Positive impact of obesity on the prognosis of liver cirrhosis.

Autor: Endo K; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Iwate Medical University School of Medicine, Yahaba, Japan., Kakisaka K; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Iwate Medical University School of Medicine, Yahaba, Japan., Abe T; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Iwate Medical University School of Medicine, Yahaba, Japan., Yusa K; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Iwate Medical University School of Medicine, Yahaba, Japan., Nakaya I; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Iwate Medical University School of Medicine, Yahaba, Japan., Watanabe T; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Iwate Medical University School of Medicine, Yahaba, Japan., Suzuki A; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Iwate Medical University School of Medicine, Yahaba, Japan., Yoshida Y; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Iwate Medical University School of Medicine, Yahaba, Japan., Oikawa T; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Iwate Medical University School of Medicine, Yahaba, Japan., Miyasaka A; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Iwate Medical University School of Medicine, Yahaba, Japan., Kuroda H; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Iwate Medical University School of Medicine, Yahaba, Japan., Matsumoto T; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Iwate Medical University School of Medicine, Yahaba, Japan.
Jazyk: angličtina
Zdroj: Journal of gastroenterology and hepatology [J Gastroenterol Hepatol] 2024 Aug; Vol. 39 (8), pp. 1663-1672. Date of Electronic Publication: 2024 May 03.
DOI: 10.1111/jgh.16590
Abstrakt: Background and Aim: The study aims to determine the prognostic impact of obesity, sarcopenic obesity, and dynapenic obesity in patients with chronic liver disease.
Methods: This retrospective observational study enrolled patients with chronic hepatitis (n = 746) and liver cirrhosis (n = 434) without hepatocellular carcinoma at entry. The patients were evaluated for sarcopenia and obesity between April 2016 and April 2022. Obesity was defined as a body mass index of ≥ 25 kg/m 2 . Sarcopenic obesity was defined as low skeletal muscle mass (pre-sarcopenia) with obesity and dynapenic obesity was defined as low muscle strength (dynapenia) with obesity. The effects of obesity on survival were evaluated retrospectively.
Results: The mean observation period was 2.5 years. Obesity, sarcopenic obesity, and dynapenic obesity were found in 271 (45.5%), 17 (2.9%), and 21 (3.5%) men, and 261 (44.7%), 59 (10.1%), and 53 (9.1%) women, respectively. A multivariate Cox proportional hazards model revealed that Child-Pugh class, dynapenia (hazard ratio [HR] 3.89), elderly (≥ 65 years old) (HR 2.11), and obesity (HR 0.58) were independently associated with overall survival (OS). However, neither sarcopenic nor dynapenic obesity were associated with OS. In patients with cirrhosis, the OS of the obese group was significantly higher than that of the non-obese group. The effect of obesity on OS was significant in elderly patients, but not in younger patients.
Conclusions: Sarcopenic and dynapenic obesity seem unrelated to the prognosis of patients with chronic liver disease. Obesity has a positive effect on the prognosis of elderly patients with cirrhosis.
(© 2024 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.)
Databáze: MEDLINE
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