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肌肉减少症与非酒精性脂肪性肝病的存在及严重程度显著相关。

Sarcopenia Is Significantly Associated with Presence and Severity of Nonalcoholic Fatty Liver Disease.

作者信息

Chung Goh Eun, Kim Min Joo, Yim Jeong Yoon, Kim Joo Sung, Yoon Ji Won

机构信息

Department of Internal Medicine, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Korea.

Division of Gastroenterology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.

出版信息

J Obes Metab Syndr. 2019 Jun;28(2):129-138. doi: 10.7570/jomes.2019.28.2.129. Epub 2019 Jun 30.

Abstract

BACKGROUND

The association between nonalcoholic fatty liver disease (NAFLD) and sarcopenia has been suggested. We investigated the association between sarcopenia and NAFLD independent of visceral adiposity and searched for the clinical characteristics that affect this association.

METHODS

We performed a retrospective study including of 5,989 subjects (mean age, 53.2 years; men, 57.3%) who underwent bioelectrical impedance analysis (BIA) and abdominal ultrasonography in 2012. The appendicular skeletal muscle mass (ASM) was assessed by BIA method. Sarcopenia was defined as ASM/weight (ASM%) <2 standard deviation of the mean for healthy young reference population. NAFLD was diagnosed by ultrasonography.

RESULTS

The prevalence of sarcopenia was 5.3%. The prevalence of NAFLD was significantly higher in subjects with sarcopenia than in those without (69.5% vs. 36.5%, <0.001). After adjusting with age, sex, visceral fat area, hypertension, diabetes, total and low-density lipoprotein cholesterol, subjects with sarcopenia showed significantly high odds of NAFLD (odds ratio [OR], 1.37; 95% confidence interval [CI], 1.02-1.84; =0.036). Subjects with sarcopenia have more likely severe grade of NAFLD compared to non-sarcopenic group (OR, 1.58; 95% CI, 1.25-2.00; <0.001). There was significant interaction for effect modification in the association between sarcopenia and NAFLD by age ( of interaction for effect modification, 0.007).

CONCLUSION

Sarcopenia was significantly associated with the presence and the severity of ultrasonography-graded NAFLD in our study population independent of visceral fatness and other metabolic confounder. Younger age showed greater magnitude of association between sarcopenia and NAFLD.

摘要

背景

非酒精性脂肪性肝病(NAFLD)与肌肉减少症之间的关联已被提出。我们研究了肌肉减少症与NAFLD之间独立于内脏脂肪的关联,并寻找影响这种关联的临床特征。

方法

我们进行了一项回顾性研究,纳入了2012年接受生物电阻抗分析(BIA)和腹部超声检查的5989名受试者(平均年龄53.2岁;男性占57.3%)。通过BIA方法评估四肢骨骼肌质量(ASM)。肌肉减少症定义为ASM/体重(ASM%)低于健康年轻参考人群平均值的2个标准差。通过超声检查诊断NAFLD。

结果

肌肉减少症的患病率为5.3%。肌肉减少症患者的NAFLD患病率显著高于无肌肉减少症患者(69.5%对36.5%,<0.001)。在调整年龄、性别、内脏脂肪面积、高血压、糖尿病、总胆固醇和低密度脂蛋白胆固醇后,肌肉减少症患者患NAFLD的几率显著更高(比值比[OR],1.37;95%置信区间[CI],1.02 - 1.84;P = 0.036)。与非肌肉减少症组相比,肌肉减少症患者更有可能患有严重程度的NAFLD(OR,1.58;95% CI,1.25 - 2.00;<0.001)。年龄对肌肉减少症与NAFLD之间的关联存在显著的效应修饰交互作用(效应修饰交互作用P值,0.007)。

结论

在我们的研究人群中,肌肉减少症与超声分级的NAFLD的存在和严重程度显著相关,独立于内脏脂肪和其他代谢混杂因素。年龄越小,肌肉减少症与NAFLD之间的关联程度越大。

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