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SYSTEMATIC REVIEW article

Front. Nutr.
Sec. Clinical Nutrition
Volume 11 - 2024 | doi: 10.3389/fnut.2024.1387602

Sarcopenic obesity is significantly associated with poorer overall survival after liver transplantation: a systematic review and meta-analysis

Provisionally accepted
Hui-Bin Huang Hui-Bin Huang *Yibing Zhu Yibing Zhu Da-Xing Yu Da-Xing Yu
  • Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China

The final, formatted version of the article will be published soon.

    Background: Sarcopenia has been shown to worsen survival after liver transplantation. However, it remains unclear whether coexisting sarcopenia and obesity, so-called sarcopenic obesity (SO), may also synergistically increase their adverse effects. This meta-analysis aimed to evaluate pre-transplant SO has an independent predictive value for survival in this population.We conducted this study according to the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines. PubMed, Embase, Web of Science, Wanfang, CNKI, and Cochrane databases were searched through October 15, 2023, for studies with any study design evaluating the relationship between SO and posttransplant survival in patient undergoing liver transplantation . We used ROBINS-E to assess the study quality. The primary outcome was all-cause mortality at any length of follow-up. We calculated pooled odds risks (ORs) or hazard risks (HR) with 95% confidence intervals (CIs). Heterogeneity was quantified with I 2 -statistics. Subgroup analyses and publication bias evaluations were also conducted.We included nine cohort studies with 2416 patients. These studies were moderate to high quality. Pre-liver transplant patients commonly experience SO, with a mean prevalence as high as 34%. Overall, patients with SO had a significant increase in overall mortality compared with patients without SO by pooled studies reported both univariate analysis [HR=1.76, 95%C 1.33-2.33, P<0.0001] and multivariate analysis (HR=2.33, 95%CI 1.34-4.04, P=0.003). Similar results were also found when comparing patients with or without SO at one, three, and five years of OR=1.83, and OR=1.54, respectively). In addition, subgroup analysis based on studies that reported HRs of both sarcopenia and SO indicated both had independent negative effects on posttransplant survival.Conclusions: Our meta-analysis showed that SO occurs frequently in liver transplant patients. SO is associated with an increased risk of mortality in such patient populations.

    Keywords: sarcopenic obesity, Liver Transplantation, Meta-analysis, Survival, Obesity

    Received: 18 Feb 2024; Accepted: 25 Nov 2024.

    Copyright: © 2024 Huang, Zhu and Yu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Hui-Bin Huang, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.