Body Compositions Correlate With Overt Hepatic Encephalopathy after Transjugular Intrahepatic Portosystemic Shunt: A Multicentre Cohort Study

Wenfeng Shi; Weiguo Xu; Ningning Fan; Yong Li; Xiaoqiong Chen; Yujie Zhao; Xiao Bai; Yang Yang

doi:10.1097/MCG.0000000000002014

Body Compositions Correlate With Overt Hepatic Encephalopathy after Transjugular Intrahepatic Portosystemic Shunt: A Multicentre Cohort Study

J Clin Gastroenterol. 2024 Apr 30. doi: 10.1097/MCG.0000000000002014. Online ahead of print.

Authors

Wenfeng Shi¹, Weiguo Xu², Ningning Fan³, Yong Li², Xiaoqiong Chen², Yujie Zhao², Xiao Bai², Yang Yang²

Affiliations

¹ Department of General Medicine.
² Zhuhai Interventional Medical Centre.
³ Department of Ophthalmology, Zhuhai People's Hospital (Zhuhai Clinical Medical College of Jinan University), Zhuhai, China.

PMID: 38683235
DOI: 10.1097/MCG.0000000000002014

Abstract

Background: The relationship between body composition and the risk of overt hepatic encephalopathy (OHE) following transjugular intrahepatic portosystemic shunt (TIPS) needs to be investigated.

Methods: Overall, 571 patients from 5 medical centers were included. To assess body compositions, we evaluated skeletal muscle indices, adipose tissue indices, sarcopenia, and myosteatosis at the third lumbar vertebral level. Univariate and Multivariate logistic regression analyses were performed to identify independent risk factors for post-TIPS OHE. An integrated score was then constructed using stepwise multiple regression analyses, with a cut-off value selected using the best Youden index. Finally, the Akaike information criterion (AIC) was performed to compare the integrated score and independent risk factors on their ability in predicting post-TIPS OHE.

Results: Sarcopenia and all skeletal muscle indices had limited associations with post-TIPS OHE. The index of the subcutaneous adipose tissue (SATI) (P=0.005; OR: 1.034, 95% CI: 1.010-1.058) and myosteatosis (297 cases, 52.01%, 125 with OHE, 42.09%; P=0.003; OR: 1.973; 95% CI: 1.262-3.084) were both ascertained as independent risk factors for post-TIPS OHE. The integrated score (ScoreALL=1.5760 + 0.0107 * SATI + 0.8579 * myosteatosis) was established with a cutoff value of -0.935. The akaike information criterion (AIC) of ScoreALL, SATI, and myosteatosis was 655.28, 691.18, and 686.60, respectively.

Conclusions: SATI and myosteatosis are independent risk factors for post-TIPS OHE. However, the integrated score was more significantly associated with post-TIPS OHE than other skeletal muscle and adipose tissue factors.