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Volume 41 Issue 10
Oct.  2025
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Article Navigation >  Journal of Clinical Hepatology  > 2025  >  41(10): 2075-2081

Risk factors for sarcopenia in patients with Wilson’s disease-related liver cirrhosis and their impact on clinical outcomes

DOI: 10.12449/JCH251018
  • 1.

    Department of Neurology，The First Affiliated Hospital of Anhui University of Chinese Medicine，Hefei 230006，China

  • 2.

    Key Laboratory of Xin’an Medicine，Ministry of Education，Hefei 230038，China

Research funding:

National Natural Science Foundation of China (82305185);

National Natural Science Foundation of China (U22A20366);

The 7th Batch of National Inheritance Project of Academic Experience of Old TCM Experts (Document No. ［2022］ 76 of the State Administration of Traditional Chinese Medicine);

Yang Wenming’s National Inheritance Studio of Famous Old TCM Experts ;

Anhui Provincial Natural Science Foundation for Young Scientists (2108085QH367);

Anhui Provincial University Natural Science Foundation Key Project (KJ2021A0555);

Anhui Provincial Quality Engineering Project for Higher Education (2023jyxm1168);

Anhui Provincial TCM Inheritance and Innovation Scientific Research Project (2024CCCX031);

Anhui University of Chinese Medicine Young Science and Technology Talent Cultivation Project (2021qnyc08);

Anhui University of Chinese Medicine Xin’an Medicine Ministry of Education Key Laboratory Open Fund Project (2020xayx12);

Research on the Digital Evaluation of Clinical Efficacy of Traditional Chinese Medicine Based on the Policy of “Digital Transformation and Development of Traditional Chinese Medicine” (YGZXKT2024180)

More Information
  • Corresponding author: WEI Taohua， weitaohua@foxmail.com （ORCID：0000-0003-3268-2491）
  • Received Date: 2024-09-25
  • Accepted Date: 2024-12-10
  • Published Date: 2025-10-25
    Abstract
  •   Objective  To investigate the incidence rate of sarcopenia in patients with Wilson’s disease （WD）-related liver cirrhosis， as well as the risk factors for sarcopenia and their impact on clinical outcomes.  Methods  A total of 140 patients with WD-related liver cirrhosis who were treated in The First Affiliated Hospital of Anhui University of Chinese Medicine from January 2019 to June 2020， and according to the third lumbar skeletal muscle mass index （L3 SMI）， the patients were divided into sarcopenia group and non-sarcopenia group. Nutritional risk screening， anthropometric measurements， and blood biochemical tests were performed for the patients to identify the influencing factors for sarcopenia. The patients were followed up for 36 — 48 months， and survival status and complications were compared between the two groups. The independent-samples t test was used for comparison of normally distributed continuous data between two groups， and the chi-square test and the Mann-Whitney U rank sum test were used for comparison of categorical data between two groups. A binary Logistic regression analysis was used to investigate the influencing factors for sarcopenia， and univariate and multivariate Cox regression analyses were used to investigate the risk factors for the prognosis of patients with WD-related liver cirrhosis. The Kaplan-Meier survival curve was plotted， and the Log-rank test was used for comparison between groups.  Results  Among the 140 patients with WD-related liver cirrhosis， 53 （37.9%） developed sarcopenia， with significantly lower body mass index （BMI） and L3 SMI than the patients without sarcopenia （t=10.550 and 3.982， both P<0.001）. The multivariate Logistic regression analysis showed that age （odds ratio ［OR］=2.243， 95% confidence interval ［CI］： 1.196 — 4.208， P=0.012）， sex （OR=0.450， 95%CI： 0.232 — 0.872， P=0.018）， BMI （OR=0.126， 95%CI： 0.089 — 0.294， P<0.001）， and hepatic encephalopathy （OR=8.367， 95%CI： 2.423 — 28.897， P<0.001） were the main influencing factors for sarcopenia in patients with WD-related liver cirrhosis. Compared with the non-sarcopenia group， the sarcopenia group had significantly higher mortality rate （χ2=6.158， P=0.019） and significantly higher incidence rates of infection （χ2=8.008， P=0.040）， recurrent abdominal/pleural efflux （χ2=17.742， P<0.001）， and hepatic encephalopathy （χ2=4.338， P=0.039）. The multivariate Cox regression analysis showed that sarcopenia （hazard ratio ［HR］=4.685， P=0.002） and hepatic encephalopathy （HR=19.156， P<0.001） were independent risk factors for death in patients with WD-related liver cirrhosis. The Kaplan-Meier survival curve analysis showed a significant reduction in survival rate in the patients with sarcopenia （P=0.003）.  Conclusion  Sarcopenia is one of the manifestations of malnutrition in patients with WD-related liver cirrhosis， which increases the risk of mortality and other complications and has an adverse effect on prognosis. There is an increased risk of sarcopenia in male patients or patients with hepatic encephalopathy， a lower level of BMI or an older age.

     

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