REVIEW article
Front. Nutr.
Sec. Nutrition and Metabolism
Volume 12 - 2025 | doi: 10.3389/fnut.2025.1649783
This article is part of the Research TopicImmunoregulation and Inflammation Interventions in Nutritional Metabolic DiseasesView all articles
The Effects of Sarcopenia on the Prognosis of Patients with Acute-on-Chronic Liver Failure: a Systematic Review and Meta-analysis
Provisionally accepted
- West China Hospital of Sichuan University, Chengdu, China
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Objectives Sarcopenia is an important indicator affecting the prognosis of patients with end-stage liver disease. The purpose of this review is to systematically review all relevant studies to evaluate the impact of sarcopenia on the prognosis of patients with ACLF. Methods We systematically searched PubMed, Web of Science, Embase, the Cochrane Library, China Biomedical Literature Service System (CINAHL), China National Knowledge Infrastructure (CNKI), the WeiPu (VIP) and the Wanfang database for relevant articles published on or before August 1, 2024. Two independent reviewers conducted literature screening against predefined inclusion/exclusion criteria. Results The systematic review included 12 cohort studies, with a total of 2,505 participants. Of these, 11 studies (2,072 participants) met the criteria for inclusion in the meta-analysis. The meta-analysis demonstrated that sarcopenia is significantly associated with an increased mortality risk in patients with ACLF [HR=1.27, 95%CI (1.05, 1.54), P<0.00001]. Subgroup analyses showed that the mortality risk was significantly increased in the subgroup of study with the outcome of short-term mortality [HR=1.54, 95%CI (1.14, 2.08)], and prospective study [HR=2.16, 95%CI (1.30, 3.60)]. Conclusion The meta-analysis of 11 studies (2,072 participants) revealed a significant association between sarcopenia and elevated mortality risk in ACLF patients. However, these findings should be interpreted with caution due to the limited number of included studies and higher heterogeneity in the analysis.
Keywords: ACLF, Mortality, Meta-analysis, prognosis, Sarcopenia, Systematic review
Received: 19 Jun 2025; Accepted: 16 Sep 2025.
Copyright: © 2025 Li, Deng, Luo, Chen, Zhao, Liu, Liu, Mao and Zhang. 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: Rong Deng, dengrongdr@126.com
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