Prevalence of sarcopenia in patients with surgical obstructive jaundice and its impact on clinical outcomes

doi:10.4240/wjgs.v17.i8.107209

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Aug 27, 2025 (publication date) through Aug 25, 2025

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World Journal of Gastrointestinal Surgery

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1948-9366

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Observational Study

World J Gastrointest Surg. Aug 27, 2025; 17(8): 107209
Published online Aug 27, 2025. doi: 10.4240/wjgs.v17.i8.107209

Table 1 Distribution of diseases in jaundice and non-jaundice patients, mean ± SD/n (%)

Parameters	Jaundice (n = 383)	Non-jaundice (n = 1325)	t/χ²	P value
Age	62.04 ± 13.18	59.49 ± 13.59	-3.220	0.001
Sex			30.766	< 0.001
Male	248 (64.7)	645 (48.7)
Female	135 (35.3)	680 (51.3)
Disease			30.551	< 0.001
Benign diseases	196 (51.2)	883 (66.6)
Biliary tract disease	126 (32.9)	692 (52.2)
Liver disease	42 (11.0)	54 (4.1)
Pancreatitis	6 (1.6)	89 (6.7)
Other benign diseases	22 (5.7)	48 (3.6)
Malignant diseases	187 (48.8)	442 (33.4)
Biliary tract tumors	88 (23.0)	56 (4.2)
Liver tumors	49 (12.8)	201 (15.2)
Pancreatic tumors	26 (6.8)	57 (4.3)
Others malignant diseases	24 (6.2)	128 (9.7)
Nutritional risks	181 (47.3)	369 (27.8)	51.269	< 0.001
BMI	23.89 ± 4.17	24.77 ± 9.86	-3.163	0.002
PhA	5.12 ± 1.14	5.37 ± 0.99	-3.974	< 0.001
Hb	124.30 ± 24.07	129.62 ± 20.42	-4.572	< 0.001
LY	1.21 ± 0.67	1.65 ± 1.61	-10.593	< 0.001
Alb	36.38 ± 6.38	39.64 ± 5.73	-9.918	< 0.001
PNI	42.45 ± 7.28	47.91 ± 9.85	-12.224	< 0.001

BMI: Body mass index; PhA: Phase angle; Hb: Hemoglobin; LY: Lymphocyte count; Alb: Albumin; PNI: Prognostic nutritional index.

Table 2 Comparison of sarcopenia and diagnostic indexes in patients with jaundice and non-jaundice, n (%)

Parameters	Jaundice (n = 383)	Non-jaundice (n = 1325)	t/χ²	P value
Slow pace	134 (35.0)	293 (22.1)	26.262	< 0.001
Decreased grip strength	164 (42.8)	361 (27.2)	33.852	< 0.001
Lower ASMI	145 (37.9)	411 (31.0)	6.331	0.012
SC	108 (28.2)	250 (18.9)	15.613	< 0.001

ASMI: Appendicular skeletal muscle index; SC: Sarcopenia.

Table 3 Incidence of sarcopenia in obstructive jaundice by etiology, mean ± SD/n (%)

Parameters	Bile duct diseases (n = 241)	Pancreatic diseases (n = 32)	Liver diseases (n = 91)	Other diseases (n = 46)	F/χ²	P value
Age	63.89 ± 13.09	63.78 ± 10.73	55.98 ± 12.85^a	63.74 ± 13.35^c	25.660	< 0.001
Sex					7.730
Male	137 (64.0)	15 (46.9)	67 (73.6)	29 (63.0)
Female	77 (36.0)	17 (53.1)	24 (26.4)	17 (37.0)
Slow pace	87 (40.7)	14 (43.8)	15 (16.5)^d^,^e^,^f	18 (39.1)	18.147	< 0.001
Decreased grip strength	107 (50.0)	13 (40.6)	22 (24.2)^j^,^k	22 (47.8)	17.959	< 0.001
Lower ASMI	88 (41.1)	19 (59.4)	18 (19.8)^g^,^h^,ⁱ	20 (43.5)	20.525	< 0.001
SC	71 (33.2)	11 (34.4)	9 (9.9)^a^,^b^,^c	17 (37.0)	20.031	< 0.001

^aP < 0.05. The proportion of sarcopenia with liver diseases was lower than in patients with bile duct diseases, pancreatic diseases, and other diseases.

^bP < 0.05. The proportion of sarcopenia with liver diseases was lower than in patients with bile duct diseases, pancreatic diseases, and other diseases.

