Evidence map›Paper›PMID 42455288›Full record

ArticleHepatology international2026

Prognostic performance of Asian Working Group for Sarcopenia 2019 and 2025 sarcopenia definitions in cirrhosis.

Kei Endo, Keisuke Kakisaka, Tokio Sasaki, Tamami Abe, Yuichi Yoshida, Hidekatsu Kuroda, Takayuki Matsumoto

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Article in Hepatology international, 2026. 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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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

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

7 authors.

Kei EndoDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Iwate Medical University School of Medicine, Idaidori 2-1-1, Yahaba, Iwate, 028-3695, Japan. keiendo@iwate-med.ac.jp.ORCID http://orcid.org/0000-0002-9698-2779
Keisuke KakisakaDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Iwate Medical University School of Medicine, Idaidori 2-1-1, Yahaba, Iwate, 028-3695, Japan.
Tokio SasakiDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Iwate Medical University School of Medicine, Idaidori 2-1-1, Yahaba, Iwate, 028-3695, Japan.
Tamami AbeDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Iwate Medical University School of Medicine, Idaidori 2-1-1, Yahaba, Iwate, 028-3695, Japan.
Yuichi YoshidaDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Iwate Medical University School of Medicine, Idaidori 2-1-1, Yahaba, Iwate, 028-3695, Japan.
Hidekatsu KurodaDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Iwate Medical University School of Medicine, Idaidori 2-1-1, Yahaba, Iwate, 028-3695, Japan.
Takayuki MatsumotoDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Iwate Medical University School of Medicine, Idaidori 2-1-1, Yahaba, Iwate, 028-3695, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

background/purpose of the studyThe Asian Working Group for Sarcopenia (AWGS) updated its criteria in 2025, adding a body mass index (BMI)-adjusted muscle index (ASM/BMI) to the conventional skeletal muscle index (SMI). We aimed to compare the prognostic performances of the AWGS 2019 and AWGS 2025 in patients with liver cirrhosis.

methodsThis retrospective cohort study included 505 patients ≥ 50 years of age with liver cirrhosis who underwent bioelectrical impedance analysis between 2016 and 2025. Sarcopenia was defined using the AWGS 2019 SMI, AWGS 2025 SMI, and AWGS 2025 ASM/BMI criteria. Landmark analysis was performed on day 180, and overall survival was evaluated. The prognostic performance was assessed using Cox regression, time-dependent ROC analysis, and Harrell's C-index.

resultsDuring a median follow-up of 5.4 years, 140 deaths occurred. Sarcopenia, as defined by each definition, was independently associated with mortality. The baseline model (age, sex, etiology, and ALBI score) showed a C-index of 0.732. The addition of sarcopenia improved discrimination for SMI-based definitions (ΔC-index 0.033 for AWGS 2025 SMI; 0.023 for AWGS 2019 SMI) but not for AWGS 2025 ASM/BMI (ΔC-index 0.005). At 3 years, the AUC values were 0.828 (AWGS 2025 SMI), 0.822 (AWGS 2019 SMI), and 0.800 (AWGS 2025 ASM/BMI), relative to 0.792 for the baseline model.

conclusionsAWGS 2025 SMI demonstrated robust prognostic performance comparable to or slightly better than that of the AWGS 2019, whereas the AWGS 2025 ASM/BMI provided limited incremental prognostic value. The height-adjusted SMI remains a reliable metric for risk stratification in cirrhosis.

Indexed as

Appendicular skeletal muscle massAsian populationBioelectrical impedance analysisBody compositionHandgrip strengthHarrell’s C-indexLandmark analysisMuscle depletionMuscle massPrognostic discriminationSex differencesSkeletal muscle indexSurvival predictionTime-dependent ROC analysis

Identifiers

PMID42455288

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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.