Excluded studies and the reasons for exclusion.

<div><p>Objectives</p><p>This study aimed to examine the potential correlation between myosteatosis and the prognosis of patients diagnosed with liver cirrhosis by a meta-analysis.</p><p>Methods</p><p>Cohort studies of relevance were acquired through comprehensive searches of the Medline, Web of Science, and Embase databases. To account for heterogeneity, a random-effects model was employed to combine the findings.</p><p>Results</p><p>The meta-analysis included 10 retrospective and four prospective cohort studies, encompassing a total of 4287 patients diagnosed with cirrhosis. The pooled findings indicated a notable decline in transplant-free survival (TFS) among individuals with liver cirrhosis and myosteatosis compared to those without this condition (risk ratio: 1.94; 95% confidence interval: 1.61 to 2.34, <i>p</i> < 0.001; I<sup>2</sup> = 49%). The predefined subgroup analyses demonstrated consistent findings across various categories, including Asian and non-Asian studies, prospective and retrospective cohort studies, patients with cirrhosis overall and those who underwent transjugular intrahepatic portosystemic shunt, studies with different follow-up durations (< or ≥ 24 months), studies employing univariate and multivariate analyses, and studies with and without an adjustment for sarcopenia (<i>p</i> > 0.05 for all subgroup differences). Additionally, Egger’s regression test indicated the presence of significant publication bias (<i>p</i> = 0.044). However, trim-and-fill analysis by including three hypothesized studies showed consistent results.</p><p>Conclusions</p><p>The presence of myosteatosis in individuals diagnosed with liver cirrhosis may potentially be linked to a poor TFS prognosis. Further investigations are required to ascertain whether enhancing myosteatosis could potentially yield a survival advantage for this particular patient population.</p></div>