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Low subcutaneous adiposity linked to mortality risk in women with cirrhosis

A lower subcutaneous adipose tissue index correlated with higher mortality in women with cirrhosis, while lower skeletal muscle predicted mortality in men with cirrhosis, according to a recently published study.

“Besides body composition, sex differences exist regarding other clinical features of liver disease,” Maryam Ebadi, PhD, from the University of Alberta Hospital, Canada, and colleagues wrote. “The findings of our study emphasize the importance of differentiating between muscle, subcutaneous and visceral adipose tissue using cross sectional imaging in patients with liver cirrhosis.”

To evaluate the prognostic significance of the skeletal muscle index (SMI), the visceral adipose tissue index (VATI) and subcutaneous adipose tissue index (SATI) in patients with cirrhosis, Ebadi and colleagues reviewed the scans of 677 patients assessed for liver transplantation, 67% of whom were men.

Compared with the women in the study, the men had higher SMI (53 vs. 45 cm²/m²; P < .001) and VATI (39 vs. 31; cm²/m²; P < .001), lower SATI (48 vs. 67 c²/m²; P < .001), and were more likely to have sarcopenia (42% vs. 24%; P < .001).

Low SATI in women — less than 60 c²m² — correlated independently with mortality (AUC = 0.64; 95% CI, 0.56-0.71). Women with a low SATI had a significantly higher mortality risk (HR = 2.06; 95% CI, 1.08-3.91) and survival rates of 71% at 6 months, 64% at 1 year, 52% at 2 years, and 36% at 5 years compared with 84%, 78%, 70% and 61% in patients with high SATI

In men, SMI correlated independently with mortality risk (HR = 0.98; 95% CI, 0.96-1), whereas the researchers observed no correlation between mortality risk in men and either VATI or SATI values.

“Subcutaneous adipose tissue plays an important role in energy storage; low SATI may reflect the severe energy exhaustion caused by cirrhosis, leading to the poor clinical outcomes,” the researchers wrote. “Our results support the need for further studies to investigate potential interactions between muscle and subcutaneous adipose indices on mortality.” – by Talitha Bennett

Disclosure: The authors report no relevant financial disclosures.