Muscle alterations are independently associated with significant fibrosis in patients with nonalcoholic fatty liver disease

Hsieh, Yun Cheng; Joo, Seung Ki; Koo, Bo Kyung; Lin, Han Chieh; Kim, Won

doi:10.1111/liv.14719

Cited by 36 publications

(40 citation statements)

References 48 publications

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“…In individuals with T2DM with NAFLD, low SMM was independently associated with liver fibrosis estimated by Transient elastography ( 31 ). In a prospective biopsy-confirmed NAFLD cohort of 521 patients indicated that low SMM was an independent predictor of significant fibrosis, ( 32 ) consistent with another biopsy-proven NAFLD cohort study ( 13 ). Miyake et al found that appendicular skeletal muscle mass remained associated with liver fibrosis estimated by liver biopsy after adjustment for confounding factors ( 33 ).…”

Section: Discussionsupporting

confidence: 79%

Association Between Skeletal Muscle Mass and Severity of Steatosis and Fibrosis in Non-alcoholic Fatty Liver Disease

et al. 2022

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BackgroundSarcopenia is known to be the risk factor of non-alcoholic fatty liver disease (NAFLD). However, studies evaluating the association of skeletal muscle mass (SMM) with liver fibrosis by transient elastography are limited. Here, we investigated the association of SMM with hepatic steatosis and fibrosis assessed in Chinese adults.MethodsPatients who underwent liver ultrasonography at the Health Promotion Center of the First Affiliated Hospital of Nanjing Medical University between January 2020 to June 2021 were enrolled. We used transient elastography to evaluate the degree of hepatic fat and liver stiffness. Appendicular skeletal muscle mass was determined by bioelectrical impedance and was adjusted for body weight to derive the skeletal muscle mass index (SMI).ResultsOf 3,602 finally enrolled individuals, 1,830 had NAFLD and 1,772 did not have NAFLD. SMI gradually decreased as the severity of hepatic steatosis increased (40.47 ± 3.94% vs. 39.89 ± 3.57% vs. 39.22 ± 3.46% vs. 37.81 ± 2.84%, P < 0.001). Individuals with F3-F4 and F2 liver fibrosis groups had significantly lower SMI than individuals with F0-F1 stages (37.51 ± 3.19% vs. 38.06 ± 3.51% vs. 39.36 ± 3.38%, P < 0.001). As the SMI increased, the percentages of subjects with mild and severe NAFLD, and the percentages of subjects in F2 and F3-F4 stage were gradually decreased. SMI was independently associated with the severity of hepatic steatosis and fibrosis by logistic regression analysis. Moreover, decreased SMI was an independent risk factor for NAFLD and fibrosis.ConclusionSMI is closely associated with liver fat content and liver fibrosis in Chinese adults with NAFLD.

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Section: Discussionsupporting

confidence: 79%

Association Between Skeletal Muscle Mass and Severity of Steatosis and Fibrosis in Non-alcoholic Fatty Liver Disease

et al. 2022

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“…Previous studies have found low muscle mass to be an independent risk factor for advanced fibrosis as assessed by NAFLD fibrosis score and the Fibrosis-4 index in a Korean population that had undergone routine health screenings [ 16 ]. In a prospective biopsy-confirmed cohort, low muscle mass was associated with significant fibrosis and advanced NAFLD [ 37 ]. Our results are consistent with previous findings that show a significant association between low muscle mass and LSM, which is a noninvasive, clinically useful method to assess the severity of hepatic fibrosis in patients with NAFLD [ 38 , 39 ].…”

Section: Discussionmentioning

confidence: 99%

The Association between Low Muscle Mass and Hepatic Steatosis in Asymptomatic Population in Korea

