Department of Human Ecology, Graduate School, Korea University, Seoul, Korea.
Department of Preventive Medicine, College of Medicine, Seoul National University, Seoul, Korea.
Metab Syndr Relat Disord. 2021 Oct;19(8):452-459. doi: 10.1089/met.2021.0011. Epub 2021 Jul 13.
The association between sarcopenia and protein intake has been well studied. However, limited data are available on the association between sarcopenia and protein intake in people with nonalcoholic fatty liver disease (NAFLD). This study aimed to investigate the association between protein intake and sarcopenia among elderly participants with NAFLD using the Korea National Health and Nutrition Examination Survey (KNHANES). Data of 4179 participants (1576 men and 2603 women, age ≥60 years) who participated in the KNHANES during 2008-2011 were obtained. Sarcopenia was defined as appendicular skeletal muscle mass/wt (%) of 1 standard deviation below the gender-specific mean for healthy adults and NAFLD as liver fat score using the fatty liver prediction models. According to their daily protein intake, participants were grouped into the high protein intake group (>1.2 g/kg/day), middle protein intake group (0.8-1.2 g/kg/day), and low protein intake group (<0.8 g/kg/day). Generalized linear models and logistic regression models were used. The overall prevalence of sarcopenia in participants with NAFLD was 16.53%. Compared with the highest protein intake group, the low protein intake group had a significantly higher risk of sarcopenia (adjustment odds ratio = 1.707; 95% confidence interval = 1.009-2.886). In the fully adjusted model, the highest protein intake group had significantly lower levels of insulin, total body fat, vitamin B, and fat intake, whereas muscle proportions, energy, carbohydrates, vitamin A, and vitamin C intake of high protein intake participants were significantly higher than other groups. The prevalence of sarcopenia and sarcopenia-related factors were significantly lower in NAFLD elderly participants with high protein intake. These results suggest that high protein intake can help prevent and manage sarcopenia in people with NAFLD.
肌肉减少症与蛋白质摄入之间的关联已得到充分研究。然而，关于非酒精性脂肪性肝病（NAFLD）患者中肌肉减少症与蛋白质摄入之间的关联，数据有限。本研究旨在通过韩国国民健康营养调查（KNHANES）调查老年 NAFLD 患者中蛋白质摄入与肌肉减少症之间的关系。
我们获得了 2008-2011 年期间参加 KNHANES 的 4179 名参与者（男性 1576 名，女性 2603 名，年龄≥60 岁）的数据。肌肉减少症定义为四肢骨骼肌质量/体重（%）低于健康成年人性别特异性平均值 1 个标准差，NAFLD 则采用脂肪肝预测模型的肝脂肪评分来定义。根据他们的日常蛋白质摄入量，参与者被分为高蛋白摄入组（>1.2g/kg/d）、中蛋白摄入组（0.8-1.2g/kg/d）和低蛋白摄入组（<0.8g/kg/d）。使用广义线性模型和逻辑回归模型进行分析。
患有 NAFLD 的参与者中肌肉减少症的总体患病率为 16.53%。与蛋白质摄入量最高的组相比，蛋白质摄入量最低的组发生肌肉减少症的风险显著更高（调整后的优势比=1.707；95%置信区间=1.009-2.886）。在完全调整的模型中，蛋白质摄入量最高的组胰岛素、总体体脂肪、维生素 B 和脂肪摄入量显著降低，而高蛋白摄入组的肌肉比例、能量、碳水化合物、维生素 A 和维生素 C 摄入量显著高于其他组。
患有 NAFLD 的老年参与者中，高蛋白摄入组的肌肉减少症和肌肉减少症相关因素的患病率显著较低。这些结果表明，高蛋白摄入有助于预防和治疗 NAFLD 患者的肌肉减少症。
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