ArticleFrontiers in physiology2025
Myosteatosis as an independent predictor for all-cause and cardiac mortality in initial-dialysis patients: a multicenter, retrospective cohort study.
Article in Frontiers in physiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Myosteatosis is associated with adverse prognosis in diseases. We aimed to establish thresholds for myosteatosis, assess its association with all-cause and cardiac mortality in initial dialysis patients, and construct a myosteatosis-based survival nomogram. assessed the predictive value of myosteatosis with all-cause and cardiac mortality in initial-dialysis patients, and constructed a myosteatosis-based survival nomogram. Methods: This multicentric retrospective study included 383 initial-dialysis patients (1/2014-12/2019). Endpoints include all-cause and cardiac mortality. Skeletal Muscle Index (SMI, cm Results: Patients were predominantly aged 18-65 years (n = 298, 77.81%), with males comprising 60.84% (n = 233). All-cause mortality was 22.72% (n = 87), of which 52.87% (n = 46) were attributed to cardiac causes. Sex-specific SMD cutoffs for predicting all-cause mortality were 32.46 HU (AUC = 0.707) in males and 34.58 HU (AUC = 0.690) in females (both P < 0.05). Myosteatosis was associated with higher all-cause (36.7%) and cardiac mortality (19.8%) (both P < 0.001), and independently predicted both outcomes (all-cause mortality: HR = 3.203, 95% CI:1.937-5.296; cardiac mortality: HR = 3.418, 95% CI:1.718-6.802). The myosteatosis-based nomogram achieved a C-index of 0.761, validated in real-world data. Conclusion: Sex-specific myosteatosis thresholds (males: SMD ≤32.46 HU; females: ≤34.58 HU) derived from L3-CT independently predicted all-cause and cardiac mortality in initial-dialysis patients. The myosteatosis-based survival nomogram demonstrated moderate-to-good predictive accuracy and potential clinical utility.
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