Abstract: Objective To explore the clinical application value of nomogram model based on The Royal Free Hospital-Nutritional Prioritizing Tool (RFH-NPT) and Systemic Immune-Inflammation Index (SII) in predicting sarcopenia in liver cirrhotic patients. Methods A total of 125 patients with liver cirrhosis hospitalized in the Department of Nephrology, Jinan Eighth People′s Hospital from June 2021 to June 2023 were selected as the observation group. Using the third lumbar skeletal muscle mass index for the diagnosis of sarcopenia, the patients were divided into a sarcopenic group (n=36) and a non-sarcopenic group (n=89), RFH-NPT and SII scores were used to assess malnutrition-inflammation. A nomogram model was developed from the results of multivariate Logistic regression. The nomogram model was internally validated by Bootstrap method, and the discriminatory ability was evaluated by C-index.The calibration curve was used to evaluate the calibration degree of the nomogram model. Results Among the 125 patients with liver cirrhosis, 36(28.8%) were diagnosed with sarcopenia. The average ages of the patients in sarcopenia group and non-sarcopenic group were (65.4±4.2) and (51.2±4.00) respectively, t=6.321, P<0.001; The albumin level in sarcopenia group and non-sarcopenic group were (27.16±4.56) g/L and (33.48±4.92)g/L, t=-3.998, P<0.001; The bilirubin level in sarcopenia group and non-sarcopenic group were (37.34±12.42)μmol/L and (25.41±10.17μmol/L, respectively, t=2.865, P=0.046, RFH-NPT score in sarcopenia group and non-sarcopenic group were 11(30.56%)and 49(55.06%), χ²=3.349, P<0.001;SII score in sarcopenia group and non-sarcopenic group were (406.22±79.46) and (312.36±61.71), respectively, t=8.362, P<0.001; There were 29(80.56%)and 32(35.95%) patients with ascites in sarcopenia group and non-sarcopenic group, respectively, χ²=5.386, P=0.025; There were 8(22.22%) and 9(10.12%) patients with hepatic encephalopathy in sarcopenia group and non-sarcopenic group, χ²=4.571, P=0.046. The results of the multivariate Logstic regression analysis showed that, Age (OR=1.423,95%CI:1.211~1.690), albumin (OR=1.701,95%CI:1.346~2.543), combined intraperitoneal effusion (OR=1.654,95%CI=1.192~2.339), RFH-NPTscore (OR=2.233, 95%CI:1.235~3.242) and SII score (OR=2.001, 95%CI:1.117~2.889) was an independent risk factor affecting the development of sarcopenia in patients with cirrhosis (P<0.05). The nomogram prediction model was constructed by Bootstrap internal validation and found good accuracy and discrimination, with C-index of 0.828 (95%CI: 0.736~0.885) and area under ROC curve (AUC) of 0.838 (95%CI: 0.744~0.913). Conclusion Elevated RFH-NPT, SII scores are independent risk factors for sarcopenia in liver cirrhotic patients, and the nomogram prediction model based on independent influencing factors can improve the predictive efficacy of concurrent sarcopenia in patients with cirrhosis.

Key words: Cirrhosis, Sarcopenia, RFH-NPT, SII, Predictive model