^cP < 0.05. The proportion of sarcopenia with liver diseases was lower than in patients with bile duct diseases, pancreatic diseases, and other diseases.

^dP < 0.05. The proportion of patients with liver disease who exhibited slow walking speed and lower ASMI values was lower than that in patients with bile duct diseases, pancreatic diseases, and other diseases.

^eP < 0.05. The proportion of patients with liver disease who exhibited slow walking speed and lower ASMI values was lower than that in patients with bile duct diseases, pancreatic diseases, and other diseases.

^fP < 0.05. The proportion of patients with liver disease who exhibited slow walking speed and lower ASMI values was lower than that in patients with bile duct diseases, pancreatic diseases, and other diseases.

^gP < 0.05. The proportion of patients with liver disease who exhibited slow walking speed and lower ASMI values was lower than that in patients with bile duct diseases, pancreatic diseases, and other diseases.

^hP < 0.05. The proportion of patients with liver disease who exhibited slow walking speed and lower ASMI values was lower than that in patients with bile duct diseases, pancreatic diseases, and other diseases.

ⁱP < 0.05. The proportion of patients with liver disease who exhibited slow walking speed and lower ASMI values was lower than that in patients with bile duct diseases, pancreatic diseases, and other diseases.

^jP < 0.05. The proportion of patients with liver disease who exhibited decreased grip strength was lower than in patients with bile duct diseases and other diseases.

^kP < 0.05. The proportion of patients with liver disease who exhibited decreased grip strength was lower than in patients with bile duct diseases and other diseases.

ASMI: Appendicular skeletal muscle index; SC: Sarcopenia.

Table 4 Comparison of sarcopenia and diagnostic indicators in benign and malignant jaundice patients, mean ± SD/n (%)

Parameters	Malignant jaundice (n = 187)	Benign jaundice (n = 196)	t/χ²	P value
Age	65.54 ± 10.11	58.69 ± 14.84	-4.633	< 0.001
Sex			0.389
Male	124 (66.3)	124 (63.3)
Female	63 (33.7)	72 (36.7)
Slow pace	82 (43.9)	52 (26.5)	12.620	< 0.001
Decreased grip strength	92 (49.2)	72 (36.7)	6.071	0.014
Lower ASMI	83 (44.4)	62 (31.6)	6.615	0.010
SC	62 (33.2)	46 (23.5)	4.434	0.035

ASMI: Appendicular skeletal muscle index; SC: Sarcopenia.

Table 5 Comparison of sarcopenia incidence according to different degrees of obstructive jaundice, mean ± SD/n (%)

Parameters	Mild (n = 167)	Moderate (n = 88)	Severe (n = 89)	Extremely severe (n = 39)	F/χ²	P value
Age	60.16 ± 13.67	59.61 ± 12.43	65.96 ± 12.47^a^,^b	66.08 ± 11.26a,b	22.192	< 0.001
Sex					5.940
Male	119 (71.3)	51 (58.0)	53 (59.6)	25 (64.1)
Female	48 (28.7)	37 (42.0)	36 (40.4)	14 (35.9)
Slow pace	46 (27.5)	23 (26.1)	41 (46.1)^b^,^c	24 (61.5)^g^,^h	23.988	<0.001
Decreased grip strength	66 (39.5)	27 (30.7)	49 (55.1)^d	22 (56.4)ⁱ	14.384	0.002
Lower ASMI	55 (32.9)	26 (29.5)	46 (51.7)^e^,^f	18 (46.2)	12.647	0.005
SC	38 (22.8)	19 (21.6)	35 (39.3)^a	16 (41.0)	12.954	0.005

^aP < 0.05. The incidence of sarcopenia was higher in the severe jaundice group than in the mild jaundice group.

^bP < 0.05. Severe jaundice exhibited slow walking was higher than those in the mild and moderate jaundice groups.

^cP < 0.05. Severe jaundice exhibited slow walking was higher than those in the mild and moderate jaundice groups.

^dP < 0.05. Patients with severe jaundice had decreased grip strength was higher than in the moderate jaundice group.

^eP < 0.05. Severe jaundice had lower ASMI value was higher than in the mild and moderate jaundice groups.

^fP < 0.05. Severe jaundice had lower ASMI value was higher than in the mild and moderate jaundice groups.

^gP < 0.05. Patients with extremely severe jaundice have a higher rate of walking slowly than those with mild and moderate jaundice.

^hP < 0.05. Patients with extremely severe jaundice have a higher rate of walking slowly than those with mild and moderate jaundice.

ⁱP < 0.05. Patients with extremely severe jaundice had decreased grip strength was higher than that seen in the moderate jaundice group.

