Kim Tae-Hoon, Jeong Chang-Won, Lee ChungSub, Noh SiHyeong, Lim Dong Wook, Kim Jin Woong, Kim Hyung Joong, Kim Youe Ree
Medical Convergence Research Center, Wonkwang University, Wonkwang University Hospital, Iksan 54538, Republic of Korea.
Department of Radiology, Chosun University Hospital of Medicine, Chosun University College, Gwangju 61453, Republic of Korea.
J Clin Med. 2023 Jun 26;12(13):4279. doi: 10.3390/jcm12134279.
It is well established that sarcopenic obesity (SO) is linked to many diseases such as metabolic and non-alcoholic fatty liver diseases, but there is little known about the relationship between SO and hepatic fibrosis progression in chronic liver disease. This study compared body composition contents in patients with non-obesity (NOb) and SO using abdominal magnetic resonance imaging and investigated the relationship between hepatic fibrosis and SO factors. This retrospective study enrolled 60 patients (28 NOb; 32 SO) from June 2014 to December 2020. Patients underwent histopathologic investigation where they classified fibrosis stages based on the Meta-analysis of Histological Data in Viral Hepatitis fibrosis scoring system. Muscle and fat areas at the third lumber vertebra level were assessed. The variation in the areas of muscle (MA), subcutaneous adipose tissue (SAT), and visceral adipose tissue (VAT) among fibrosis stages, and associations between hepatic fibrosis and SO factors, were analyzed. There were significant differences in SAT and VAT ( < 0.001), whereas there was no difference in MA ( = 0.064). There were significant differences in MA/SAT ( = 0.009), MA/VAT ( < 0.001), and MA/(SAT+VAT) ( < 0.001). In all the patients, hepatic fibrosis positively correlated with serum aspartate aminotransferase level (AST, = 0.324; = 0.025). Especially in SO patients, hepatic fibrosis closely correlated with body mass index (BMI, = 0.443; = 0.011), AST ( = 0.415; = 0.044), VAT ( = 0.653; < 0.001), MA/VAT ( = -0.605; < 0.001), and MA/(SAT+VAT) ( = -0.416; = 0.018). However, there was no association in NOb patients. This study demonstrated that SO patients had larger SAT and VAT than NOb patients. Hepatic fibrosis in SO positively correlated with body visceral fat composition in combination with BMI and AST level. These findings will be useful for understanding the relationship between the hepatic manifestation of fibrosis and body fat composition in sarcopenia and SO.
肌肉减少性肥胖（SO）与许多疾病相关，如代谢性疾病和非酒精性脂肪性肝病，这一点已得到充分证实，但关于SO与慢性肝病肝纤维化进展之间的关系却知之甚少。本研究使用腹部磁共振成像比较了非肥胖（NOb）患者和SO患者的身体成分含量，并研究了肝纤维化与SO因素之间的关系。这项回顾性研究纳入了2014年6月至2020年12月期间的60例患者（28例NOb；32例SO）。患者接受了组织病理学检查，他们根据病毒性肝炎纤维化评分系统的组织学数据荟萃分析对纤维化阶段进行分类。评估了第三腰椎水平的肌肉和脂肪面积。分析了纤维化阶段之间肌肉面积（MA）、皮下脂肪组织（SAT）和内脏脂肪组织（VAT）面积的变化，以及肝纤维化与SO因素之间的关联。SAT和VAT存在显著差异（<0.001），而MA无差异（=0.064）。MA/SAT（=0.009）、MA/VAT（<0.001）和MA/（SAT+VAT）（<0.001）存在显著差异。在所有患者中，肝纤维化与血清天冬氨酸氨基转移酶水平呈正相关（AST，=0.324；=0.025）。特别是在SO患者中，肝纤维化与体重指数（BMI，=0.443；=0.011）、AST（=0.415；=0.044）、VAT（=0.653；<0.001）、MA/VAT（= -0.605；<0.001）和MA/（SAT+VAT）（= -0.416；=0.018）密切相关。然而，在NOb患者中没有关联。本研究表明，SO患者的SAT和VAT比NOb患者大。SO中的肝纤维化与身体内脏脂肪成分以及BMI和AST水平呈正相关。这些发现将有助于理解肌肉减少症和SO中纤维化的肝脏表现与身体脂肪成分之间的关系。
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