Hashimoto Yoshitaka, Osaka Takafumi, Fukuda Takuya, Tanaka Muhei, Yamazaki Masahiro, Fukui Michiaki
Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan.
Endocr J. 2016 Oct 29;63(10):877-884. doi: 10.1507/endocrj.EJ16-0124. Epub 2016 Jul 9.
Recent cross-sectional studies revealed that sarcopenia is associated with non-alcoholic fatty liver disease (NAFLD) in general population. However, it remains to be elucidated that the association between skeletal muscle mass index (SMI) and hepatic steatosis in patients with type 2 diabetes. In this cross-sectional study of 145 Japanese patients (79 men and 66 women) with type 2 diabetes, we examined the correlation of SMI with hepatic steatosis. Skeletal muscle mass was estimated from bioimpedance analysis measurements and SMI (%) was defined as skeletal muscle mass (kg)/total body weight (kg) × 100. Controlled attenuation parameter (CAP) evaluated with transient elastography, was used for assessment of hepatic steatosis. In addition, we also investigated the association between SMI and prevalence of NAFLD, which was defined as CAP over 237.8 dm, using logistic regression analysis. Fifty-eight (74%) men and thirty-nine (60%) women had NAFLD. Multiple regression analysis demonstrated that SMI was independently correlated with CAP (β = -0.35, P = 0.007) in men after adjusting for age, body mass index, hemoglobin A1c, triglycerides/ HDL-C ratio, C-reactive protein and gamma-glutamyl transferase. On the other hand, SMI was not associated with CAP in women. Odds ratio per incremental 1% of SMI for prevalence of NAFLD was 0.80 (95% CI 0.64-0.97, P = 0.021) after adjusting for age, BMI, smoking statues, triglycerides/ HDL-C ratio, HbA1c, and gamma-glutamyl transferase in men. In conclusion, SMI was negatively associated with hepatic steatosis in men with type 2 diabetes.
近期的横断面研究表明，一般人群中肌肉减少症与非酒精性脂肪性肝病（NAFLD）相关。然而，2型糖尿病患者的骨骼肌质量指数（SMI）与肝脂肪变性之间的关联仍有待阐明。在这项对145例日本2型糖尿病患者（79例男性和66例女性）的横断面研究中，我们研究了SMI与肝脂肪变性的相关性。通过生物电阻抗分析测量估算骨骼肌质量，SMI（%）定义为骨骼肌质量（kg）/总体重（kg）×100。使用瞬时弹性成像评估的受控衰减参数（CAP）用于评估肝脂肪变性。此外，我们还使用逻辑回归分析研究了SMI与NAFLD患病率之间的关联，NAFLD定义为CAP超过237.8 dm。58名（74%）男性和39名（60%）女性患有NAFLD。多元回归分析表明，在调整年龄、体重指数、糖化血红蛋白、甘油三酯/高密度脂蛋白胆固醇比值、C反应蛋白和γ-谷氨酰转移酶后，男性的SMI与CAP独立相关（β = -0.35，P = 0.007）。另一方面，女性的SMI与CAP无关。在调整男性的年龄、体重指数、吸烟状况、甘油三酯/高密度脂蛋白胆固醇比值、糖化血红蛋白和γ-谷氨酰转移酶后，SMI每增加1%，NAFLD患病率的比值比为0.80（95%可信区间0.64 - 0.97，P = 0.021）。总之，2型糖尿病男性患者的SMI与肝脂肪变性呈负相关。
