Presence of sarcopenia identifies a special group of lean NAFLD in middle-aged and older people - PubMed (original) (raw)

. 2023 Apr;17(2):313-325.

doi: 10.1007/s12072-022-10439-z. Epub 2022 Nov 3.

Qingxia Huang # 2, Shuai Ma # 1, Lingyan Chen 3, Qi Wu 1, Li Wu 1, Hui Ma 3, Xiaoming Li 1, Qian Li 1, Qiqige Aleteng 1, Yu Hu 3, Wanyuan He 4, Jian Gao 5, Huandong Lin 1, Huiru Tang 6, Xin Gao 7, Mingfeng Xia 8

Affiliations

Presence of sarcopenia identifies a special group of lean NAFLD in middle-aged and older people

Xiaopeng Zhu et al. Hepatol Int. 2023 Apr.

Abstract

Background: Sarcopenia, the age-related loss of muscle mass and function, is closely associated and frequently concomitant with non-alcoholic fatty liver disease (NAFLD). We aimed to investigate the clinical features of the sarcopenic NAFLD patients from middle-aged and older people.

Methods: A total of 1305 patients with NAFLD from the Shanghai Changfeng Study were included for analysis. Sarcopenia was diagnosed based on the height-adjusted appendicular skeletal muscle mass (ASM/height2). We comprehensively analyzed the metabolic phenotype, carotid artery condition, liver fibrosis score, and serum metabolomic profile of each participant.

Results: Among the middle-aged and older population, 68.1% of patients with sarcopenia and NAFLD were lean. Sarcopenia was independently associated with increased risk of carotid plaque (OR, 2.22; 95%CI 1.23-4.02) and liver fibrosis (OR, 2.07; 95%CI 1.24-3.44), and the sarcopenic lean NAFLD patients were characterized by a higher risk of carotid plaque (p = 0.008) and liver fibrosis (p = 0.001) than the non-sarcopenic lean NAFLD patients, despite their lower BMI and similar prevalence of metabolic syndrome and diabetes. Further serum metabolomic examination indicated that the sarcopenic lean NAFLD patients presented a distinct metabolomic profile prone to carotid plaque and liver fibrosis, with upregulated serum valine, N-acetylneuraminyl-glycoproteins, lactic acid, small LDL triglycerides and VLDL5 components, and reduced components of HDL4. A sarcopenic characterization score based on above metabolites was established and could also predict increased risk of carotid plaque and liver fibrosis.

Conclusion: The presence of sarcopenia identifies a special subgroup of lean NAFLD with increased risk of cardiovascular disease and liver fibrosis clinically.

Keywords: Cardiovascular disease; Liver fibrosis; NMR-based metabolome; Non-alcoholic fatty liver disease; Sarcopenia.

© 2022. Asian Pacific Association for the Study of the Liver.

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