The Role of Skeletal Muscle in Development of Nonalcoholic Fatty Liver Disease

Abstract

BackgroundNonalcoholic fatty liver disease (NAFLD) is closely correlated with abnormal accumulation of visceral fat, but the role of skeletal muscle remains unclear. The aim of this study was to elucidate the role of skeletal muscle in development of NAFLD.MethodsAmong 11,116 subjects (6,242 males), we examined the effects of skeletal muscle mass and visceral fat area (VFA, by bioelectric impedance analysis) on NAFLD using by the fatty liver index (FLI).ResultsOf the total subjects (9,565 total, 5,293 males) included, 1,848 were classified as having NALFD (FLI ≥60). Body mass index, lipid profile, fasting plasma glucose, hemoglobin A1c, prevalence of type 2 diabetes (DM), hypertension (HTN), and metabolic syndrome were higher in males than females, but FLI showed no significant difference. The low FLI group showed the lowest VFA and highest skeletal muscle mass of all the groups. Skeletal muscle to visceral fat ratio (SVR) and skeletal muscle index had inverse correlations with FLI, when adjusted for age and gender. In multivariate regression analysis, SVR was negatively associated with FLI. Among SVR quartiles, the highest quartile showed very low risk of NAFLD when adjusted for age, gender, lipid profile, DM, HTN, and high sensitivity C-reactive protein from the lowest quartiles (odds ratio, 0.037; 95% confidence interval, 0.029 to 0.049).ConclusionSkeletal muscle mass was inversely associated with visceral fat area, and higher skeletal muscle mass may have a beneficial effect in preventing NAFLD. These results suggest that further studies are needed to ameliorate or slow the progression of sarcopenia.

Volume-dependent effect of supervised exercise training on fatty liver and visceral adiposity index in subjects with type 2 diabetes The Italian Diabetes Exercise Study (IDES)

“…engagement in resistance training, when strength was excluded from the model. This is consistent with the observations that skeletal muscle mass was inversely associated with FLI values [32] and that muscle fat accumulation correlated with NASH severity [33]. Altogether, these data point to a role of skeletal muscle, in addition to adipose tissue, in the pathogenesis of NAFLD.…”

The relationship between hepatic steatosis and skeletal muscle mass index in men with type 2 diabetes

“…Recent cross-sectional studies revealed the association between sarcopenia and NAFLD in general population [17][18][19]. To our knowledge, this is the first study to investigate the association between SMI and hepatic steatosis in patients with type2 diabetes.…”

“…We obtained readings for skeletal muscle mass (SMM, kg) and visceral fat area (VFA, cm 2 ). Skeletal muscle mass index (SMI, %) was expressed as percent, dividing the SMM (kg) by total body weight (kg) [17][18][19].…”

Glucocorticoids and non-alcoholic fatty liver disease

“…NALFD is associated with sarcopaenia and individuals with low muscle mass have a higher risk of developing NAFLD (63,64). Given the well-described detrimental effects GCs have on muscle, an indirect mechanism of NAFLD from myokine secretion, protein mediator or increased insulin resistance is plausible (20,65).…”