Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan.
Department of Internal Medicine, Matsushita Memorial Hospital, Osaka, Japan.
Liver Int. 2020 Jan;40(1):120-130. doi: 10.1111/liv.14253. Epub 2019 Sep 22.
BACKGROUND & AIMS: Sarcopenia is reported to be associated with nonalcoholic fatty liver disease (NAFLD). Evaluation of skeletal muscle attenuation and area by computed tomography (CT) may represent a promising approach for evaluation of the risk of NAFLD. We examined the association between skeletal muscle characteristics and NAFLD and investigated the combined effect of these parameters on the prevalence of NAFLD.
In this cross-sectional study, we analysed data from 632 middle-aged Japanese subjects without daily alcohol intake (353 men and 279 women) from a cohort of employees undergoing annual health examinations. The cross-sectional skeletal muscle area was evaluated on the basis of CT data at the level of the third lumbar vertebrae, and the skeletal muscle index (SMI) and density (SMD) were calculated. The subjects were divided into four study groups according to their SMI and SMD relative to median values.
One hundred forty men and forty-three women had NAFLD. Total SMI (odds ratio [OR] per 1.0 cm /kg/m increase 0.43, 95% confidence interval [CI] 0.29-0.64 in men and OR 0.21, 95% CI 0.10-0.42 in women) and total SMD (OR, per 1.0 Hounsfield Unit increase 0.88, 95% CI 0.83-0.93 in men and 0.88, 0.82-0.95 in women) were significantly associated with the prevalence of NAFLD after adjusting for covariates. The subgroup with simultaneous presence of low SMI and low SMD was associated with a significantly higher prevalence of NAFLD compared with other groups.
Both SMI and SMD are independently associated with the prevalence of NAFLD.
据报道，肌肉减少症与非酒精性脂肪性肝病（NAFLD）有关。通过计算机断层扫描（CT）评估骨骼肌衰减和面积可能是评估 NAFLD 风险的一种有前途的方法。我们研究了骨骼肌特征与 NAFLD 的关系，并探讨了这些参数联合对 NAFLD 患病率的影响。
在这项横断面研究中，我们分析了来自参加年度健康检查的员工队列中的 632 名无每日饮酒史的中年日本受试者（男性 353 名，女性 279 名）的数据。根据第三腰椎水平的 CT 数据评估骨骼肌的横截面积，并计算骨骼肌指数（SMI）和密度（SMD）。根据 SMI 和 SMD 与中位数的关系，将受试者分为四组。
140 名男性和 43 名女性患有 NAFLD。总 SMI（每增加 1.0 cm/kg/m 的比值比 [OR] 0.43，95%置信区间 [CI] 0.29-0.64 在男性和 OR 0.21，95%CI 0.10-0.42 在女性）和总 SMD（每增加 1.0 个 Hounsfield 单位的 OR，0.88，95%CI 0.83-0.93 在男性和 0.88，0.82-0.95 在女性）与调整协变量后的 NAFLD 患病率显著相关。同时存在低 SMI 和低 SMD 的亚组与其他组相比，NAFLD 的患病率显著更高。
SMI 和 SMD 均与 NAFLD 的患病率独立相关。
