Widespread Muscle Loss in Autoimmune Hepatitis and Its Adverse Prognostic Impact.
Hepatol Res 2026 May 09. [Online ahead of print]

Abstract

AIM

Reports on the prevalence of sarcopenia in patients with autoimmune hepatitis (AIH) are limited, and its association with prognosis remains unclear. Therefore, we evaluated sarcopenia-related factors and their prognostic impact associated with AIH and compared these findings with those of patients with primary biliary cholangitis (PBC).

METHODS

We retrospectively analyzed 161 patients with AIH or PBC who were followed up at our institution and underwent computed tomography (CT) between January 2004 and February 2025. Data on sex, age, comorbidities, sarcopenia-related factors, treatment, cirrhosis, and clinical outcomes were reviewed. Patients with the PBC-AIH overlap syndrome or concomitant malignancy were excluded. Sarcopenia was assessed using the psoas muscle mass index (PMI) on CT.

RESULTS

A total of 67 and 94 patients had AIH and PBC, respectively. The two groups showed no significant differences in the proportion of males, 5-year survival, or the prevalence of cirrhosis at diagnosis and other autoimmune diseases. A low PMI was observed in 32.8% and 17.0% of patients with AIH and PBC, respectively, and was significantly more frequent in patients with AIH (p = 0.02). Among patients with AIH, those with a low PMI had significantly poorer survival than those without it. Factors associated with poor prognosis in patients with AIH included a higher model for the end-stage liver disease (MELD) score, low PMI, and the presence of cirrhosis.

CONCLUSION

CT-based assessment of PMI in patients with AIH may provide supplementary prognostic information for risk stratification at diagnosis.

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Authors+Show Affiliations

Tadokoro T0000-0001-9975-386XDepartment of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Kagawa, Japan.
Morishita A0000-0002-0760-3045Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Kagawa, Japan.
Manabe TDepartment of Gastroenterology and Hepatology, Takamatsu Red Cross Hospital, Takamatsu, Japan.
Tai HDepartment of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Kagawa, Japan.
Yano RDepartment of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Kagawa, Japan.
Nakahara MDepartment of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Kagawa, Japan.
Oura K0000-0002-9531-7240Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Kagawa, Japan.
Fujita K0000-0001-9390-7565Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Kagawa, Japan.
Mimura SDepartment of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Kagawa, Japan.
Tani JDepartment of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Kagawa, Japan.
Kobara HDepartment of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Kagawa, Japan.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

42104812