Guo Wen, Zhao Xin, Miao Mengyuan, Liang Xiuru, Li Xiaona, Qin Pei, Lu Jing, Zhu Wenfang, Wu Juan, Zhu Chen, Xu Nianzhen, Zhang Qun
Department of Health Promotion Center, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China.
Front Nutr. 2022 Apr 26;9:883015. doi: 10.3389/fnut.2022.883015. eCollection 2022.
Sarcopenia is known to be the risk factor of non-alcoholic fatty liver disease (NAFLD). However, studies evaluating the association of skeletal muscle mass (SMM) with liver fibrosis by transient elastography are limited. Here, we investigated the association of SMM with hepatic steatosis and fibrosis assessed in Chinese adults.
Patients who underwent liver ultrasonography at the Health Promotion Center of the First Affiliated Hospital of Nanjing Medical University between January 2020 to June 2021 were enrolled. We used transient elastography to evaluate the degree of hepatic fat and liver stiffness. Appendicular skeletal muscle mass was determined by bioelectrical impedance and was adjusted for body weight to derive the skeletal muscle mass index (SMI).
Of 3,602 finally enrolled individuals, 1,830 had NAFLD and 1,772 did not have NAFLD. SMI gradually decreased as the severity of hepatic steatosis increased (40.47 ± 3.94% vs. 39.89 ± 3.57% vs. 39.22 ± 3.46% vs. 37.81 ± 2.84%, < 0.001). Individuals with F3-F4 and F2 liver fibrosis groups had significantly lower SMI than individuals with F0-F1 stages (37.51 ± 3.19% vs. 38.06 ± 3.51% vs. 39.36 ± 3.38%, < 0.001). As the SMI increased, the percentages of subjects with mild and severe NAFLD, and the percentages of subjects in F2 and F3-F4 stage were gradually decreased. SMI was independently associated with the severity of hepatic steatosis and fibrosis by logistic regression analysis. Moreover, decreased SMI was an independent risk factor for NAFLD and fibrosis.
SMI is closely associated with liver fat content and liver fibrosis in Chinese adults with NAFLD.
已知肌肉减少症是非酒精性脂肪性肝病（NAFLD）的危险因素。然而，通过瞬时弹性成像评估骨骼肌质量（SMM）与肝纤维化之间关联的研究有限。在此，我们调查了中国成年人中SMM与肝脂肪变性和纤维化的关联。
纳入2020年1月至2021年6月期间在南京医科大学第一附属医院健康促进中心接受肝脏超声检查的患者。我们使用瞬时弹性成像评估肝脂肪程度和肝脏硬度。通过生物电阻抗测定四肢骨骼肌质量，并根据体重进行调整以得出骨骼肌质量指数（SMI）。
在最终纳入的3602名个体中，1830例患有NAFLD，1772例未患NAFLD。随着肝脂肪变性严重程度增加，SMI逐渐降低（40.47±3.94%对39.89±3.57%对39.22±3.46%对37.81±2.84%，<0.001）。F3 - F4期和F2期肝纤维化组个体的SMI显著低于F0 - F1期个体（37.51±3.19%对38.06±3.51%对39.36±3.38%，<0.001）。随着SMI增加，轻度和重度NAFLD患者的百分比以及F2期和F3 - F4期患者的百分比逐渐降低。通过逻辑回归分析，SMI与肝脂肪变性和纤维化的严重程度独立相关。此外，SMI降低是NAFLD和纤维化的独立危险因素。
在患有NAFLD的中国成年人中SMI与肝脏脂肪含量和肝纤维化密切相关。
