Sarcopenic obesity is significantly associated with poorer overall survival after liver transplantation: a systematic review and meta-analysis
BackgroundSarcopenia 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 whether pre-tran...
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Frontiers Media S.A.
2024-12-01
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| Series: | Frontiers in Nutrition |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fnut.2024.1387602/full |
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| author | Hui-Bin Huang Yi-Bing Zhu Da-Xing Yu |
| author_facet | Hui-Bin Huang Yi-Bing Zhu Da-Xing Yu |
| author_sort | Hui-Bin Huang |
| collection | DOAJ |
| description | BackgroundSarcopenia 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 whether pre-transplant SO independently predicts survival in this population.MethodsWe conducted this study according to the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines. The PubMed, Embase, Web of Science, Wanfang, CNKI, and Cochrane databases were searched up to 15 October 2023, for studies with any study design evaluating the relationship between SO and post-transplant survival in patients 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 (HRs) with 95% confidence intervals (CIs). Heterogeneity was quantified with I2 statistics. Subgroup analyses and publication bias evaluations were also conducted.ResultsWe included nine cohort studies with 2,416 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 exhibited a significantly higher overall mortality than patients without SO, as demonstrated by pooled studies using 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 1, 3, and 5 years of follow-up (OR = 1.86, 95%CI 1.22–2.83; OR = 1.83, 95%CI: 1.27–2.64; and OR = 1.54, 95% CI 1.02–2.34, respectively). In addition, subgroup analysis based on studies that reported HRs of both sarcopenia and SO indicated both had independent negative effects on post-transplant survival.ConclusionOur meta-analysis showed that SO occurs frequently in liver transplant patients. SO is associated with an increased risk of mortality in such patient populations.Systematic review registrationhttps://doi.org/10.37766/inplasy2024.2.0069 [inplasy2024.2.0069]. |
| format | Article |
| id | doaj-art-3d56edc9c82147438ff17d3ad4c0fb50 |
| institution | Kabale University |
| issn | 2296-861X |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Nutrition |
| spelling | doaj-art-3d56edc9c82147438ff17d3ad4c0fb502024-12-16T16:41:06ZengFrontiers Media S.A.Frontiers in Nutrition2296-861X2024-12-011110.3389/fnut.2024.13876021387602Sarcopenic obesity is significantly associated with poorer overall survival after liver transplantation: a systematic review and meta-analysisHui-Bin HuangYi-Bing ZhuDa-Xing YuBackgroundSarcopenia 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 whether pre-transplant SO independently predicts survival in this population.MethodsWe conducted this study according to the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines. The PubMed, Embase, Web of Science, Wanfang, CNKI, and Cochrane databases were searched up to 15 October 2023, for studies with any study design evaluating the relationship between SO and post-transplant survival in patients 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 (HRs) with 95% confidence intervals (CIs). Heterogeneity was quantified with I2 statistics. Subgroup analyses and publication bias evaluations were also conducted.ResultsWe included nine cohort studies with 2,416 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 exhibited a significantly higher overall mortality than patients without SO, as demonstrated by pooled studies using 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 1, 3, and 5 years of follow-up (OR = 1.86, 95%CI 1.22–2.83; OR = 1.83, 95%CI: 1.27–2.64; and OR = 1.54, 95% CI 1.02–2.34, respectively). In addition, subgroup analysis based on studies that reported HRs of both sarcopenia and SO indicated both had independent negative effects on post-transplant survival.ConclusionOur meta-analysis showed that SO occurs frequently in liver transplant patients. SO is associated with an increased risk of mortality in such patient populations.Systematic review registrationhttps://doi.org/10.37766/inplasy2024.2.0069 [inplasy2024.2.0069].https://www.frontiersin.org/articles/10.3389/fnut.2024.1387602/fullsarcopenic obesityliver transplantationmeta-analysissurvivalobesity |
| spellingShingle | Hui-Bin Huang Yi-Bing Zhu Da-Xing Yu Sarcopenic obesity is significantly associated with poorer overall survival after liver transplantation: a systematic review and meta-analysis Frontiers in Nutrition sarcopenic obesity liver transplantation meta-analysis survival obesity |
| title | Sarcopenic obesity is significantly associated with poorer overall survival after liver transplantation: a systematic review and meta-analysis |
| title_full | Sarcopenic obesity is significantly associated with poorer overall survival after liver transplantation: a systematic review and meta-analysis |
| title_fullStr | Sarcopenic obesity is significantly associated with poorer overall survival after liver transplantation: a systematic review and meta-analysis |
| title_full_unstemmed | Sarcopenic obesity is significantly associated with poorer overall survival after liver transplantation: a systematic review and meta-analysis |
| title_short | Sarcopenic obesity is significantly associated with poorer overall survival after liver transplantation: a systematic review and meta-analysis |
| title_sort | sarcopenic obesity is significantly associated with poorer overall survival after liver transplantation a systematic review and meta analysis |
| topic | sarcopenic obesity liver transplantation meta-analysis survival obesity |
| url | https://www.frontiersin.org/articles/10.3389/fnut.2024.1387602/full |
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