Volaklis Konstantinos, Freuer Dennis, Meisinger Christa, Linseisen Jakob
Epidemiology, Medical Faculty, University of Augsburg, Stenglingstr. 2, Augsburg, 86156, Germany.
7FIT, Cardiac Rehabilitation Center, Augsburg, Germany.
Lipids Health Dis. 2025 Sep 9;24(1):278. doi: 10.1186/s12944-025-02694-4.
This study aimed to investigate the gender-specific associations of skeletal muscle mass and fat mass with non-alcoholic fatty liver disease (NAFLD) and NAFLD-related liver fibrosis in two population-based studies.
Analyses were based on data from the MEGA (n = 238) and the MEIA study (n = 594) conducted between 2018 and 2023 in Augsburg, Germany. Bioelectrical impedance analysis was used to evaluate relative skeletal muscle mass (rSM) and SM index (SMI) as well as relative fat mass (rFM) and FM index (FMI); furthermore, the fat-to-muscle ratio was built. The fatty liver index (FLI) was calculated to identify NAFLD. To estimate the degree of liver fibrosis, liver stiffness was assessed in the MEGA study using ultrasound elastography. Multivariable gamma regression models with log-link were used to analyze the respective associations.
After adjusting for confounders, FMI and rFM (p < 0.001) as well as SMI (p < 0.001) were significantly positive associated with FLI. The associations were non-linear, and effect modification by gender (p < 0.001) existed in all models except for SMI, while age modified the rSM and SMI results. The effect estimates for FMI and rFMI were higher in men than in women but approached each other at the high FMI range. Increasing rSM was inversely associated with FMI. The fat-to-muscle ratio was positively associated with FLI in men and women. However, no associations were found between the exposure variables and liver fibrosis.
This population-based study demonstrated gender-specific positive associations between fat mass parameters and FLI, and an inverse association with rSM. Furthermore, for rSM effect modification by age was observed. Neither in men nor in women associations between body composition and liver fibrosis could be identified.
本研究旨在通过两项基于人群的研究，调查骨骼肌质量和脂肪量与非酒精性脂肪性肝病（NAFLD）及NAFLD相关肝纤维化的性别特异性关联。
分析基于2018年至2023年在德国奥格斯堡进行的MEGA研究（n = 238）和MEIA研究（n = 594）的数据。采用生物电阻抗分析评估相对骨骼肌质量（rSM）和SM指数（SMI）以及相对脂肪量（rFM）和FM指数（FMI）；此外，构建了脂肪与肌肉比率。计算脂肪肝指数（FLI）以识别NAFLD。为评估肝纤维化程度，在MEGA研究中使用超声弹性成像评估肝脏硬度。使用具有对数链接的多变量伽马回归模型分析各自的关联。
在调整混杂因素后，FMI、rFM（p < 0.001）以及SMI（p < 0.001）与FLI显著正相关。这些关联是非线性的，除SMI外，所有模型中均存在性别效应修正（p < 0.001），而年龄修正了rSM和SMI的结果。男性中FMI和rFMI的效应估计值高于女性，但在高FMI范围内两者接近。rSM增加与FMI呈负相关。脂肪与肌肉比率在男性和女性中均与FLI正相关。然而，未发现暴露变量与肝纤维化之间存在关联。
这项基于人群的研究表明，脂肪量参数与FLI之间存在性别特异性正相关，与rSM呈负相关。此外，观察到rSM存在年龄效应修正。在男性和女性中均未发现身体成分与肝纤维化之间存在关联。
