Impact of Changes in Body Composition after Transjugular Intrahepatic Portosystemic Shunt Creation on Morbidity and Mortality: A Systematic Review.

IF 1.3 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Techniques in Vascular and Interventional Radiology Pub Date : 2025-09-01 Epub Date: 2025-07-09 DOI:10.1016/j.tvir.2025.101060

Takeshi Suzuki, Khashayar Farsad

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引用次数: 0

Abstract

Changes in body composition, including the reversal of sarcopenia, after transjugular intrahepatic portosystemic shunt (TIPS) creation have been reported to impact morbidity and mortality. This systematic review aims to identify changes in body composition that could serve as markers for post-TIPS outcomes in patients with cirrhosis. Electronic databases including Ovid Medline, Embase, and Central Register of Controlled Trials were searched from inception to February 5, 2025 to analyze the impact of changes in body composition on post-TIPS outcomes in patients with cirrhosis. A total of 16 studies were included in the review. Most studies reported that post-TIPS skeletal muscle gain often caused a reversal of sarcopenia (18%-66%) and contributed to improvements in morbidity and mortality. In particular, patients with pre-TIPS sarcopenia received the greatest benefit. Skeletal muscle index showed the most substantial increase within 6 months after TIPS creation, while the psoas muscle index or the transverse psoas muscle thickness/ height increased as early as 1-3 months after TIPS creation. Reversal of sarcopenia after TIPS creation may contribute to improvements in morbidity and mortality in cirrhosis. Skeletal muscle tends to show the most substantial increase within 6 months after TIPS creation, with the psoas muscle index observed as an early imaging biomarker. Further research is needed to identify the underlying physiologic mechanisms responsible for these observed body composition changes and to prospectively assess the impact on clinical outcomes.

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经颈静脉肝内门静脉系统分流术后机体成分变化对发病率和死亡率的影响：一项系统综述。

经颈静脉肝内门静脉系统分流术（TIPS）产生后，身体成分的改变，包括肌肉减少症的逆转，已被报道影响发病率和死亡率。本系统综述旨在确定身体成分的变化，这些变化可以作为肝硬化患者tips后预后的标志物。从开始到2025年2月5日，检索了包括Ovid Medline、Embase和Central Register of Controlled Trials在内的电子数据库，以分析身体成分变化对肝硬化患者tips后结局的影响。本综述共纳入了16项研究。大多数研究报道，tips术后骨骼肌增加通常会导致肌肉减少症的逆转（18%-66%），并有助于改善发病率和死亡率。特别是，tips前肌肉减少症患者获益最大。在TIPS制作后6个月内，骨骼肌指数的增加最为明显，而腰肌指数或腰肌横肌厚度/高度在TIPS制作后1-3个月内增加。TIPS产生后肌肉减少症的逆转可能有助于改善肝硬化的发病率和死亡率。在TIPS形成后的6个月内，骨骼肌往往表现出最显著的增长，腰肌指数被观察为早期成像生物标志物。需要进一步的研究来确定导致这些观察到的身体成分变化的潜在生理机制，并前瞻性地评估对临床结果的影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Techniques in Vascular and Interventional Radiology RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-

CiteScore

2.70

自引率

0.00%

发文量

期刊介绍： Interventional radiology is an area of clinical diagnosis and management that is highly technique-oriented. Therefore, the format of this quarterly journal, which combines the visual impact of an atlas with the currency of a journal, lends itself perfectly to presenting the topics. Each issue is guest edited by a leader in the field and is focused on a single clinical technique or problem. The presentation is enhanced by superb illustrations and descriptive narrative outlining the steps of a particular procedure. Interventional radiologists, neuroradiologists, vascular surgeons and neurosurgeons will find this a useful addition to the clinical literature.