Graduate School, Tianjin Medical University, Tianjin, China.
Department of Endocrinology, Health Management Center, Tianjin Union Medical Center, Nankai University Affiliated Hospital, Tianjin, China.
Scand J Gastroenterol. 2021 Mar;56(3):312-320. doi: 10.1080/00365521.2021.1879244. Epub 2021 Feb 3.
Obesity and sarcopenia are known to be closely related to nonalcoholic fatty liver disease (NAFLD). We attempted to explore the combined influence of fat and muscle tissue on NAFLD by using visceral fat area to appendicular muscle mass ratio (VAR) as a novel parameter.
In this cross-sectional study, a total of 3255 adults (1399 men and 1856 women) coming for a health examination were enrolled. NAFLD was diagnosed using ultrasound and VAR was measured by bioelectrical impedance analyzer.
The prevalence of NAFLD was 46.5% in men and 26.6% in women. VAR differed significantly between subjects with and without NAFLD (4.27 vs. 3.26 in men, 7.89 vs. 5.01 in women, respectively, < .001). Logistic regression analysis determined VAR as a risk factor for NAFLD, and the multivariable-adjusted odds ratios in the highest VAR quartile was 9.57 (95%CI: 5.98-15.30) for men and 12.37 (95%CI: 6.37-24.05) for women. From the receiver operating characteristic analysis, the area under the curve was 0.767 and 0.834, with the suitable cut-off VAR value of 3.469 and 6.357 for men and women, respectively. To control the influence of obesity, all subjects were stratified according to their BMI. For each BMI group, individuals with VAR above the cut-off value had significant higher prevalence and risk of NAFLD, with odds ratios ranging from 1.76 to 4.75.
Increased VAR is strongly associated with higher risk of NAFLD in both sexes independent of obesity and can serve as a screening reference for NAFLD.
肥胖症和肌肉减少症与非酒精性脂肪性肝病（NAFLD）密切相关。我们试图通过使用内脏脂肪面积与四肢骨骼肌质量比（VAR）作为一种新的参数来探讨脂肪和肌肉组织对 NAFLD 的综合影响。
在这项横断面研究中，共纳入了 3255 名进行健康检查的成年人（男性 1399 名，女性 1856 名）。使用超声诊断 NAFLD，并通过生物电阻抗分析仪测量 VAR。
男性中 NAFLD 的患病率为 46.5%，女性中为 26.6%。患有和不患有 NAFLD 的患者的 VAR 差异有统计学意义（男性分别为 4.27 和 3.26，女性分别为 7.89 和 5.01，均<0.001）。Logistic 回归分析确定 VAR 是 NAFLD 的危险因素，最高 VAR 四分位数的多变量校正比值比在男性中为 9.57（95%CI：5.98-15.30），在女性中为 12.37（95%CI：6.37-24.05）。从受试者工作特征分析来看，曲线下面积为 0.767 和 0.834，男性和女性的合适截断 VAR 值分别为 3.469 和 6.357。为了控制肥胖的影响，根据 BMI 将所有受试者分层。对于每个 BMI 组，VAR 值高于截断值的个体患有 NAFLD 的患病率和风险显著更高，比值比范围为 1.76-4.75。
VAR 的增加与男女两性的 NAFLD 风险增加密切相关，与肥胖无关，可作为 NAFLD 的筛查参考。
