Сorrelation between somatotypes and body fat changes in patients with liver cirrhosis

Objective. To evaluate the nature of changes in body fat composition in cirrhotic patients of various somatotypes.

Materials and methods. The data of 46 cirrhotic patients and 20 volunteers were analyzed. Anthropometric examination was carried out according to methodological requirements with assessing the body composition of patients by means of bioimpedance analysis using ABC-01 Medass system (NTC Medass, Russia). Somatotypes were determined according to the Heath–Carter method. Ranks for the somatotype scale were assigned as endomorphy scores increased. Spearman rank correlation was used to identify the relationships between the variables. Differences between continuous variables were determined using the Mann–Whitney test. Statistical analysis was performed using Statistica 10 (StatSoft Inc., USA).

Results. Child–Pugh scores for men and women were 9 (7.3–11.8) and 7 (6–9), respectively. Body fat percentage (BFP) of cirrhotic patients accounted for 27.7% (23.3–33) in men and 41.2% (33.6–46.3) in women. In healthy volunteers, the BFP was 21.9% (13.9–26.3) in men and 32.7% (29.3–41.6) in women. Assessment of the relationships between liver cirrhosis severity and body fat was characterized by a correlation coefficient of r = -0.47528 (p-value < 0.001). A significant negative correlation was determined between the liver cirrhosis severity according to Child–Pugh scores and somatotypes (r = -0.30536, p = 0.03905).

Conclusion. The results of this study emphasize the correlation between somatotypes and changes in BFP in patients with liver cirrhosis of various degrees of severity. The sum of Child–Pugh scores and endomorphic indicators demonstrated the inverse relationship, which must be taken into account when developing mathematical models of the personalized prognosis of liver cirrhosis.

1. Asrani SK, Devarbhavi H, Eaton J, Kamath PS. Burden of liver diseases in the world. J Hepatol. 2019;70(1):151–71. doi: 10.1016/j.jhep.2018.09.014

2. Maslennikov RV, Tatarkina MA, Mayevskaya MV, Pavlov CS, Zharkova MS, Ivashkin VT. The impact of bacterial overgrowth syndrome and systemic inflammation on abdominal hemodynamics in liver cirrhosis. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2017;27(4):52–61 (In Russ.). doi: 10.22416/1382-4376-2017-27-4-52-61

3. Maslennikov RV, Driga AA, Ivashkin KV, Zharkova MS, Mayevskaya MV, Pavlov CS, Arslanyan MG, Musina NB, Berezina YN, Ivashkin VT. Small intestinal bacterial overgrowth syndrome and systemic inflammation in pathogenesis of hemodynamic changes at liver cirrhosis. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2017;27(3):45–56 (In Russ.). doi:10.22416/1382-4376-2017-27-3-45-56

4. GBD 2017 Cirrhosis Collaborators. The global, regional, and national burden of cirrhosis by cause in 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet Gastroenterol Hepatol. 2020;5(3):245–66. doi: 10.1016/S2468-1253(19)30349-8

5. Ebadi M, Bhanji RA, Mazurak VC, Montano-Loza AJ. Sarcopenia in cirrhosis: from pathogenesis to interventions. J Gastroenterol. 2019;54(10):845–859. doi: 10.1007/s00535-019-01605-6

6. Montano-Loza AJ, Angulo P, Meza-Junco J, Prado CM, Sawyer MB, Beaumont C, Esfandiari N, Ma M, Baracos VE. Sarcopenic obesity and myosteatosis are associated with higher mortality in patients with cirrhosis. J Cachexia Sarcopenia Muscle. 2016;7(2):126–35. doi: 10.1002/jcsm.12039

7. Kobayashi A, Kaido T, Hamaguchi Y, Okumura S, Shirai H, Yao S, Kamo N, Yagi S, Taura K, Okajima H, Uemoto S. Impact of Sarcopenic Obesity on Outcomes in Patients Undergoing Hepatectomy for Hepatocellular Carcinoma. Ann Surg. 2019;269(5):924–31. doi: 10.1097/SLA.0000000000002555

8. Benjamin J, Shasthry V, Kaal CR, Anand L, Bhardwaj A, Pandit V, Arora A, Rajesh S, Pamecha V, Jain V, Kumar G, Loria A, Puri P, Joshi YK, Sarin SK. Characterization of body composition and definition of sarcopenia in patients with alcoholic cirrhosis: A computed tomography based study. Liver Int. 2017;37(11):1668– 74. doi: 10.1111/liv.13509

9. Ginès P, Krag A, Abraldes JG, Solà E, Fabrellas N, Kamath PS. Liver cirrhosis. Lancet. 2021;398(10308):1359–76. doi: 10.1016/S0140-6736(21)01374-X

10. Nikolaev DV, Smirnov AV, Bobrinskaya IG, Rudnev SG. Bioimpedance analysis of human body composition. Moscow: Nauka; 2009 (In Russ.). https://medass.su/wp-content/uploads/2017/03/book2009.pdf

11. Ebadi M, Bhanji RA, Tandon P, Mazurak V, Baracos VE, Montano-Loza AJ. Review article: prognostic significance of body composition abnormalities in patients with cirrhosis. Aliment Pharmacol Ther. 2020;52(4):600–18. doi: 10.1111/apt.15927

12. Cichoż-Lach H, Michalak A. A Comprehensive Review of Bioelectrical Impedance Analysis and Other Methods in the Assessment of Nutritional Status in Patients with Liver Cirrhosis. Gastroenterol Res Pract. 2017;2017:6765856. doi: 10.1155/2017/6765856

13. Ennaifer R, Cheikh M, Romdhane H, Sabbagh S, Ben Nejma H, Bougassas W, Bel Hadj N. Does protein energy malnutrition affect the outcome in Tunisian cirrhotic patients? Tunis Med. 2016;94(2):172–6. PMID: 27532543

14. Kiseleva YaV, Zharikov YuO, Maslennikov RV, Pavlov ChS, Nikolenko VN. Molecular aspects of alcoholic liver fibrosis progression. Medical News of the North Caucasus. 2020;15(2):288–93 (In Russ.). doi: 10.14300/mnnc.2020.15070

15. Kalaitzakis E. Gastrointestinal dysfunction in liver cirrhosis. World J Gastroenterol. 2014;20(40):14686-95. doi: 10.3748/wjg.v20.i40.14686.