LB091 - SARCOPENIC OBESITY IN PATIENTS WITH DECOMPENSATED CIRRHOSIS AND VITAMIN D DEFICIENCY OR INSUFFICIENCY

LB091

SARCOPENIC OBESITY IN PATIENTS WITH DECOMPENSATED CIRRHOSIS AND VITAMIN D DEFICIENCY OR INSUFFICIENCY

M. Arnoriaga^1,*, R. Díaz-Ruíz², M. Poca³, E. Roman ⁴, B. Cuyàs ⁵, R. Panadero⁶, I. Bañares ⁷, Á. Morales ¹, C. Serrano¹, C. Velasco¹, C. Cuerda¹, M. Rapado-Castro⁸, R. Bañares², G. Soriano⁹, R. García-Martínez ¹⁰, I. Bretón¹

¹Nutrition Unit, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), ²Department of Gastroenterology, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Facultad de Medicina, Universidad Complutense de Madrid, CIBERehd, Madrid, ³Department of Gastroenterology, Hospital de Hospital de la Santa Creu i Sant Pau, Institut de Recerca Sant Pau (IR Sant Pau), Universitat Autònoma de Barcelona, CIBERehd, ⁴Department of Gastroenterology, Hospital de la Santa Creu i Sant Pau, Institut de Recerca Sant Pau (IR Sant Pau), Universitat Autònoma de Barcelona, CIBERehd. University Nursing School EUI-Sant Pau, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, ⁵Department of Gastroentery, Hospital de la Santa Creu i Sant Pau, Institut de Recerca Sant Pau (IR Sant Pau), Universitat Autònoma de Barcelona, CIBERehd, Barcelona, ⁶Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, CIBERSAM, ISCIII, School of Medicine, Universidad Complutense, ⁷Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), ⁸Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, CIBERSAM, ISCIII, School of Medicine, Universidad Complutense, University of Melbourne, Melbourne, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, ⁹Department of Gastroenterology, Hospital de la Santa Creu i Sant Pau, Institut de Recerca Sant Pau (IR Sant Pau), Universitat Autònoma de Barcelona, CIBERehd, Barcelona, ¹⁰Department of Internal Medicine, Hospital General Universitario Gregorio Marañón, Universidad Complutense de Madrid, CIBERehd, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain

Rationale: Sarcopenic obesity may worsen the prognosis and survival of patients with cirrhosis, particularly in patients with decompensated cirrhosis. In addition, vitamin D influences the onset and progression of sarcopenia. To date, there is limited data about the prevalence and the diagnostic criteria for sarcopenic obesity in this population. 

Methods: This is an observational cohort study including patients with cirrhosis and vitamin D deficiency or insufficiency discharged after hospitalization in two tertiary hospitals from Spain. Exclusion criteria included vitamin D supplementation at the time of the inclusion and comorbidities with life expectancy < 6 months amog others. Clinical data was collected. Dual-energy-X-ray absorptiometry was used to assess body composition. Cut-off values: Obesity, body fat: ≥ 27% men, ≥ 38% women. Low handgrip strength < 27 kg men, <16 kg women. Low appendicular skeletal muscle mass (ASMM): ASMM/Body weight < 25.7% men, < 19.4% women.

Results: We studied 39 (74.4% males) subjects with a median age of 69 [62-79] years and a BMI of 28.5 [24.4-30.2] kg/m². The median of vitamin D levels was 13.4 [8.9-21.0] µg/L, 71.8% of subjects had a vitamina D deficiency. Etiology of cirrhosis included: hepatitis C virus (n=6), alcoholic liver disease (n=16), hepatitis B virus (n=2), nonalcoholic steatohepatitis (n=6), mixed (n=9). Child-Pugh score: Class A (n=13), Class B (n=20), Class C (n=6). 18 subjects (88.9% men) presented obesity (46.2%). Probable sarcopenic obesity defined as having low handgrip strength was found in 12 subjects (30.8%). Confirmed sarcopenic obesity was observed in 5 males (12.8%). Cardiovascular disease (100% vs 44.1%, p= 0.027) and hydrothorax (60% vs 5.9%, p=0.010) were more prevalent in subjects with sarcopenic obesity compared to subjects with no sarcopenic obesity. Basal vitamin D deficiency or insufficiency was similar in both groups and was not associated with body composition in our sample.  

Conclusion: The prevalence of sarcopenic obesity in the present study of subjects with decompensated cirrhosis and vitamin D deficiency or insufficiency was 12.8%. Sarcopenic obesity was associated with negative outcomes. Effective strategies to prevent sarcopenic obesity are needed, particularly in high-risk subjects with decompensated cirrhosis. 

Disclosure of Interest: None declared