AUTHOR=Wang Xiaoyu , Sun Mingyu , Li Yifan , Guo Gaoyue , Yang Wanting , Mao Lihong , Yu Zihan , Hui Yangyang , Fan Xiaofei , Cui Binxin , Jiang Kui , Sun Chao 

TITLE=Association of myosteatosis with various body composition abnormalities and longer length of hospitalization in patients with decompensated cirrhosis

JOURNAL=Frontiers in Nutrition

VOLUME=Volume 9 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/nutrition/articles/10.3389/fnut.2022.921181

DOI=10.3389/fnut.2022.921181

ISSN=2296-861X

ABSTRACT=Background: Myosteatosis is linked to dismal outcomes in the context of cirrhosis. However, association of myosteatosis with various body composition abnormalities remains enigmatic. We aimed to clarify the determinants of myosteatosis and its relationship with other body composition profiles and length of hospitalization (LOH).
Methods: We retrospectively analyzed the data of 473 consecutive cirrhotic patients hospitalized for decompensation. Computed tomography-based segmentation of the cross-sectional area at the third lumbar vertebra was used to evaluate body composition abnormalities. The categories of myosteatosis were built according to our previously outcome-based cutoffs for each gender.
Results: Totally, 83 patients (17.55%) were stratified as myosteatosis, of whom 85.54% have concomitant high visceral adiposity indicative of increased visceral adipose tissue index (VATI). The prevalence of sarcopenia showed no significant difference between the groups with and without myosteatosis. Multivariate analysis showed advanced age (OR = 1.097, P <0.001), higher visceral to subcutaneous ratio of adipose tissue area ([VSR]; OR = 1.574, P = 0.032) and higher VATI (OR = 1.026, P <0.001) are independently associated with myosteatosis. Correlation analyses revealed a positive relationship between IMAC and VATI (ρ = 0.48, P <0.001), SATI (ρ = 0.36, P <0.001) and age (ρ = 0.36, P <0.001). None of the skeletal muscle or adipose tissue indicators was significantly related to longer LOH. 
Conclusion: Higher VSR, higher VATI and advanced age are associated with myosteatosis among patients with cirrhosis at decompensation phase. It is tempting to target divergent adipose tissue depots aimed at timely intervention/prevention for myosteatosis.