Mikami Kenichiro, Endo Tetsu, Sawada Naoya, Igarashi Go, Kimura Masayo, Hasegawa Takuma, Iino Chikara, Sawada Kaori, Ando Masataka, Sugimura Yoshikuni, Mikami Tatsuya, Nakaji Shigeyuki, Matsuzaka Masashi, Sakuraba Hirotake, Fukuda Shinsaku
Department of Gastroenterology, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki City, Aomori 036-8562, Japan.
Department of Internal Medicine, Owani Hospital, 40-4 Kawaradate, Kuradate, Owani Town, Aomori 038-0212, Japan.
J Clin Biochem Nutr. 2022 May;70(3):273-282. doi: 10.3164/jcbn.21-61. Epub 2021 Nov 26.
We evaluated the feasibility of using serum creatinine-to-cystatin C ratio in the assessments of muscle mass and strength in nonalcoholic fatty liver disease. In a community-based cross-sectional study, skeletal muscle mass and handgrip strength were assessed in 641 Japanese adults. Low skeletal muscle mass index and low handgrip strength were defined as indicated in the sarcopenia diagnostic criteria of the Japan Society of Hepatology. Nonalcoholic fatty liver disease was defined as fatty liver on ultrasonography in the absence of other causes of steatosis. The creatinine-to-cystatin C ratio was useful for identifying the participants with low skeletal muscle mass index, with an area under the receiver-operating characteristic curve of 0.84 [95% confidence interval (CI), 0.77-0.91] in men and 0.72 in women (95% CI, 0.65-0.78), and those with low handgrip strength, with an area under the receiver-operating characteristic curve of 0.96 (95% CI, 0.93-0.99) in men and 0.79 (95% CI, 0.66-0.92) in women. Moreover, the creatinine-to-cystatin C ratio correlated with skeletal muscle mass index ( = 0.511, <0.001) and handgrip strength ( = 0.657, <0.001), whereas it did not correlate with exacerbation of hepatic steatosis. In this study, creatinine-to-cystatin C ratio correlated with muscle mass and strength in nonalcoholic fatty liver disease regardless of hepatic steatosis.
我们评估了使用血清肌酐与胱抑素 C 比值来评估非酒精性脂肪性肝病患者肌肉质量和力量的可行性。在一项基于社区的横断面研究中，对 641 名日本成年人的骨骼肌质量和握力进行了评估。低骨骼肌质量指数和低握力按照日本肝脏学会的肌少症诊断标准进行定义。非酒精性脂肪性肝病定义为超声检查显示的脂肪肝，且不存在其他脂肪变性原因。肌酐与胱抑素 C 比值有助于识别低骨骼肌质量指数的参与者，男性受试者的受试者工作特征曲线下面积为 0.84[95%置信区间（CI），0.77 - 0.91]，女性为 0.72（95%CI，0.65 - 0.78）；对于识别低握力的参与者，男性受试者工作特征曲线下面积为 0.96（95%CI，0.93 - 0.99），女性为 0.79（95%CI，0.66 - 0.92）。此外，肌酐与胱抑素 C 比值与骨骼肌质量指数（r = 0.511，P < 0.001）和握力（r = 0.657，P < 0.001）相关，而与肝脂肪变性的加重无关。在本研究中，无论肝脂肪变性情况如何，肌酐与胱抑素 C 比值均与非酒精性脂肪性肝病患者的肌肉质量和力量相关。
