The role of changes in subcutaneous and visceral adiposity, sarcopenic obesity, and myosteatosis/muscle quality in cirrhosis: How to diagnose it and its contribution to prognosis

Abstract

Recent advances in body composition evaluation have recognized the inability of the BMI to differentiate between body compartments and limited accuracy in the presence of ascites or edema, major complications in patients with cirrhosis. By using computed tomography image-based analysis of two major body compartments, muscle and adipose tissue, sex-dependent differences in body composition have been identified in patients with cirrhosis. Abnormalities in body composition, i.e., sarcopenia, myosteatosis, high visceral adiposity, low subcutaneous adiposity, and sarcopenic obesity, are common in patients with cirrhosis and constitute important prognostic factors. Considering an association between body composition abnormalities and adverse outcomes in patients with cirrhosis, early identification of these abnormalities is critical to enable proper interventions.