Decreased Subcutaneous Adipose Tissue Correlates with Higher Portal Hypertension And Poor Survival in Patients with Cirrhosis: A Retrospective Binary-center Study

This study aimed to investigate the impact of hepatic venous portal gradient (HVPG) on BC values and the prognostic value of BC value in cirrhotic patients. A total of 173 cirrhotic patients with HVPG and Computed Tomography scan were screened retrospectively from a binary-center database. Seven BC values, including skeletal muscle index (SMI), subcutaneous adipose tissue index (SATI), deep SATI (dSATI), superficial SATI (sSATI), visceral adipose tissue index (VATI), and ratio of VATI and SATI (VSR) along with skeletal muscle radiodensity (SMRD), were analyzed. The correlation analyses and multiple linear regression were used to assess the impact of HVPG on BC values. The cumulative survival rate was assessed and risk factors of survival were identified by competing risk analysis using Fine-Gray model. Among 173 patients with a mean age 53.7±10.5 years, there were 111(64.2%) males and 62(35.8%) females. In male patients, SATI, dSATI and sSATI inversely correlated with HVPG, respectively (SATI: rho=-0.227; dSATI: rho=-0.229; sSATI: rho=-0.219; all P<0.05), especially in patients aged≤60 years or with compensated cirrhosis; Male patients with clinically significant portal hypertension (CSPH) had a lower SATI, dSATI, sSATI and SMRD than those without CSPH. After adjusted multiple linear models, male sex, Child-Pugh class B or C and elevated HVPG contributed to decreased SATI. Multiple competing survival analysis showed a lower SATI (male:<38 cm2/m2; female:<23 cm2/m2) and Child-Pugh B or C predict mortality. Decreased SATI, dSATI and sSATI were more closely associated with increased HVPG. A lower SATI and Child-Pugh B or C predicted mortality.