Chung

Park

Kim

et al. 2021

Life

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Background: An association between low muscle mass and nonalcoholic fatty liver disease (NAFLD) has been suggested. We investigated this relationship using controlled attenuation parameter (CAP). Methods: A retrospective cohort of subjects had liver FibroScan® (Echosens, Paris, France) and bioelectrical impedance analyses during health screening exams. Low muscle mass was defined based on appendicular skeletal muscle mass/body weight ratios of one (class I) or two (class II) standard deviations below the sex-specific mean for healthy young adults. Results: Among 960 subjects (58.1 years; 67.4% male), 344 (45.8%, class I) and 110 (11.5%, class II) had low muscle mass. After adjusting for traditional metabolic risk factors, hepatic steatosis, defined as a CAP ≥ 248 dB/m, was associated with low muscle mass (class I, odds ratio (OR): 1.96, 95% confidence interval (CI): 1.38–2.78; class II, OR: 3.33, 95% CI: 1.77–6.26). A dose-dependent association between the grade of steatosis and low muscle mass was also found (class I, OR: 1.88, for CAP ≥ 248, <302; OR: 2.19, in CAP ≥ 302; class II, OR: 2.33, for CAP ≥ 248, <302; OR: 6.17, in CAP ≥ 302). High liver stiffness was also significantly associated with an increased risk of low muscle mass (class I, OR: 1.97, 95% CI: 1.31–2.95; class II, OR: 2.96, 95% CI: 1.51–5.78). Conclusion: Hepatic steatosis is independently associated with low muscle mass in a dose-dependent manner. The association between hepatic steatosis and low muscle mass suggests that particular attention should be given to subjects with NAFLD for an adequate assessment of muscle mass.

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“…Sarcopenia and myosteatosis are also linked with liver problems other than NAFLD that shows their key role in liver problems. A Canadian review study reported a high prevalence of myosteatosis and sarcopenia in patients with liver abnormalities such as cirrhosis [127] . In a Korean cohort, it was found that the severity of fibrosis in NAFLD is strongly associated with visceral fat content and quality and quantity of muscles.…”

Section: Nafld Pathophysiology Sarcopenia and Myosteatosismentioning

confidence: 99%

Sarcopenia in the setting of nonalcoholic fatty liver

Arrese¹,

Cabello-Verrugio²,

Arab³

et al. 2022

MTOD

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Nonalcoholic fatty liver is a worldwide common problem with more prevalence in non-Asian populations that is closely correlated with the muscle-related disorder sarcopenia. The incidence of both health issues has been observed to be strongly interlinked where presence of one exacerbates the other. Nonalcoholic fatty liver disease (NAFLD) pathophysiology increases the muscle loss, while the onset of NAFLD in sarcopenic patients aggravates the liver problems as compared to non-sarcopenic patients. Scarcity of research on the subject provides very little evidence about the cause and effect of disorders. No FDA approved drugs are available to date for NAFLD and sarcopenia. Research is underway to understand the complex biochemical pathways involved in the development of both disorders. This review is a small contribution toward understanding sarcopenia in the setting of NAFLD that provides insight on the common pathophysiological profile of sarcopenia and NAFLD and portrays a novel way of delving into the subject by introducing the concept of cortisol crosstalk with the muscle-liver axis. Sarcopenia and NAFLD are considered metabolism-related problems, and cortisol, being a glucocorticoid, plays an important role in metabolism of fats, carbohydrates, and proteins. Cushing’s syndrome, characterized by abnormally elevated concentrations of blood cortisol/enhanced intracellular activity, shares many pathologic conditions (such as insulin resistance, metabolic syndrome, abnormal levels of specific cytokines, and obesity) with NAFLD and sarcopenia. Hence, cortisol can be a potential biomarker in sarcopenia and NAFLD. As cortisol activity at cellular level is controlled by 11β-hydroxysteroid dehydrogenase type 1 and 2 (11β-HSD1/2) enzymes that convert inactive steroid precursor into active cortisol, these enzymes can be targeted for the study of sarcopenia and NAFLD. Combined studies on NAFLD and sarcopenia with respect to cortisol open a new avenue of research in the understanding of both disorders.

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Muscle alterations are independently associated with significant fibrosis in patients with nonalcoholic fatty liver disease

Cited by 36 publications

References 48 publications

Association Between Skeletal Muscle Mass and Severity of Steatosis and Fibrosis in Non-alcoholic Fatty Liver Disease

Association Between Skeletal Muscle Mass and Severity of Steatosis and Fibrosis in Non-alcoholic Fatty Liver Disease

The Association between Low Muscle Mass and Hepatic Steatosis in Asymptomatic Population in Korea

Sarcopenia in the setting of nonalcoholic fatty liver

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