Diabetes as a Risk Factor for Sarcopenia in Patients with MASH-Related Cirrhosis
Shinya Sato1, Hiroaki Takaya1, Tadashi Namisaki1
1Department of Gastroenterology, Nara Medical University, Kashihara 634-8521, Japan.
Journal of Clinical Medicine
|December 30, 2025
Summary
Diabetes mellitus worsens outcomes in metabolic dysfunction-associated steatohepatitis (MASH) cirrhosis, increasing sarcopenia and reducing survival. This highlights diabetes as a key prognostic marker for high-risk MASH patients.
Area of Science:
- Hepatology
- Metabolic Diseases
- Clinical Outcomes Research
Background:
- Metabolic dysfunction-associated steatohepatitis (MASH) is a primary driver of cirrhosis.
- The prognostic significance of diabetes mellitus (DM) in MASH-associated cirrhosis requires further elucidation.
Purpose of the Study:
- To compare clinical outcomes, including mortality, liver-related events (LREs), and sarcopenia, between cirrhotic patients with and without DM.
Main Methods:
- Patients with MASH-related cirrhosis were categorized into DM (DM-MASH) and non-DM (non-DM MASH) groups.
- Survival, LREs, and sarcopenia prevalence were analyzed using Kaplan-Meier analysis, log-rank tests, and Fisher's exact test.
- Logistic regression identified risk factors for sarcopenia.
Main Results:
- DM-MASH patients exhibited significantly shorter median survival (1523 vs. 2618 days; p < 0.05).
- The incidence of LREs was higher in the DM-MASH group.
- Sarcopenia prevalence was significantly greater in DM-MASH patients (36.1% vs. 19.7%; p < 0.05), with DM being an independent predictor.
Conclusions:
- Diabetes mellitus is linked to poorer outcomes in MASH-driven cirrhosis.
- DM is associated with increased sarcopenia and reduced survival in MASH cirrhosis.
- DM may serve as a prognostic indicator for high-risk MASH cirrhosis patients.
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