# Prevalence and clinical relevance of sarcopenia in Chinese patients with porto-sinusoidal vascular disorder

## TL;DR

This study finds that sarcopenia is common in Chinese patients with a rare liver disease and is linked to worse outcomes after treatment for bleeding.

## Contribution

The study reports the prevalence and clinical impact of sarcopenia in Chinese PSVD patients, identifying it as an independent predictor of rebleeding.

## Key findings

- Sarcopenia was observed in 18.5% of the 92 PSVD patients studied.
- Sarcopenia was associated with a higher risk of rebleeding after endoscopic treatment.
- TIPS placement was linked to increased muscle mass in PSVD patients.

## Abstract

Porto-sinusoidal vascular disorder (PSVD) is a rare vascular liver disease that has similar manifestations to liver cirrhosis. However, limited information is available on the prevalence and clinical impacts of sarcopenia in patients with PSVD in China.

We enrolled 92 patients with PSVD from West China Hospital between January 2019 to June 2024 to analyze and characterize the burden of sarcopenia. The psoas muscle mass index (PMI), measured at the third lumbar vertebra (L3-PMI, cm2/m2), was used for quantitative analysis of skeletal muscle mass. Age- and sex- specific cut-off values, optimized for the Chinese population, were endorsed for the diagnosis of sarcopenia.

Sarcopenia was observed in 17 out of the 92 PSVD patients (18.5%). The sarcopenia group had a higher proportion of patients with a history of esophagogastric variceal bleeding (EGVB) compared to the non-sarcopenia group (88.24% vs. 60.0%, p = 0.046). Transjugular intrahepatic portosystemic shunt (TIPS) creation significantly increased L3-PMI [4.84 (3.70–5.44) vs. 5.10 (4.40–6.10), p = 0.0153]. During the 1-year follow-up after endoscopic treatment, the cumulative incidence of rebleeding was significantly higher in the sarcopenia group than in the non-sarcopenia group [HR 4.39, 95% CI 1.01–19.10, log-rank p = 0.0485]. Multivariate Cox regression analysis showed that sarcopenia was an independent predictor of 1-year variceal rebleeding.

Sarcopenia is common in patients with PSVD, particularly among those with a history of EGVB. TIPS placement may potentially enhance the muscle mass of PSVD patients. Importantly, sarcopenia appears to negatively impact clinical outcomes in PSVD patients undergoing endoscopic therapy for variceal bleeding.