{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T21:40:53Z","timestamp":1792446053712,"version":"4.5.0"},"reference-count":29,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,9,14]],"date-time":"2021-09-14T00:00:00Z","timestamp":1631577600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100017950","name":"Shanghai Municipal Health Commission","doi-asserted-by":"publisher","award":["201840233"],"award-info":[{"award-number":["201840233"]}],"id":[{"id":"10.13039\/100017950","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J cachexia sarcopenia muscle"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Diagnostic criteria for sarcopenia have not been established in Chinese. This study established criteria based on the L3\u2010skeletal muscle index (L3\u2010SMI) and assessed its value for outcomes predicting in cirrhotic Chinese patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Totally 911 subjects who underwent a CT scan at two centres were enrolled in Cohort 1 (394 male and 417 female subjects, aged 20\u201380\u00a0years). The data of those subjects younger than 60\u00a0years (365 male and 296 female subjects) were used to determine the reference intervals of the L3\u2010SMI and its influencing factors. Cohort 2 consisted of 480 patients (286 male and 184 female patients) from three centres, and their data were used to investigate the prevalence of sarcopenia and evaluate the value of L3\u2010SMI for predicting the prognosis and complications of cirrhosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Age and sex had the greatest effects on the L3\u2010SMI (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a00.001). The L3\u2010SMI scores were clearly higher in male patients than in female patients (52.94\u00a0\u00b1\u00a08.41 vs. 38.91\u00a0\u00b1\u00a05.65\u00a0cm\n                      <jats:sup>2<\/jats:sup>\n                      \/m\n                      <jats:sup>2<\/jats:sup>\n                      ,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a00.001) and sharply declined in subjects aged\u00a0\u2265\u00a060\u00a0years. Based on the mean \u22121.28\u00a0\u00d7\u00a0SD among adults aged\u00a0&lt;\u00a060\u00a0years, the L3\u2010SMI cut\u2010off value for sarcopenia was 44.77\u00a0cm\n                      <jats:sup>2<\/jats:sup>\n                      \/m\n                      <jats:sup>2<\/jats:sup>\n                      in male patients and 32.50\u00a0cm\n                      <jats:sup>2<\/jats:sup>\n                      \/m\n                      <jats:sup>2<\/jats:sup>\n                      in female patients. Using these values, 22.5% of the cirrhotic patients (28.7% of male patients and 11.9% of female patients) were diagnosed with sarcopenia. Compared with non\u2010sarcopenia individuals, sarcopenia patients had lower body mass index (21.28\u00a0\u00b1\u00a03.01 vs. 24.09\u00a0\u00b1\u00a03.39\u00a0kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ,\n                      <jats:italic>P\u00a0&lt;<\/jats:italic>\n                      \u00a00.001) and serum albumin levels (31.54\u00a0\u00b1\u00a05.93 vs. 32.93\u00a0\u00b1\u00a05.95\u00a0g\/L,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.032), longer prothrombin times (16.39\u00a0\u00b1\u00a03.05 vs. 15.71\u00a0\u00b1\u00a03.20\u00a0s,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.049), higher total bilirubin concentrations (41.33\u00a0\u00b1\u00a057.38 vs. 32.52\u00a0\u00b1\u00a031.48\u00a0\u03bcmol\/L,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.039), worse liver function (Child\u2013Pugh score, 8.05\u00a0\u00b1\u00a02.11 vs. 7.32\u00a0\u00b1\u00a02.05,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.001), higher prevalence of cirrhosis\u2010related complications (81.82% vs. 62.24%,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a00.001) and mortality (30.68% vs. 11.22%,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a00.001). Overall survival was significantly lower in the sarcopenia group [risk ratio (RR)\u00a0=\u00a02.643, 95% confidence interval (CI) 1.646\u20134.244,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a00.001], accompanied with an increased cumulative incidence of ascites (RR\u00a0=\u00a01.827, 95% CI 1.259\u20132.651,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.002), spontaneous bacterial peritonitis (RR\u00a0=\u00a03.331, 95% CI 1.404\u20137.903,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.006), hepatic encephalopathy (RR\u00a0=\u00a01.962, 95% CI 1.070\u20133.600,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.029), and upper gastrointestinal varices (RR\u00a0=\u00a02.138, 95% CI 1.319\u20133.466,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.002). Subgroup analysis showed sarcopenia shortened the survival of the patients with Model For End\u2010Stage Liver Disease score\u00a0&gt;\u00a014 (RR\u00a0=\u00a04.310, 95% CI 2.091\u20138.882,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a00.001) or Child\u2013Pugh C (RR\u00a0=\u00a03.081, 95% CI 1.516\u20136.260,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.002).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Sarcopenia is a common comorbidity of cirrhosis and can be used to predict cirrhosis\u2010related complications and the prognosis.<\/jats:p>\n                  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of Radiology, Shanghai Chest Hospital Shanghai Jiao Tong University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun\u2010Qing","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Shandong Provincial Hospital Affiliated to Shandong First Medical University  Jinan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7137-112X","authenticated-orcid":false,"given":"Wei\u2010Fen","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Changzheng Hospital Second Military Medical University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,9,14]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)60121-5"},{"key":"e_1_2_9_3_1","first-page":"1","article-title":"Burden of cirrhosis and other chronic liver 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