Visceral fat is associated with cirrhotic portal vein thrombosis

Expert Rev Gastroenterol Hepatol. 2019 Oct;13(10):1017-1022. doi: 10.1080/17474124.2019.1651644. Epub 2019 Aug 8.

Abstract

Background: Central obesity, due to the accumulation of visceral fat(VF), is one of the main risk factors for venous thrombosis. The aim of this study was to determine if VF may be a risk factor for development of portal vein thrombosis(PVT) in cirrhotic patients.Methods: A total of 214 cirrhotic patients at the outpatient clinic were consecutively included, undergoing an anthropometric evaluation, blood tests and bioimpedance.Results: Median MELDscore was10. Prior liver decompensation occurred in 44.9% of patients and 35.6% of patients had large esophageal varices. Mean body mass index was 28.7 Kg/m2 (39.3%were obese) and mean waist circumference(WC) was 103.8 cm. A 7.5% of patients had PVT at the time of inclusion. PVT was more frequent in males(93.8 vs. 68.2%, p = 0.03). Patients with PVT had a higher WC(111.9 vs. 103.2 cm, p = 0.02) and VF (17.1 vs. 14.5, p = 0.04). PVT was also more frequent in patients with prior decompensation (81.3 vs. 41.9%, p < 0.01) and with large esophageal varices(62.5 vs. 33.3%, p = 0.02). In the simplified multivariate analysis, PVT was independently associated with the presence of portal hypertension(OR 13, 95%CI 1.6-108.3, p = 0.02) and VF(OR 1.2, 95%CI 1.03-1.3, p = 0.01).Conclusion: VF was independently associated with PVT in cirrhotic patients. VF may be more reliable than conventional anthropometric measurements for cirrhotic patients.

Keywords: Portal vein thrombosis; bioelectrical impedance analysis; liver cirrhosis; visceral fat.

MeSH terms

  • Adiposity*
  • Aged
  • Electric Impedance
  • Female
  • Humans
  • Hypertension, Portal / epidemiology
  • Intra-Abdominal Fat / physiopathology*
  • Liver Cirrhosis / diagnosis
  • Liver Cirrhosis / epidemiology*
  • Male
  • Middle Aged
  • Obesity, Abdominal / diagnosis
  • Obesity, Abdominal / epidemiology*
  • Obesity, Abdominal / physiopathology
  • Portal Vein* / diagnostic imaging
  • Prevalence
  • Prognosis
  • Risk Assessment
  • Risk Factors
  • Spain / epidemiology
  • Venous Thrombosis / diagnostic imaging
  • Venous Thrombosis / epidemiology*
  • Waist Circumference