TY - JOUR
T1 - Both muscle quantity and quality are predictors of waiting list mortality in patients with end-stage liver disease
AU - Bot, Daphne
AU - Droop, Anneke
AU - Lucassen, Claudia J.
AU - van Veen, Mariëlle E.
AU - van Vugt, Jeroen L.A.
AU - Shahbazi Feshtali, Shirin
AU - Leistra, Eva
AU - Tushuizen, Maarten E.
AU - van Hoek, Bart
N1 - Publisher Copyright:
© 2021 The Author(s)
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/4
Y1 - 2021/4
N2 - Background and aims: Malnutrition is highly prevalent in patients with end-stage liver disease (ESLD) and associated with impaired clinical outcome. Previous studies focused on one component of body composition and not in combination with nutritional intake, while both are components of the nutritional status. We aimed to evaluate the most important risk factors regarding body composition (muscle mass, muscle quality and fat mass) and nutritional intake (energy and protein intake) for waiting list mortality in patients with ESLD awaiting liver transplantation (LTx). Methods: Consecutive patients with ESLD listed for LTx between 2007 and 2014 were investigated. Muscle mass quantity (Skeletal Muscle Mass Index, SMI), and muscle quality (Muscle Attenuation, MA), and various body fat compartments were measured on computed tomography using SliceOmatic. Nutritional intake (e.g. energy and protein intake) was assessed. Multivariable stepwise forward Cox regression analysis was used for statistical analysis. Results: 261 Patients (mean age 54 years, 74.7% male) were included. Low SMI and MA were found to be statistically significant predictors of an increased risk for waiting list mortality in patients with ESLD, with a HR of 2.580 (95%CI 1.055–6.308) and HR of 9.124 (95%CI 2.871–28.970), respectively. No association between percentage adipose tissue, and protein and energy intake with waiting list mortality was found in this study. Conclusion: Both low muscle quantity and quality, and not nutritional intake, were independent risk factors for mortality in patients with ESLD.
AB - Background and aims: Malnutrition is highly prevalent in patients with end-stage liver disease (ESLD) and associated with impaired clinical outcome. Previous studies focused on one component of body composition and not in combination with nutritional intake, while both are components of the nutritional status. We aimed to evaluate the most important risk factors regarding body composition (muscle mass, muscle quality and fat mass) and nutritional intake (energy and protein intake) for waiting list mortality in patients with ESLD awaiting liver transplantation (LTx). Methods: Consecutive patients with ESLD listed for LTx between 2007 and 2014 were investigated. Muscle mass quantity (Skeletal Muscle Mass Index, SMI), and muscle quality (Muscle Attenuation, MA), and various body fat compartments were measured on computed tomography using SliceOmatic. Nutritional intake (e.g. energy and protein intake) was assessed. Multivariable stepwise forward Cox regression analysis was used for statistical analysis. Results: 261 Patients (mean age 54 years, 74.7% male) were included. Low SMI and MA were found to be statistically significant predictors of an increased risk for waiting list mortality in patients with ESLD, with a HR of 2.580 (95%CI 1.055–6.308) and HR of 9.124 (95%CI 2.871–28.970), respectively. No association between percentage adipose tissue, and protein and energy intake with waiting list mortality was found in this study. Conclusion: Both low muscle quantity and quality, and not nutritional intake, were independent risk factors for mortality in patients with ESLD.
KW - Body composition
KW - Liver cirrhosis
KW - Liver transplantation
KW - Malnutrition
KW - Muscle
KW - Sarcopenia
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U2 - 10.1016/j.clnesp.2021.01.022
DO - 10.1016/j.clnesp.2021.01.022
M3 - Article
C2 - 33745592
AN - SCOPUS:85100654176
VL - 42
SP - 272
EP - 279
JO - Clinical Nutrition ESPEN
JF - Clinical Nutrition ESPEN
SN - 2405-4577
ER -