ASMI: Appendicular skeletal muscle index; SC: Sarcopenia.

Table 6 Correlation analysis between total bilirubin level and each index

Parameters	Lower ASMI	Decreased grip strength	SC	Slow pace	PhA	Nutritional risks
r	-0.125	-0.152	0.126	0.202	-0.178	0.214
P value	0.014	0.003	0.014	< 0.001	< 0.001	< 0.001

ASMI: Appendicular skeletal muscle index; SC: Sarcopenia; PhA: Phase angle.

Table 7 Logistic regression analysis of obstructive jaundice, sarcopenia, and related indicators

Parameters	Single-factor regression analysis		Multivariate regression analysis
Parameters	OR (95%CI)	P value	OR (95%CI)	P value
Slow pace	1.895 (1.481, 2.426)	< 0.001	1.627 (1.185, 2.234)	0.003
Decreased grip strength	1.950 (1.540, 2.469)	< 0.001	1.669 (1.212, 2.300)	0.002
Lower ASMI	1.355 (1.069, 1.717)	0.012	1.035 (0.677, 1.582)
SC	1.689 (1.300, 2.194)	< 0.001	1.014 (0.979, 1.050)

ASMI: Appendicular skeletal muscle index; SC: Sarcopenia.

Table 8 Comparison between sarcopenia and non-sarcopenia patients with obstructive jaundice, mean ± SD/n (%)

Parameters	SC (n = 108)	Non-SC (n = 275)	t/χ²	P value
Age	70.44 ± 11.20	58.71 ± 12.42	-8.865	< 0.001
Sex			3.555
Male	62 (57.4)	186 (67.6)
Female	46 (42.6)	89 (32.4)
Malignant diseases	62 (57.4)	125 (45.5)	4.434	0.035
Nutritional risks	73 (67.6)	108 (39.3)	24.952	< 0.001
BMI	20.83 ± 2.72	25.11 ± 4.02	-9.712	< 0.001
PhA	4.27 ± 0.84	5.44 ± 1.07	-9.549	< 0.001
Hb	115.76 ± 20.69	127.69 ± 24.50	-4.588	< 0.001
LY	1.12 ± 0.57	1.25 ± 0.70	-1.520
Alb	34.85 ± 6.21	36.99 ± 6.36	-3.349	0.001
PNI	40.45 ± 7.14	43.24 ± 7.19	-3.700	< 0.001

BMI: Body mass index; PhA: Phase angle; Hb: Hemoglobin; LY: Lymphocyte count; Alb: Albumin; PNI: Prognostic nutritional index; SC: Sarcopenia.

Table 9 Logistic regression analysis of sarcopenia in patients with obstructive jaundice

Parameters	Single-factor regression analysis		Multivariate regression analysis
Parameters	OR (95%CI)	P value	OR (95%CI)	P value
Age	1.105 (1.076, 1.135)	< 0.001	1.077 (1.040, 1.114)	< 0.001
Malignant diseases	1.617 (1.032, 2.535)	0.036	0.951 (0.463, 1.565)
Nutritional risks	3.225 (2.016, 5.160)	< 0.001	1.682 (0.906, 3.124)
BMI	0.664 (0.602, 0.734)	< 0.001	0.703 (0.630, 0.784)	< 0.001
PhA	0.311 (0.235, 0.413)	< 0.001	0.706 (0.474, 1.050)
Hb	0.979 (0.969, 0.988)	< 0.001	0.998 (0.983, 1.014)
Alb	0.946 (0.912, 0.982)	0.003	0.994 (0.894, 1.105)
PNI	0.952 (0.923, 0.983)	0.002	1.003 (0.918, 1.095)

BMI: Body mass index; PhA: Phase angle; Hb: Hemoglobin; LY: Lymphocyte count; Alb: Albumin; PNI: Prognostic nutritional index.

Table 10 Logistic regression analysis of slow walking speed in patients with obstructive jaundice

Parameters	Single-factor regression analysis		Multivariate regression analysis
Parameters	OR (95%CI)	P value	OR (95%CI)	P value
Age	1.101 (1.074, 1.129)	< 0.001	1.066 (1.035, 1.098)	< 0.001
Malignant diseases	2.163 (1.408, 3.321)	< 0.001	1.674 (1.005, 2.788)	0.048
Nutritional risks	2.389 (1.554, 3.674)	< 0.001	1.186 (0.710, 1.979)
BMI	0.907 (0.858, 0.959)	0.001	0.990 (0.926, 1.058)
PhA	0.388 (0.304, 0.496)	< 0.001	0.591 (0.419, 0.833)	0.003
Hb	0.982 (0.973, 0.992)	< 0.001	1.000 (0.987, 1.012)
LY	0.879 (0.634, 1.218)	0.438
Alb	0.947 (0.914, 0.980)	0.002	0.975 (0.894, 1.063)
PNI	0.958 (0.930, 0.987)	0.005	1.013 (0.942, 1.090)

BMI: Body mass index; PhA: Phase angle; Hb: Hemoglobin; LY: Lymphocyte count; Alb: Albumin; PNI: Prognostic nutritional index.

