Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea.
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Gut Liver. 2024 May 15;18(3):509-519. doi: 10.5009/gnl230238. Epub 2023 Nov 28.
BACKGROUND/AIMS: : Reports on the association between sarcopenic visceral obesity and non-alcoholic fatty liver disease (NAFLD)-associated morbidities remain scarce. We investigated the association between sarcopenia and visceral obesity, and the influence of this association on hepatic and coronary comorbidities.
: The appendicular skeletal muscle mass to visceral fat area ratio (SV ratio) was evaluated using bioelectric impedance analysis. NAFLD and significant liver fibrosis were assessed using transient elastography, and high atherosclerotic cardiovascular disease (ASCVD) risk was defined as a 10-year ASCVD risk score >10%. Sarcopenia was defined as appendicular skeletal muscle mass adjusted by body mass index (<0.789 for men and <0.512 for women).
: In total, 82.0% (n=1,205) of the entire study population had NAFLD, and 14.6% of these individuals (n=176) exhibited significant liver fibrosis. Individuals with the lowest SV ratio had a significantly increased risk of NAFLD, significant liver fibrosis, and high ASCVD risk (all p<0.05). Individuals with both the lowest SV ratio and sarcopenia had the highest risk of developing NAFLD (odds ratio [OR]=3.11), significant liver fibrosis (OR=2.03), and high ASCVD risk (OR=4.15), compared with those with a higher SV ratio and without sarcopenia (all p<0.05).
: Low SV ratio combined with sarcopenia was significantly associated with an increased risk of NAFLD, significant liver fibrosis, and high ASCVD risk among individuals with a high risk of NAFLD.
背景/目的:关于肌少性内脏肥胖与非酒精性脂肪性肝病(NAFLD)相关合并症之间的关联报告仍然很少。我们研究了肌少症与内脏肥胖之间的关系,以及这种关系对肝脏和冠状动脉合并症的影响。
使用生物电阻抗分析评估四肢骨骼肌质量与内脏脂肪面积的比值(SV 比值)。使用瞬时弹性成像评估 NAFLD 和显著的肝纤维化,高动脉粥样硬化性心血管疾病(ASCVD)风险定义为 10 年 ASCVD 风险评分>10%。肌少症定义为根据体重指数调整的四肢骨骼肌质量(男性<0.789,女性<0.512)。
在整个研究人群中,82.0%(n=1205)患有 NAFLD,其中 14.6%(n=176)存在显著的肝纤维化。SV 比值最低的个体患 NAFLD、显著肝纤维化和高 ASCVD 风险的风险显著增加(均 p<0.05)。SV 比值和肌少症均最低的个体发生 NAFLD 的风险最高(比值比[OR]=3.11)、显著肝纤维化(OR=2.03)和高 ASCVD 风险(OR=4.15),与 SV 比值较高且无肌少症的个体相比(均 p<0.05)。
在具有高 NAFLD 风险的个体中,低 SV 比值与肌少症相结合与 NAFLD、显著肝纤维化和高 ASCVD 风险的风险增加显著相关。