Evidence map›Paper›PMID 34785325›Full record

SynthesisJournal of hepatology2022

Effect of sarcopenia on survival in patients with cirrhosis: A meta-analysis.

Xinxing Tantai, Yi Liu, Yee Hui Yeo, Michael Praktiknjo, Ezequiel Mauro, Yuhei Hamaguchi, Cornelius Engelmann, Peng Zhang, Jae Yoon Jeong, Jeroen Laurens Ad van Vugt and 22 more

Registry-linked trialOpen access · bronzeAbstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Journal of hepatology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06121492 (Oral Branched-chain Amino Acid Supplementation for Cirrhotic Patients With Sarcopenia), which is not on this map. Cited by 244 papers, 17 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
244citing papers in PubMed, 17 pooled it
31.6field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06121492 phase3enrolling by invitationnot on this mapstarted 2023, after this paper: background citation

Oral Branched-chain Amino Acid Supplementation for Cirrhotic Patients With Sarcopenia: a Double-blinded Randomized Controlled Trial

TypeinterventionalSponsorMahidol UniversityRan2023 to 2026Enrolled86ConditionsSarcopenia, Cirrhosis of the LiverArmsBranched-chain amino acid, Placebo
3 · Its place in the literature

Who cites it

244 citing papers in PubMed, 17 syntheses or guidelines pooled it, 383 citations in OpenAlex.

  1. Ultrasound-Based Skeletal Muscle Assessment for Prognostication in Cirrhosis: A Systematic Review.Liver international : official journal of the International Association for the Study of the Liver · 2026
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184 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

32 authors at 17 institutions in 11 countries.

Xinxing TantaiDepartment of Gastroenterology, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, PR China.
Yi LiuDepartment of Infectious Diseases, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, PR China.
Yee Hui YeoDivision of General Internal Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA. Electronic address: yeehui.yeo@cshs.org.
Michael PraktiknjoDepartment of Internal Medicine I, University Hospital Bonn, Bonn, Germany.
Ezequiel MauroLiver Transplant Unit, Liver Unit, Hospital Italiano de Bs. As., Buenos Aires, Argentina.
Yuhei HamaguchiDepartment of Gastrointestinal Surgery, Japanese Red Cross Osaka Hospital, Osaka, Japan.
Cornelius EngelmannDivision of Hepatology, Department of Medicine II, Leipzig University Medical Center, Leipzig, Germany; Department of Hepatology and Gastroenterology, Campus Virchow-Klinikum and Charité Campus Mitte, Charité - Universitaetsmedizin Berlin, Berlin, Germany; Institute for Liver and Digestive Health, University College London, London, UK.
Peng ZhangDepartment of Surgery, University of Michigan Medical School, Ann Arbor, Michigan, MI, USA.
Jae Yoon JeongDepartment of Gastroenterology and Hepatology, National Medical Center, Seoul, South Korea.
Jeroen Laurens Ad van VugtDepartment of Surgery, Division of HPB and Transplant Surgery, Erasmus MC University Medical Centre, Rotterdam, Netherlands.
Huijuan XiaoDepartment of Nutrition, The Third Central Hospital of Tianjin, Tianjin, China.
Huan DengNational & Local Joint Engineering Research Center of Biodiagnosis and Biotherapy, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, PR China; Shaanxi Provincial Clinical Research Center for Hepatic & Splenic Diseases, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, PR China.
Xu GaoDepartment of Gastroenterology, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, PR China; Department of Infectious Diseases, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, PR China.
Qing YeDepartment of Gastroenterology and Hepatology, The Third Central Hospital of Tianjin, Tianjin, PR China.
Jiayuan ZhangXi'an Jiaotong University Library, Xi'an, PR China.
Longbao YangDepartment of Gastroenterology, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, PR China.
Yaqin CaiDepartment of Gastroenterology, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, PR China.
Yixin LiuDepartment of Gastroenterology, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, PR China.
Na LiuDepartment of Gastroenterology, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, PR China.
Zongfang LiNational & Local Joint Engineering Research Center of Biodiagnosis and Biotherapy, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, PR China; Shaanxi Provincial Clinical Research Center for Hepatic & Splenic Diseases, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, PR China; Key Laboratory of Environment and Genes Related to Diseases, Xi'an Jiaotong University, Ministry of Education of China, Xi'an, PR China.
Tao HanDepartment of Gastroenterology and Hepatology, The Third Central Hospital of Tianjin, Tianjin, PR China.
Toshimi KaidoDepartment of Gastroenterological and General Surgery, St Luke's International Hospital, Tokyo, Japan.
Joo Hyun SohnDepartment of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, South Korea.
Christian StrassburgDepartment of Internal Medicine I, University Hospital Bonn, Bonn, Germany.
Thomas BergDivision of Hepatology, Department of Medicine II, Leipzig University Medical Center, Leipzig, Germany.
Jonel TrebickaDepartment of Internal Medicine I, Goethe University Clinic Frankfurt, Germany; European Foundation for Study of Chronic Liver Failure, Barcelona, Spain; Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark; Institute of Bioengineering Catalunya, Barcelona, Spain.
Yao-Chun HsuCenter for Liver Diseases, E-Da Hospital, School of Medicine, I-Shou University, Kaohsiung, Taiwan; Division of Gastroenterology and Hepatology, Fu Jen Catholic University Hospital, New Taipei, Taiwan.
Jan Nicolaas Maria IJzermansDepartment of Surgery, Division of HPB and Transplant Surgery, Erasmus MC University Medical Centre, Rotterdam, Netherlands.
Jinhai WangDepartment of Gastroenterology, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, PR China. Electronic address: jinhaiwang@hotmail.com.
Grace L SuDepartment of Medicine, University of Michigan Medical School, Ann Arbor, Michigan, MI, USA; Medicine Service VA Ann Arbor Healthcare System, Ann Arbor, Michigan, MI, USA.
Fanpu JiDepartment of Infectious Diseases, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, PR China; National & Local Joint Engineering Research Center of Biodiagnosis and Biotherapy, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, PR China; Shaanxi Provincial Clinical Research Center for Hepatic & Splenic Diseases, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, PR China; Key Laboratory of Environment and Genes Related to Diseases, Xi'an Jiaotong University, Ministry of Education of China, Xi'an, PR China. Electronic address: jifanpu1979@163.com.
Mindie H NguyenDivision of Gastroenterology and Hepatology, Stanford University Medical Center, Palo Alto, CA, USA; Department of Epidemiology and Population Health, Stanford University, Palo Alto, CA, United States.
Second Affiliated Hospital of Xi'an Jiaotong University · CNTianjin Third Central Hospital · CNErasmus MC · NLUniversity Hospital Bonn · DEUniversity of Michigan · USCedars-Sinai Medical Center · USFu Jen Catholic University · TWGoethe University Frankfurt · DEHanyang University Guri Hospital · KRHospital Italiano de Buenos Aires · ARLeipzig University · DENational Medical Center · KROsaka Hospital · JPPalo Alto University · USSt. Luke's International Hospital · JPUniversity College London · GBXi'an Jiaotong University · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND &

