Serum Myostatin Predicts the Risk of Hepatocellular Carcinoma in Patients with Alcoholic Cirrhosis: A Multicenter Study

Abstract Background Sarcopenia, characterized by age-related muscle loss, is common in patients with liver cirrhosis (LC). LC's metabolic burdens include protein and energy metabolism disorders, potentially leading to secondary sarcopenia. This study explores the prognostic role of serum myostatin levels in predicting hepatocellular carcinoma (HCC) development in individuals with alcoholic liver cirrhosis (ALC). Aim of the Work The aim of this study is to investigate the prognostic performance of serum myostatin levels on HCC development in patients with alcoholic liver cirrhosis (ALC). Patients and Methods We conducted a retrospective observational study using stored serum samples from a single center. We analyzed serum myostatin levels and assessed their correlation with HCC development in ALC patients. Results Serum myostatin levels were significantly higher in patients with HCC compared to those without (p < 0.001). Our analysis revealed a significant correlation between baseline myostatin levels and various clinical parameters, including gender (p < 0.0001), serum albumin (p < 0.0001), prothrombin time (PT) (p = 0.0188), serum ammonia (p < 0.002), and Child Pugh score (p < 0.0001). Multivariate Cox analyses identified age, gender, body mass index (BMI), platelet counts, and serum myostatin levels as independent risk factors for HCC development (p < 0.001). Conclusion Elevated serum myostatin levels are associated with an increased risk of HCC development in ALC patients. Myostatin may play a role in hepatic fibrogenesis and carcinogenesis, making it a potential prognostic marker for HCC in this population. A serum myostatin level cutoff of 3.9 ng/ml exhibited high sensitivity (92.3%) and specificity (82.35%) for detecting HCC. These findings suggest that serum myostatin levels could serve as a valuable tool for identifying high-risk ALC patients who may benefit from closer monitoring for HCC development.