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Subcutaneous adipose tissue index predicts mortality in cirrhotic females

20 Aug 2018
The obesity epidemic hits Malaysia hard with cardiovascular disease occurring during younger ages.

Female patients with cirrhosis who have low subcutaneous adipose tissue index (SATI) scores are at a higher risk of mortality, a recent study has found.

Researchers analysed 677 computer tomography images taken at the 3rd lumbar vertebra. Three body composition indices were obtained: SATI, visceral adipose tissue index and skeletal muscle index (SMI). Cox proportional and competing-risk analysis hazard models were used to determine the relationship between the measured indices and mortality risk.

The study sample was predominantly male (67 percent) with an average age of 57±7 years. Males tended to have elevated SMI (53±12 v 45±9 cm2/m2) while females had higher SATI (67±52 vs 48±36 cm2/m2; p<0.001 for both). Body mass index was comparable between the sexes.

Multivariate analysis showed that in female patients with ascites, SATI <60 cm2/m2 was significantly associated with higher mortality relative to those with high SATI (hazard ratio [HR], 2.06; 95 percent CI, 1.08–3.91; p=0.03) and was independently predictive of mortality (area under the curve [AUC], 0.64; 0.56–0.71; p<0.001).

Using 60 cm2/m2 as a threshold, researchers further showed that the 6-month, 1-year, 2-year and 5-year probabilities of survival in females with low SATI were 71 percent, 64 percent, 52 percent and 36 percent, respectively. The corresponding values in patients with high SATI were 84 percent, 78 percent, 70 percent and 61 percent.

In comparison, SMI (HR, 0.98; 0.96–1.00; p=0.02) but not SATI was a predictor of mortality in males.

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Christina Lau, 09 Oct 2019

Nivolumab, used in the first-line treatment of patients with advanced hepatocellular carcinoma (HCC), has demonstrated clinically meaningful improvements in overall survival (OS) and response rates vs sorafenib in the phase III CheckMate 459 study, although the improvement in OS did not reach statistical significance.