Clinical and pathological features of sarcopenia‐related indices in patients with non‐alcoholic fatty liver disease

Abstract

Background Sarcopenia is diagnosed with the skeletal muscle index (SMI) or the sarcopenia index (SI). We previously reported that the ratio of skeletal muscle mass to body fat mass (SF ratio) was a novel index of sarcopenia in patients with non‐alcoholic fatty liver disease (NAFLD). The aim of this retrospective study was to evaluate sarcopenia with these indices in patients with NAFLD. Methods One hundred and fifty‐six consecutive patients with biopsy‐proven NAFLD and alanine aminotransferase (ALT) >40 IU/L were enrolled. Liver function and body composition were evaluated in 121 patients after 12 months. We evaluated the relationship between histological findings, changes in liver function, and the SMI, SI, and SF ratio. Results Of the 156 patients enrolled, 13.5% and 26.3% were diagnosed with sarcopenia with the SMI and SI. In patients with hepatic fibrosis stage <2, the SI and the SF ratio were significantly greater than in patients with fibrosis stage ≥2. There was no difference in SMI between groups. In the cohort assessed at baseline and 12 months later, transaminase activity and SMI decreased significantly, and the SF ratio increased over time. A multivariate analysis revealed the presence of the PNPLA3 G allele and an increase in SF ratio (odds ratio, 7.406) as predictive factors of ALT reduction >30% from baseline. Conclusions Due to the high prevalence of obesity, we should consider both skeletal muscle mass and body fat mass in the diagnosis and treatment of NAFLD. The SF ratio could be a useful index in sarcopenic NAFLD.

Calf Circumference as a Useful Predictor of Sarcopenia in Patients With Liver Diseases

“…CC is used to mainly evaluate muscle mass (correlation coefficient of our data between CC and SMI was: r=0.79 in males and r=0.83 in females) and BMI is used to mainly evaluate fat mass. BMI can be critical for assessing sarcopenia in CLDs, while caution should be exercised for the presence of sarcopenic obese patients (40). In this study, of the 175 male patients with visceral obesity (WC ≥85 cm), 10 (5.71%) had sarcopenia, while of the 91 female patients with visceral obesity (WC ≥90 cm), 5 (5.49%) had sarcopenia.…”

Creatinine‐to‐bodyweight ratio is a predictor of incident non‐alcoholic fatty liver disease: A population‐based longitudinal study

“…However, to investigate the association between decreased muscle mass and the risk of NAFLD, several studies have used a SMI that is calculated as the skeletal muscle mass divided by bodyweight; that is, a weight-adjusted SMI (%). [20][21][22][23][24][25] A weight-adjusted SMI might decline when the bodyweight increases due to the increase in fat mass.…”

“…[20][21][22] Several research groups have reported an association between NAFLD and decreased the skeletal muscle mass analyzed using the weight-adjusted skeletal muscle mass index (SMI). [20][21][22][23][24][25] Therefore, the evaluation of only serum creatinine, which reflects the skeletal muscle mass, might be inaccurate for the prediction of NAFLD. We thus hypothesized that serum creatinine divided by bodyweight can reflect the proportion of skeletal muscle mass in the body mass.…”

Muscle mass and cellular membrane integrity assessment in patients with nonalcoholic fatty liver disease

“…However, muscle mass (MM) has also gained prominence in several diseases, including NAFLD 3 . It seems that the connection between the liver, adipose tissue, and muscle occurs through the expression of insulin receptors in these tissues, in view of the anabolic role of insulin, in the presence of IR in myocytes, protein catabolism increases, resulting in MM depletion and, consequently, in sarcopenia 4 .…”