Medicine I, University Hospital Bonn, Germany.

Christian P Strassburg (CP)

Department of Internal Medicine I, University Hospital Bonn, Germany.

Julian Luetkens (J)

Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Germany.

Tobias J Weismüller (TJ)

Department of Internal Medicine I, University Hospital Bonn, Germany; Department of Internal Medicine, Gastroenterology and Oncology, Vivantes Humboldt Hospital Berlin, Germany.

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Classifications MeSH