Center for Preventive Medicine, Keio University Hospital, Tokyo, Japan.
Center for Preventive Medicine, Keio University Hospital, Tokyo, Japan.
Clin Nutr ESPEN. 2021 Apr;42:166-172. doi: 10.1016/j.clnesp.2021.01.045. Epub 2021 Feb 9.
BACKGROUND & AIMS: Osteosarcopenic obesity (OSO) encompassing obesity, sarcopenia and osteopenia, is due to redistribution or infiltration of fat into muscle and bone. This cross-sectional study evaluated the association between OSO and non-alcoholic fatty liver disease (NAFLD).
Obesity, sarcopenia and osteopenia was defined using the percentage of body fat mass, reduced muscle mass, and the percentage of young adult mean < 80%, measured by dual-energy x-ray absorptiometry, respectively. Non-obese and obese NAFLD was diagnosed by ultrasound and body mass index cut-off point (25 kg/m). A total of 619 subjects ≥ 50 years who completed health checkups were divided into obesity group including OSO and sarcopenic obesity (SO) alone phenotype, and non-obesity group that did not belong to any phenotype, including standard (St).
Overall osteopenia and OSO were detected in only 10% and 1% in males, compared with 45% and 9% in females, respectively. Multivariate analysis for females demonstrated a significant association of OSO with non-obese NAFLD (odds ratio = 3.737, 95% confidence interval = 1.365-10.233, P = 0.010), while the association between SO alone and non-obese NAFLD was equivocal. The OSO phenotype had a significantly higher proportion of slower walking speed and weaker grip strength, compared to the St phenotype. The proportion of OSO increased with age in contrast to constant prevalence of non-obese NAFLD.
Non-obese NAFLD had a significant association with OSO in females, independent of plausible confounders. These results suggest that non-obese NAFLD might be an independent risk factor for OSO.
包含肥胖、肌肉减少症和骨质疏松症的骨肌减少性肥胖（OSO）是由于脂肪在肌肉和骨骼中的重新分布或浸润所致。本横断面研究评估了 OSO 与非酒精性脂肪性肝病（NAFLD）之间的关系。
采用双能 X 射线吸收仪分别测量体脂肪质量百分比、肌肉质量减少和年轻成人平均值<80%的百分比来定义肥胖、肌肉减少症和骨质疏松症。非肥胖和肥胖的 NAFLD 通过超声和体重指数切点（25kg/m2）诊断。共有 619 名≥50 岁完成健康检查的受试者分为肥胖组，包括 OSO 和单纯性肌肉减少性肥胖（SO）表型，以及非肥胖组，不包括任何表型，包括标准（St）组。
男性总体骨质疏松症和 OSO 的检出率分别仅为 10%和 1%，而女性分别为 45%和 9%。女性多变量分析显示，OSO 与非肥胖型 NAFLD 显著相关（比值比=3.737，95%置信区间=1.365-10.233，P=0.010），而 SO 单独与非肥胖型 NAFLD 的相关性尚不确定。与 St 表型相比，OSO 表型的步行速度较慢和握力较弱的比例明显更高。与非肥胖型 NAFLD 的恒定患病率相反，OSO 表型的比例随年龄增长而增加。
在女性中，非肥胖型 NAFLD 与 OSO 显著相关，独立于可能的混杂因素。这些结果表明，非肥胖型 NAFLD 可能是 OSO 的一个独立危险因素。
