Onishi Shuhei, Miyai Nobuyuki, Zhang Yan, Oka Toshifumi, Nogami Eriko, Utsumi Miyoko, Arita Mikio
Graduate School of Health and Nursing Science, Wakayama Medical University, 580 Mikazura, P.O. Box 641-0011, Wakayama, Japan.
Graduate School of Medicine, Wakayama Medical University, Wakayama, Japan.
Aging Clin Exp Res. 2022 Jan;34(1):185-192. doi: 10.1007/s40520-021-01902-2. Epub 2021 Jun 12.
Excessive alcohol intake complicated by liver dysfunction has been presumed to affect skeletal muscles. This study aimed to examine the association between excessive alcohol intake, liver fibrosis, and loss of skeletal muscle mass in elderly men.
The study participants comprised 799 community-dwelling elderly men (age, 71 ± 3 years) with no history of treatment for liver disease. Bioelectrical impedance analysis was performed to estimate the appendicular skeletal muscle mass (ASM) of each participant. The ASM values were also normalized for height (ASM index). Liver fibrosis was evaluated using the Fib4 index, which was calculated using participant age, AST level, ALT level, and platelet count. Usual alcohol intake was estimated based on the type of alcohol, frequency of drinking, and amount of alcohol consumed per day.
Among the excess drinkers (≥ 20 g/day), the ASM index of the subgroup with liver fibrosis (Fib4 index ≥ 2.67) was significantly lower than that of the subgroup with no liver fibrosis (Fib4 index < 2.67). However, no significant difference between the subgroups was found in the non-drinkers and moderate drinkers (< 20 g/day). In multiple regression analysis, the Fib4 index was significantly associated with the ASM index, independent of potential confounding factors. The association between the Fib4 index and ASM index was more pronounced in excess drinkers than in non-drinkers and moderate drinkers.
These results suggest that liver fibrosis is associated with loss of skeletal muscle mass in elderly men, and excessive alcohol intake combined with liver fibrosis may lead to greater muscle mass reduction than each individual condition.
过量饮酒并发肝功能不全被认为会影响骨骼肌。本研究旨在探讨老年男性过量饮酒、肝纤维化与骨骼肌质量丧失之间的关联。
研究参与者包括799名无肝病治疗史的社区老年男性（年龄71±3岁）。采用生物电阻抗分析来估计每位参与者的四肢骨骼肌质量（ASM）。ASM值也根据身高进行了标准化（ASM指数）。使用Fib4指数评估肝纤维化，该指数通过参与者的年龄、AST水平、ALT水平和血小板计数计算得出。根据饮酒类型、饮酒频率和每日饮酒量来估计通常的酒精摄入量。
在过量饮酒者（≥20克/天）中，肝纤维化亚组（Fib4指数≥2.67）的ASM指数显著低于无肝纤维化亚组（Fib4指数<2.67）。然而，在不饮酒者和适度饮酒者（<20克/天）的亚组之间未发现显著差异。在多元回归分析中，Fib4指数与ASM指数显著相关，独立于潜在的混杂因素。Fib4指数与ASM指数之间的关联在过量饮酒者中比在不饮酒者和适度饮酒者中更为明显。
这些结果表明，肝纤维化与老年男性骨骼肌质量丧失有关，过量饮酒与肝纤维化相结合可能比单独每种情况导致更大程度的肌肉量减少。
