Relationship between body composition and the histology of non‐alcoholic fatty liver disease: a cross‐sectional study

Abstract

Background Causes of non-alcoholic fatty liver disease and its progression include visceral fat accumulation and loss of muscle mass; however, which of the two phenomena is more critical is unclear. Therefore, we intended to examine the relationship between body composition and non-alcoholic fatty liver disease progression as indicated by fibrosis and the non-alcoholic fatty liver disease activity score. Methods This cross-sectional study comprised 149 patients (55 men; age, 20–76 years) treated for non-alcoholic fatty liver disease between December 2010 and January 2020. Body composition measurements, histological examinations of liver samples, and comprehensive blood chemistry tests were performed. The relationship between body composition and non-alcoholic fatty liver disease histology findings was analyzed using the logistic regression model. Results Fibrosis was significantly and inversely correlated with muscle mass and appendicular skeletal muscle mass and significantly and positively correlated with fat mass, fat mass/height squared, visceral fat area, and waist-hip ratio (P < 0.05). After adjustment for sex, blood chemistry measurements, and body composition indices, fibrosis remained associated with appendicular skeletal muscle mass, fat mass, fat mass/height squared, and visceral fat area (P < 0.05). Non-alcoholic fatty liver disease activity score ≥ 5 significantly correlated with fat mass and fat mass/height squared in a univariate but not multivariate analysis. Conclusions Fibrosis in non-alcoholic fatty liver disease, an indicator of unfavorable long-term outcomes, is associated with more indices of fat mass than of those of muscle mass. Hence, fat mass should be controlled to prevent non-alcoholic fatty liver disease progression.

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

“…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 ). In the present study, liver fibrosis was defined by transient elastography and similar results were obtain form our study.…”

Cutoff Points of Waist Circumference for Predicting Incident Non-Alcoholic Fatty Liver Disease in Middle-Aged and Older Korean Adults

“…Previous studies have revealed an association between body composition and the risk for NAFLD [ 7 , 20 ]. A recent cross-sectional study has shown that fat mass indices were more strongly associated with fibrosis than were muscle mass indices [ 7 ].…”

“…Previous studies have revealed an association between body composition and the risk for NAFLD [ 7 , 20 ]. A recent cross-sectional study has shown that fat mass indices were more strongly associated with fibrosis than were muscle mass indices [ 7 ]. Other cross-sectional analyses in the Rotterdam Study reported that both high fat mass and lower lean mass were associated with NAFLD risk.…”

“…Many previous studies have evaluated the relationship between body composition indicators and NAFLD [ 7 , 8 , 9 , 10 , 11 , 12 ]. Body mass index (BMI) and waist circumference (WC), widely used indicators for identifying obesity or abdominal obesity, are well-known risk factors for NAFLD [ 8 , 12 ].…”

“…In addition, low muscle mass or muscle mass index emerged as a risk factor for NAFLD [ 10 , 11 ]. Most studies suggested that high fat mass could better predict NAFLD incidence [ 7 , 9 ]. However, there have been few studies showing which indicator would mostly be associated with NAFLD incidence.…”