Appendicular Skeletal Muscle Mass to Visceral Fat Area Ratio Predicts Hepatic Morbidities - PubMed (original) (raw)

. 2024 May 15;18(3):509-519.

doi: 10.5009/gnl230238. Epub 2023 Nov 28.

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Appendicular Skeletal Muscle Mass to Visceral Fat Area Ratio Predicts Hepatic Morbidities

Eugene Han et al. Gut Liver. 2024.

Abstract

Background/aims: : Reports on the association between sarcopenic visceral obesity and non-alcoholic fatty liver disease (NAFLD)-associated morbidities remain scarce. We investigated the association between sarcopenia and visceral obesity, and the influence of this association on hepatic and coronary comorbidities.

Methods: : The appendicular skeletal muscle mass to visceral fat area ratio (SV ratio) was evaluated using bioelectric impedance analysis. NAFLD and significant liver fibrosis were assessed using transient elastography, and high atherosclerotic cardiovascular disease (ASCVD) risk was defined as a 10-year ASCVD risk score >10%. Sarcopenia was defined as appendicular skeletal muscle mass adjusted by body mass index (<0.789 for men and <0.512 for women).

Results: : In total, 82.0% (n=1,205) of the entire study population had NAFLD, and 14.6% of these individuals (n=176) exhibited significant liver fibrosis. Individuals with the lowest SV ratio had a significantly increased risk of NAFLD, significant liver fibrosis, and high ASCVD risk (all p<0.05). Individuals with both the lowest SV ratio and sarcopenia had the highest risk of developing NAFLD (odds ratio [OR]=3.11), significant liver fibrosis (OR=2.03), and high ASCVD risk (OR=4.15), compared with those with a higher SV ratio and without sarcopenia (all p<0.05).

Conclusions: : Low SV ratio combined with sarcopenia was significantly associated with an increased risk of NAFLD, significant liver fibrosis, and high ASCVD risk among individuals with a high risk of NAFLD.

Keywords: Morbidity; Non-alcoholic fatty liver disease; Obesity; Sarcopenia.

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Conflict of interest statement

CONFLICTS OF INTEREST

S.U.K. has served as an advisory committee member Gilead Sciences, Bayer, Eisai, and Novo Nordisk. He is a speaker for Gilead Sciences, GSK, Bayer, Eisai, AbbVie, Echosens, MSD, Eisai, Otsuka, and Bristol-Myers Squibb. He has also received a research grant from AbbVie and Bristol-Myers Squibb. S.H.A. is an editorial board member of the journal but was not involved in the peer reviewer selection, evaluation, or decision process of this article. No other potential conflicts of interest relevant to this article were reported.

Figures

Fig. 1

Fig. 1

Associations among SV ratio, NAFLD, and significant liver fibrosis. The proportion of NAFLD in the entire population (A), individuals without sarcopenia (B), and individuals with sarcopenia (C). The proportion of significant liver fibrosis in individuals with NAFLD (D), individuals with NAFLD but without sarcopenia (E), and individuals with NAFLD and sarcopenia (F). SV ratio, appendicular skeletal muscle mass to visceral fat area ratio; NAFLD, nonalcoholic fatty liver disease. *p<0.05 by post hoc analyses when compared with the lowest SV ratio tertile; †p<0.05 by post hoc analyses when compared with the middle SV ratio tertile.

Fig. 2

Fig. 2

Associations among sarcopenia, SV ratio, NAFLD, significant liver fibrosis, and high ASCVD risk. The proportion of fatty liver disease (A), significant liver fibrosis (B), high ASCVD risk (C), and high ASCVD risk in individuals without a history of ASCVD (D). SV ratio, skeletal muscle mass to visceral fat area ratio; NAFLD, nonalcoholic fatty liver disease; ASCVD, atherosclerotic cardiovascular disease. *p<0.05 by post hoc analyses when compared with sarcopenia (–) and a higher SV ratio; †p<0.05 by post hoc analyses when compared with sarcopenia (–) and the lowest SV ratio; ‡p<0.05 by post hoc analyses when compared with sarcopenia (+) and a higher SV ratio.

Fig. 3

Fig. 3

Changes in CAP and LSM values in individuals with NAFLD. Changes in the CAP and LSM value according to the SV ratio (A, B) and sarcopenia (C, D) among individuals with NAFLD. Data are presented as the mean±SD. Between-group differences (change from baseline) were tested for significance using analysis of covariance. CAP, controlled attenuation parameter; LSM, liver stiffness measurement; NAFLD, nonalcoholic fatty liver disease; SV ratio, skeletal muscle mass to visceral fat area ratio. *p=0.049 for the mean change from baseline.

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