Abstract: Objective The aim of this study was to investigate the prevalence of sarcopenia (Sp) in patients with hepatitis B-induced liver cirrhosis(LC) and its impact on occurrence of hepatic encephalopathy (HE) after transjugular intrahepatic portosystemic shunt (TIPS). Methods This retrospective study included 128 patients with hepatitis B-induced LC who underwent TIPS at the First Affiliated Hospital, University of Science and Technology of China between March 2019 and December 2022. Sp was diagnosed by measurement and calculation of the ratio of the maximal transverse diameter of the right psoas muscle at the umbilical level on CT images to height (TPMT/H), with a cutoff value of ≤16.8 mm/m. Risk factors for HE were analyzed by using Cox regression models. Patients were followed-up until March 2024,with a median follow-up period of 39(15,60) months. Results Of the 128 patients, Sp was found in 54 cases (42.2%); age and blood ammonia levels in patients with Sp were (56.3±11.8) yr and (56.3±22.2)μmol/L, both significantly older or higher than [(50.2±10.6) yr and (48.6±20.4)μmol/L, respectively, P<0.05], while TPMT/H ratio and serum albumin levels were (14.2±1.9)mm/m and (30.9±5.3)g/L, both significantly lower than [(19.9±2.3)mm/m and (33.1±5.6)g/L, respectively, P<0.05] in those without Sp; by end of 6-month of follow-up, the incidence of HE after TIPS in Sp group was 53.7%, much higher than 16.2% (P<0.001) in patients without Sp; patients with HE after TIPS had significantly older age, high blood ammonia levels, Child-Pugh scores, MELD scores and lower TPMT/H ratio compared to those without HE (P<0.05); Cox univariate analysis identified these factors as significantly associated with HE occurrence (P<0.05), and multivariate Cox analysis revealed only TPMT/H as the independent predictor for post-TIPS HE (HR=0.779,95% CI: 0.708-0.858, P<0.001). Conclusion Sp is highly prevalent among patients with hepatitis B-induced LC, which might greatly increases the risk of HE after TIPS.

Key words: Liver Cirrhosis, Sarcopenia, Transjugular intrahepatic portosystemic shunt, Hepatic encephalopathy