Table 11 Logistic regression analysis of reduced grip strength in patients with obstructive jaundice

Parameters	Single-factor regression analysis		Multivariate regression analysis
Parameters	OR (95%CI)	P value	OR (95%CI)	P value
Age	1.104 (1.078, 1.131)	< 0.001	1.062 (1.032, 1.093)	< 0.001
Malignant diseases	1.668 (1.109, 2.508)	0.014	0.988 (0.586, 1.667)
Nutritional risks	3.052 (2.005, 4.648)	< 0.001	1.566 (0.932, 2.631)	0.090
BMI	0.837 (0.788, 0.889)	< 0.001	0.902 (0.840, 0.969)	0.005
PhA	0.291 (0.221, 0.383)	< 0.001	0.547 (0.383, 0.781)	0.001
Hb	0.978 (0.969, 0.987)	< 0.001	1.001 (0.988, 1.013)
LY	0.778 (0.565, 1.071)	0.124
Alb	0.923 (0.891, 0.956)	< 0.001	0.970 (0.888, 1.059)
PNI	0.938 (0.911, 0.967)	< 0.001	0.992 (0.921, 1.069)

BMI: Body mass index; PhA: Phase angle; Hb: Hemoglobin; LY: Lymphocyte count; Alb: Albumin; PNI: Prognostic nutritional index.

Table 12 Logistic regression analysis of appendicular skeletal muscle index reductions in patients with obstructive jaundice

Parameters	Single-factor regression analysis		Multivariate regression analysis
Parameters	OR (95%CI)	P value	OR (95%CI)	P value
Age	1.070 (1.048, 1.092)	< 0.001	1.048 (1.017, 1.079)	0.002
Malignant diseases	1.725 (1.137, 2.617)	0.010	0.916 (0.517, 1.623)
Nutritional risks	2.771 (1.809, 4.246)	< 0.001	1.765 (0.990, 3.147)	0.054
BMI	0.632 (0.572, 0.698)	< 0.001	0.658 (0.591, 0.733)	< 0.001
PhA	0.386 (0.303, 0.492)	< 0.001	0.763 (0.533, 1.091)
Hb	0.983 (0.974, 0.992)	< 0.001	1.005 (0.992, 1.019)
LY	0.670 (0.473, 0.948)	0.024	0.858 (0.561, 1.314)
Alb	0.983 (0.951, 1.016)	0.302
PNI	0.976 (0.949, 1.004)	0.089

BMI: Body mass index; PhA: Phase angle; Hb: Hemoglobin; LY: Lymphocyte count; Alb: Albumin; PNI: Prognostic nutritional index.

Table 13 Influence of related sarcopenia on postoperative clinical outcomes in patients with obstructive jaundice, mean ± SD/n (%)

Parameters	SC (n = 82)	Non-SC (n = 181)	t/χ²	P value
Hospitalization expenses	36917.59 ± 21297.73	34662.17 ± 22760.28	-0.676
Postoperative hospital stay	11.33 ± 6.75	9.19 ± 7.32	-2.431	0.016
Total hospital stay	17.10 ± 7.69	15.98 ± 8.55	-1.887	0.032
Occurrence of postoperative complications	38 (46.3)	60 (33.1)	4.201	0.040
Clavien-Dindo Classification
Grade I, II	35 (42.7)	50 (17.6)	5.850	0.016
Grade Ⅲ and above	3 (3.6)	10 (5.5)	0.418

SC: Sarcopenia.

Citation: Zhang RN, Cui JY, Zhao ZH, Li YT, Liu ZW, Zhang JY, Wei Q, Lu YM, Chen QP. Prevalence of sarcopenia in patients with surgical obstructive jaundice and its impact on clinical outcomes. World J Gastrointest Surg 2025; 17(8): 107209
URL: https://www.wjgnet.com/1948-9366/full/v17/i8/107209.htm
DOI: https://dx.doi.org/10.4240/wjgs.v17.i8.107209