恢复骨骼肌质量作为 MAFLD 肝脂肪沉积改善的独立决定因素。

Restoring skeletal muscle mass as an independent determinant of liver fat deposition improvement in MAFLD.

机构信息

Department of Gastroenterology, The First Affiliated Hospital, Sun Yat-sen University, No. 58 Zhongshan II Road, Yuexiu District, Guangzhou, 510080, China.

Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital, Sun Yat-sen University, No. 58 Zhongshan II Road, Yuexiu District, Guangzhou, 510080, Guangdong, China.

出版信息

Skelet Muscle. 2023 Dec 19;13(1):23. doi: 10.1186/s13395-023-00333-z.

DOI:10.1186/s13395-023-00333-z

PMID:38115119

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10731792/

Abstract

AIMS

Cross-sectional studies have demonstrated the association of skeletal muscle mass with metabolic-associated fatty liver disease (MAFLD), while longitudinal data are scarce. We aimed to explore the impact of changes in relative skeletal muscle mass on the MAFLD treatment response.

METHODS

MAFLD patients undergoing magnetic resonance imaging-based proton density fat fraction for liver fat content (LFC) assessments and bioelectrical impedance analysis before and after treatment (orlistat, meal replacement, lifestyle modifications) were enrolled. Appendicular muscle mass (ASM) was adjusted by weight (ASM/W).

RESULTS

Overall, 256 participants were recruited and divided into two groups: with an ASM/W increase (n=166) and without an ASM/W increase (n=90). There was a great reduction in LFC in the group with an ASM/W increase (16.9% versus 8.2%, P < 0.001). However, the change in LFC in the group without an ASM/W increase showed no significant difference (12.5% versus 15.0%, P > 0.05). △ASM/W [odds ratio (OR)=1.48, 95% confidence interval (CI) 1.05-2.07, P = 0.024] and △total fat mass (OR=1.45, 95% CI 1.12-1.87, P = 0.004) were independent predictors for steatosis improvement (relative reduction of LFC ≥ 30%). The subgroup analysis showed that, despite without weight loss, decrease in HOMA-IR (OR=6.21, 95% CI 1.28-30.13, P=0.023), △total fat mass (OR=3.48, 95% CI 1.95-6.21, P <0.001 and △ASM/W (OR=2.13, 95% CI 1.12-4.05, P=0.022) independently predicted steatosis improvement.

CONCLUSIONS

ASM/W increase and loss of total fat mass benefit the resolution of liver steatosis, independent of weight loss for MAFLD.

摘要

目的

横断面研究已经证明了骨骼肌质量与代谢相关脂肪性肝病（MAFLD）之间的关联，而纵向数据则相对较少。我们旨在探讨相对骨骼肌质量变化对 MAFLD 治疗反应的影响。

方法

本研究纳入了接受磁共振成像质子密度脂肪分数检测肝脏脂肪含量（LFC）评估和治疗前后生物电阻抗分析（奥利司他、代餐、生活方式改变）的 MAFLD 患者。调整体重后的四肢骨骼肌质量（ASM/W）。

结果

总体而言，共招募了 256 名参与者，分为两组：ASM/W 增加组（n=166）和 ASM/W 未增加组（n=90）。ASM/W 增加组的 LFC 显著降低（16.9%比 8.2%，P<0.001）。然而，ASM/W 未增加组的 LFC 变化无显著差异（12.5%比 15.0%，P>0.05）。△ASM/W [比值比（OR）=1.48，95%置信区间（CI）1.05-2.07，P=0.024]和△总脂肪量（OR=1.45，95%CI 1.12-1.87，P=0.004）是改善脂肪变性的独立预测因子（LFC 相对降低≥30%）。亚组分析显示，尽管体重未减轻，但 HOMA-IR 降低（OR=6.21，95%CI 1.28-30.13，P=0.023）、△总脂肪量（OR=3.48，95%CI 1.95-6.21，P<0.001）和△ASM/W（OR=2.13，95%CI 1.12-4.05，P=0.022）独立预测脂肪变性改善。