Association of Omega-3 Polyunsaturated Fatty Acids with Sarcopenia in Liver Cirrhosis Patients with Hepatocellular Carcinoma

Background and Aims:Sarcopenia is associated with the prognosis of patients with liver cirrhosis and hepatocellular carcinoma(HCC).Given their diverse physiological activities,we hypothesized that plasma fatty acids might influence the progression of sarcopenia.This study aimed to clarify the association between fatty acids and sarcopenia in cirrhotic patients with HCC.Methods:In this singlecenter retrospective study,we registered 516 cases and analyzed 414 cases of liver cirrhosis and HCC.The skeletal muscle mass index was measured using a transverse computed tomography scan image at the third lumbar vertebra.The cutoff value for sarcopenia followed the criteria set by the Japan Society of Hepatology.Fatty acid concentrations were measured by gas chromatography.Results:Fatty acid levels,particularly omega-3(n-3)polyunsaturated fatty acid(PUFA),were lower in patients with poor liver function(Child-Pugh grade B/C)and were negatively correlated with the albumin-bilirubin score(p<0.0001).The prognosis of HCC patients with low PUFA levels was significantly worse.Among the different fatty acid fractions,only n-3 PUFAs significantly correlated with skeletal muscle mass index(p=0.0026).In the multivariate analysis,the n-3 PUFA level was an independent variable associated with sarcopenia(p=0.0006).Conclusions:A low level of n-3 PUFAs was associated with sarcopenia in patients with liver cirrhosis and HCC.