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Association between sarcopenia and hepatic encephalopathy after transjugular intrahepatic portosystemic shunt in patients with cirrhosis: a systematic review and meta-analysis

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Abstract

Purpose

The association between the presence of sarcopenia in patients with cirrhosis and the onset of hepatic encephalopathy (HE) after transjugular intrahepatic portosystemic shunt (TIPS) is yet to be established. We conducted a systematic review and meta-analysis to provide a thorough summary of the available evidence on this association.

Methods

A thorough search of the literature was performed in the PubMed, EMBASE, and Web of Science databases. The protocol was duly registered on PROSPERO (CRD42023398856). The hazard ratio (HR) and corresponding 95% confidence intervals (CIs) for the occurrence of HE after TIPS were extracted from studies comparing cirrhotic patients with and without sarcopenia. These data were then combined using a random-effect model.

Results

A total of 1135 patients from seven cohort studies that met our eligibility criteria were included in the meta-analysis. Our findings indicate a significantly higher risk of post-TIPS HE among cirrhotic patients with sarcopenia compared to those without sarcopenia (HR, 2.35; 95% CIs 1.32–4.19; p = 0.004; I2 = 75%). The findings remained consistent across subgroups stratified by liver disease etiology, study location, and severity of hepatic dysfunction.

Conclusion

The study demonstrated that sarcopenia was strongly linked to an increased likelihood post-TIPS HE among cirrhotic patients.

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Data availability

Data sharing is not applicable to this article as no new data were created in this study.

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Acknowledgments

The authors thank Dr. Yazhou He for his statistical assistance. Dr. He serves as a senior biostatistician at the Department of Epidemiology and Medical Statistics, West China School of Public Health, Sichuan University.

Funding

Xiaoze Wang received funding from the National Natural Science Foundation of China (No. 82200681).

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Authors and Affiliations

  1. Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, 610041, China

    Yuanyuan Li & Langli Gao

  2. Department of Gastroenterology and Hepatology, West China Hospital, Sichuan University, 37 Guoxue Lane, Chengdu, 610041, Sichuan, China

    Yuxin Guo & Xiaoze Wang

  3. West China School of Nursing, Sichuan University, Chengdu, 610041, China

    Langli Gao

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Li, Y., Guo, Y., Wang, X. et al. Association between sarcopenia and hepatic encephalopathy after transjugular intrahepatic portosystemic shunt in patients with cirrhosis: a systematic review and meta-analysis. Abdom Radiol 49, 575–585 (2024). https://doi.org/10.1007/s00261-023-04095-6

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