aimsThe association between sarcopenia and prognosis in patients with cirrhosis remains to be determined. In this study, we aimed to quantify the association between sarcopenia and the risk of mortality in patients with cirrhosis, stratified by sex, underlying liver disease etiology, and severity of hepatic dysfunction.

methodsPubMed, Web of Science, EMBASE, and major scientific conference sessions were searched without language restriction through 13 January 2021 with an additional manual search of bibliographies of relevant articles. Cohort studies of ≥100 patients with cirrhosis and ≥12 months of follow-up that evaluated the association between sarcopenia, muscle mass and the risk of mortality were included.

resultsTwenty-two studies involving 6,965 patients with cirrhosis were included. The pooled prevalence of sarcopenia in patients with cirrhosis was 37.5% overall (95% CI 32.4%-42.8%), and was higher in male patients, those with alcohol-associated liver disease, those with Child-Pugh grade C cirrhosis, and when sarcopenia was defined by L3-SMI (third lumbar-skeletal muscle index). Sarcopenia was associated with an increased risk of mortality in patients with cirrhosis (adjusted hazard ratio [aHR] 2.30, 95% CI 2.01-2.63), with similar findings in a sensitivity analysis of patients with cirrhosis without hepatocellular carcinoma (aHR 2.35, 95% CI 1.95-2.83) and in subgroups stratified by sex, liver disease etiology, and severity of hepatic dysfunction. The association between quantitative muscle mass index and mortality further supports the association between sarcopenia and poor prognosis (aHR 0.95, 95% CI 0.93-0.98). There was no significant heterogeneity in any of our analyses.

conclusionsSarcopenia was highly and independently associated with higher risk of mortality in patients with cirrhosis. LAY SUMMARY: The prevalence of sarcopenia and its association with death in patients with cirrhosis remain unclear. This meta-analysis indicated that sarcopenia affected about one-third of patients with cirrhosis and up to 50% of patients with alcohol-related liver disease or Child-Pugh class C cirrhosis. Sarcopenia was independently associated with an ∼2-fold higher risk of mortality in patients with cirrhosis. The mortality rate increased with greater severity or longer durations of sarcopenia. Increasing awareness about the importance of sarcopenia in patients with cirrhosis among stakeholders must be prioritized.

Indexed as

HumansLiver CirrhosisPrognosisRisk FactorsSarcopeniaSurvival Analysisalcohol-associated liver diseasecirrhosisprognosissarcopeniaskeletal muscle index

Identifiers

PMID34785325
OpenAlexW3214325528

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.