P453 - THE IMPACT OF SARCOPENIC OBESITY ON SURVIVAL PROGNOSIS IN PATIENTS WITH LIVER CIRRHOSIS

P453

THE IMPACT OF SARCOPENIC OBESITY ON SURVIVAL PROGNOSIS IN PATIENTS WITH LIVER CIRRHOSIS

A. Naganuma^1,*, Y. Ogawa^2,3, Y. Suzuki¹, H. Yasuoka¹, T. Hoshino¹, T. Hatanaka⁴, T. Hoshino⁵, N. Itagaki⁵, T. Sekiguchi⁵, S. Oikawa⁵, K. Ichikawa⁵, M. Inazuka⁵, I. Inukai⁵, M. Tanaka⁵, A. Kumagai⁵, H. Aoki⁵, H. Ogihara⁵, M. Inagawa⁵, T. Ogawa⁵, S. Kakizaki³

¹Department of Gastroenterology, NHO Takasaki General Medical Center, Takasaki, ²Department of Nutrition, NHO Shinshu Ueda Medical Center, Ueda, ³Department of Clinical Research, NHO Takasaki General Medical Center, Takasaki, ⁴Department of Gastroenterology, Gunmaken Saiseikai Maebashi Hospital, Maebashi, ⁵Nutrition Support Team, NHO Takasaki General Medical Center, Takasaki, Japan

Rationale: Sarcopenic Obesity (SO) combines sarcopenia and obesity, presenting higher risks than either condition alone. While the European Society for Clinical Nutrition and Metabolism (ESPEN) and European Association for the Study of Obesity (EASO) proposed unified SO criteria in 2022, the Japanese Working Group on Sarcopenic Obesity (JWGSO) recently developed specific criteria for Asian populations (Geriatr Gerontol Int 2024). This study investigates the impact of SO on survival in liver cirrhosis patients using these new Japanese criteria.

Methods: We conducted a retrospective observational study of 76 consecutive cirrhotic patients who underwent bioelectrical impedance analysis (BIA) at our hospital between August and November 2017. Parameters included demographics, cirrhosis etiology, Child-Pugh classification, presence of ascites, hepatocellular carcinoma (HCC), SO status, and survival. SO was determined using JWGSO criteria (i. screening with BMI ≥25kg/m², ii. Hand grip (M: < 28 kg; F: < 18 kg) and limb skeletal muscle mass corrected for BMI (M: < 0.798 kg/BMI; F: < 0.512 kg/BMI)).

Results: Among 76 patients (40 males, 53%; median age 72 years), etiologies included HCV (46), alcohol (13), MASH (10), HBV (4), and others (3). Child-Pugh classifications were A (59), B (16), and C (1); 15 had ascites and 49 had HCC. SO was present in 2 males (5%) and 6 females (17%). The SO group showed a trend toward worse median survival time compared to the non-SO group (23 m. vs 61 m., P=0.07). In females only, SO significantly reduced survival (23 m. vs 93 m., P=0.047).

Conclusion: Sarcopenic obesity in cirrhotic patients was a significant poor prognostic factor, especially in females. This finding highlights the clinical importance of SO in liver cirrhosis and suggests the need for new therapeutic approaches.

References: Ishii K, et al. Geriatr Gerontol Int. 2024 Oct;24(10):997-1000. doi: 10.1111/ggi.14978.

Disclosure of Interest: None declared