Psoas Muscle Density Predicts Occurrences of Hepatic Encephalopathy in Patients Receiving Transjugular Intrahepatic Portosystemic Shunts within 1 year

Cai, Weimin; Lin, Han-Yu; Qi, Ruyi; Lin, Xiuqing; Zhao, Yuan; Chen, Weizhen; Huang, Zhiming

doi:10.1007/s00270-021-02961-8

Cited by 10 publications

(4 citation statements)

References 44 publications

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“…Moreover, myosteatosis has been associated with higher mortality in LC patients [ 22 , 107 , 118 ] and with the risk of developing HE in LC patients [ 20 , 119 ], but not with the length of hospital stay in patients with decompensated cirrhosis [ 120 ].…”

Section: Sarcopeniamentioning

confidence: 99%

Osteosarcopenia in NAFLD/MAFLD: An Underappreciated Clinical Problem in Chronic Liver Disease

Musio

Perazza

Leoni

et al. 2023

IJMS

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Chronic liver disease (CLD), including non-alcoholic fatty liver disease (NAFLD) and its advanced form, non-alcoholic steatohepatitis (NASH), affects a significant portion of the population worldwide. NAFLD is characterised by fat accumulation in the liver, while NASH is associated with inflammation and liver damage. Osteosarcopenia, which combines muscle and bone mass loss, is an emerging clinical problem in chronic liver disease that is often underappreciated. The reductions in muscle and bone mass share several common pathophysiological pathways; insulin resistance and chronic systemic inflammation are the most crucial predisposing factors and are related to the presence and gravity of NAFLD and to the worsening of the outcome of liver disease. This article explores the relationship between osteosarcopenia and NAFLD/MAFLD, focusing on the diagnosis, prevention and treatment of this condition in patients with CLD.

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Section: Sarcopeniamentioning

confidence: 99%

Osteosarcopenia in NAFLD/MAFLD: An Underappreciated Clinical Problem in Chronic Liver Disease

Musio

Perazza

Leoni

et al. 2023

IJMS

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“…Several studies confirm the relationship between poor body composition status and post-TIPS HE. Two studies found a thin or low-density psoas muscle CT scan to be associated with high post-TIPS HE incidence [ 33 , 73 ]. Other studies used skeletal muscle index (ratio of the muscle in arms and legs to height) as a measure of sarcopenia and found that 50 out of 56 patients with sarcopenia and none of the 6 patients without sarcopenia developed post-TIPS HE and that patients with improvement in skeletal muscle index reversing from sarcopenic to non-sarcopenic had a lower risk of developing post-TIPS OHE 6 months after TIPS [ 32 , 74 , 75 ].…”

Section: Risk Factorsmentioning

confidence: 99%

Post-Transjugular Intrahepatic Portosystemic Shunt (TIPS) Hepatic Encephalopathy—A Review of the Past Decade’s Literature Focusing on Incidence, Risk Factors, and Prophylaxis

Friis,

Thomsen,

Laleman

et al. 2023

JCM

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Transjugular intrahepatic portosystemic shunt (TIPS) is an established treatment for portal hypertension and its’ complications in liver cirrhosis, yet the development of hepatic encephalopathy (HE) remains a significant concern. This review covers the reported incidence, risk factors, and management strategies for post-TIPS HE over the past decade. Incidence varies widely (7–61%), with factors like age, liver function, hyponatremia, and spontaneous portosystemic shunts influencing risk. Procedural aspects, including TIPS timing, indication, and stent characteristics, also contribute. Pharmacological prophylaxis with lactulose and rifaximin shows promise, but current evidence is inconclusive. Procedural preventive measures, such as shunt embolization and monitoring portal pressure gradients, are explored. Treatment involves pharmacological options like lactulose and rifaximin, and procedural interventions like stent diameter reduction. Ongoing studies on novel predictive markers and emerging treatments, such as faecal microbiota transplant, reflect the evolving landscape in post-TIPS HE management. This concise review provides clinicians with insights into the multifaceted nature of post-TIPS HE, aiding in improved risk assessment, prophylaxis, and management for patients undergoing TIPS procedures.

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“…TIPS can increase the incidence of HE by 30-55% post-procedure, with 90% of affected patients developing it within the first three months. [8][9][10][11] While the association between TIPS placement and HE exacerbation is well-documented, the mechanism is poorly understood. Ammonia level is usually associated with HE, but studies examining ammonia level and HE development are conflicting.…”

Section: Introductionmentioning

confidence: 99%

“…TIPS can increase the incidence of HE by 30-55% post-procedure, with 90% of affected patients developing it within the first three months. 8–11…”

Section: Introductionmentioning

confidence: 99%

Pre- and Post-Portosystemic Shunt Placement Metabolomics Reveal Molecular Signatures for the Development of Hepatic Encephalopathy

Machado

Ramos

Gauglitz

et al. 2023

Preprint

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Hepatic encephalopathy (HE) is a common complication of advanced liver disease causing brain dysfunction. This is likely due to the accumulation of unfiltered toxins within the bloodstream. A known risk factor for developing or worsening HE is the placement of a transjugular intrahepatic portosystemic shunt (TIPS), which connects the pre-hepatic and post-hepatic circulation allowing some blood to bypass the dysfunctional liver and decreases portal hypertension. To better understand the pathophysiology of post-TIPS HE, we conducted a multi-center prospective cohort study employing metabolomic analyses on hepatic vein and peripheral vein blood samples from participants with cirrhosis undergoing elective TIPS placement, measuring chemical modifications and changes in concentrations of metabolites resulting from TIPS placement. In doing so, we identified numerous alterations in metabolites, including bile acids, glycerophosphocholines, and bilirubins possibly implicated in the development and severity of HE.

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Psoas Muscle Density Predicts Occurrences of Hepatic Encephalopathy in Patients Receiving Transjugular Intrahepatic Portosystemic Shunts within 1 year

Cited by 10 publications

References 44 publications

Osteosarcopenia in NAFLD/MAFLD: An Underappreciated Clinical Problem in Chronic Liver Disease

Osteosarcopenia in NAFLD/MAFLD: An Underappreciated Clinical Problem in Chronic Liver Disease

Post-Transjugular Intrahepatic Portosystemic Shunt (TIPS) Hepatic Encephalopathy—A Review of the Past Decade’s Literature Focusing on Incidence, Risk Factors, and Prophylaxis

Pre- and Post-Portosystemic Shunt Placement Metabolomics Reveal Molecular Signatures for the Development of Hepatic Encephalopathy

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