Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK; Faculty of Medicine, Universidad Diego Portales, Santiago, Chile; British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK.
British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK.
J Hepatol. 2022 May;76(5):1021-1029. doi: 10.1016/j.jhep.2022.01.010. Epub 2022 Jan 24.
BACKGROUND & AIMS: Cross-sectional studies have reported that lower muscle mass and strength are risk factors for non-alcoholic fatty liver disease (NAFLD). However, the evidence from prospective studies is limited. This study examined both the strength and pattern of the associations between these 2 physical capability markers and severe NAFLD using data from the UK Biobank study.
A total of 333,295 participants were included in this prospective study. Grip strength was measured using a Jamar J00105 hydraulic hand dynamometer, and the Janssen equation was used to estimate skeletal muscle mass by bioelectrical impedance. Muscle mass was adjusted for body weight and all exposures were sex-standardised. Associations of muscle mass and strength with severe NAFLD (defined as hospital admission or death) were first investigated by tertile of each exposure using Cox proportional hazard models. Non-linear associations were investigated using penalised cubic splines fitted in the Cox proportional hazard models.
After a median follow-up of 10 years (IQR 9.3 to 10.7 years), 3,311 individuals had severe NAFLD (3,277 hospitalisations and 34 deaths). Compared with the lowest tertile of muscle mass, the risk of severe NAFLD was lower in the middle (hazard ratio 0.76; 95% CI 0.70-0.83) and the highest tertile (hazard ratio 0.46; 95% CI 0.40-0.52). Tertiles of grip strength showed a similar pattern. Non-linearity was only identified for muscle mass (p <0.001). Being on the lower tertile of grip strength and muscle mass accounted for 17.7% and 33.1% of severe NAFLD cases, respectively.
Lower muscle mass and grip strength were associated with higher risk of developing severe NAFLD. Interventions to improve physical capability may be protective, but this needs to be investigated in appropriately designed trials.
Lower muscle mass - both quantity and quality - were associated with a higher risk of severe non-alcoholic fatty liver disease. Therefore, improving muscle mass might be a protective factor against this increasing public health problem.
横断面研究报告称，肌肉量和力量较低是非酒精性脂肪性肝病（NAFLD）的危险因素。然而，前瞻性研究的证据有限。本研究使用英国生物库研究的数据，检查了这两个身体能力标志物与严重 NAFLD 之间的关联的强度和模式。
这项前瞻性研究共纳入了 333295 名参与者。使用 Jamar J00105 液压手动测力计测量握力，使用 Janssen 方程通过生物电阻抗法估计骨骼肌质量。肌肉质量按体重进行调整，所有暴露因素均按性别标准化。首先使用 Cox 比例风险模型，根据每个暴露因素的三分位数，对肌肉质量和力量与严重 NAFLD（定义为住院或死亡）的关联进行研究。使用 Cox 比例风险模型中的惩罚三次样条拟合来研究非线性关联。
中位随访 10 年（IQR 9.3 至 10.7 年）后，3311 人患有严重 NAFLD（3277 例住院治疗和 34 例死亡）。与肌肉质量最低三分位相比，中间（危险比 0.76；95%CI 0.70-0.83）和最高三分位（危险比 0.46；95%CI 0.40-0.52）的严重 NAFLD 风险较低。握力的三分位也呈现出类似的模式。仅对肌肉质量识别到非线性（<0.001）。握力和肌肉质量处于较低三分位数的人分别占严重 NAFLD 病例的 17.7%和 33.1%。
肌肉质量和握力较低与严重 NAFLD 风险增加相关。改善身体能力的干预措施可能具有保护作用，但这需要在适当设计的试验中进行研究。
肌肉质量和握力较低与严重非酒精性脂肪性肝病风险增加相关。改善身体能力的干预措施可能具有保护作用，但这需要在适当设计的试验中进行研究。
