Doctoral Programs in Medical Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan.
Japan Society for the Promotion of Science, Tokyo, Japan.
J Gastroenterol. 2018 Apr;53(4):535-547. doi: 10.1007/s00535-017-1377-3. Epub 2017 Aug 8.
Not only obesity but also sarcopenia is associated with NAFLD. The influence of altered body composition on the pathophysiology of NAFLD has not been fully elucidated. The aim of this study is to determine whether skeletal muscle mass to visceral fat area ratio (SV ratio) affects NAFLD pathophysiology.
A total of 472 subjects were enrolled. The association between SV ratio and NAFLD pathophysiological factors was assessed in a cross-sectional nature by stratification analysis.
When the SV ratio was stratified by quartiles (Q -Q ), the SV ratio showed a negative relationship with the degree of body mass index, HOMA-IR, and liver stiffness (Q , 8.9 ± 7.5 kPa, mean ± standard deviation; Q , 7.5 ± 6.2; Q , 5.8 ± 3.7; Q , 5.0 ± 1.9) and steatosis (Q , 282 ± 57 dB/m; Q , 278 ± 58; Q , 253 ± 57; Q , 200 ± 42) measured by transient elastography. Levels of leptin and biochemical markers of liver cell damage, liver fibrosis, inflammation and oxidative stress, and hepatocyte apoptosis were significantly higher in subjects in Q than in those in Q , Q , or Q . Moreover, fat contents in femoral muscles were significantly higher in subjects in Q and the change was associated with weakened muscle strength. In logistic regression analysis, NAFLD subjects with the decreased SV ratio were likely to have an increased risk of moderate-to-severe steatosis and that of advanced fibrosis.
Decreased muscle mass coupled with increased visceral fat mass is closely associated with an increased risk for exacerbating NAFLD pathophysiology.
不仅肥胖，而且肌肉减少症也与 NAFLD 相关。改变的身体成分对 NAFLD 病理生理学的影响尚未完全阐明。本研究旨在确定骨骼肌质量与内脏脂肪面积比（SV 比）是否影响 NAFLD 病理生理学。
共纳入 472 例受试者。通过分层分析，从横断面角度评估 SV 比与 NAFLD 病理生理因素之间的关系。
当 SV 比按四分位数（Q-Q）分层时，SV 比与体重指数、HOMA-IR 和肝脏硬度的程度呈负相关（Q1：8.9±7.5 kPa，平均值±标准差；Q2：7.5±6.2；Q3：5.8±3.7；Q4：5.0±1.9）和通过瞬态弹性成像测量的脂肪变性（Q1：282±57 dB/m；Q2：278±58；Q3：253±57；Q4：200±42）。Q1 组的瘦素水平和肝损伤、肝纤维化、炎症和氧化应激以及肝细胞凋亡的生化标志物明显高于 Q2、Q3 和 Q4 组。此外，Q1 组的股四头肌脂肪含量明显较高，且这种变化与肌肉力量减弱有关。在逻辑回归分析中，SV 比值降低的 NAFLD 患者发生中重度脂肪变性和进展性纤维化的风险增加。
肌肉质量减少伴内脏脂肪质量增加与 NAFLD 病理生理学恶化的风险增加密切相关。
