Sarcopenia Is Associated With Significant Liver Fibrosis Independently of Obesity and Insulin Resistance in Nonalcoholic Fatty Liver Disease: Nationwide Surveys (KNHANES 2008-2011)
Sarcopenia Is Associated With Significant Liver Fibrosis Independently of Obesity and Insulin Resistance in Nonalcoholic Fatty Liver Disease: Nationwide Surveys (KNHANES 2008-2011)
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肌肉减少症与非酒精性脂肪性肝病中独立于肥胖和胰岛素抵抗的显著肝纤维化相关：全国调查（KNHANES 2008-2011）
DOI：
10.1002/hep.28376
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发表时间：
2016-03-01
期刊：
影响因子：
13.5
通讯作者：
Han, Kwang-Hyub
中科院分区：
文献类型：
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作者：
Lee, Yong-ho;Kim, Seung Up;Han, Kwang-Hyub
骨量减少与非酒精性脂肪性肝病(NAFLD)有关。这项研究调查了NAFLD受试者的骨肉减少是否与显著的肝纤维化有关。分析了2008-2011年韩国国民健康和营养检查调查数据库中的数据。以NAFLD肝脂评分、NAFLD综合评分或肝脏脂肪变性指数定义NALFD。采用NAFLD纤维化评分、FIB-4和Forns指数评价肝纤维化程度。显著的肝纤维化被定义为FIB-4和FIB；=2.67，以及最高的四分位数的NFS值和Forns指数。用双能X线骨密度仪计算骨量减少指数(=附件骨骼肌总质量[kg]/体质量指数(kg/m(2)。使用NAFLD肝脂评分，在9676名受试者中有2761人(28.5%)被诊断为NAFLD。在NAFLD受试者中，有337例(12.2%)出现骨质疏松症。在纤维化预测模型中，骨质疏松症与显著的肝纤维化显著相关(均P<；0.05)。在根据体重指数和胰岛素抵抗的稳态模型评估进行分层的亚组中，一直存在显著的相关关系(优势比=1.76-2.68，取决于亚组，均P<；0.05)。多变量Logistic回归分析显示，在调整了其他混杂因素后，SI与非酒精性肝纤维化的显著肝纤维化之间存在独立关联(优势比=0.52-0.67，均P<；0.01)。其他NAFLD(NAFLD综合评分，肝脏脂肪变性指数)和纤维化预测模型(FIB-4和Forns指数)也得出了类似的结果。结论：在NAFLD受试者中，骨骼肌减少与显著的肝纤维化有关，并且这种联系与肥胖和胰岛素抵抗无关。
Sarcopenia is associated with nonalcoholic fatty liver disease (NAFLD). This study investigated whether sarcopenia is associated with significant liver fibrosis in subjects with NAFLD. Data from the Korean National Health and Nutrition Examination Surveys 2008-2011 database were analyzed. NALFD was defined by NAFLD liver fat score, comprehensive NAFLD score, or hepatic steatosis index. Degree of liver fibrosis was assessed by NAFLD fibrosis score (NFS), FIB-4, and Forns index. Significant liver fibrosis was defined as FIB-4 >= 2.67 and the highest quartile values of NFS and Forns index. Sarcopenia index (= total appendicular skeletal muscle mass [kg]/body mass index (kg/m(2)]) was calculated using dual-energy X-ray absorptiometry. Using the NAFLD liver fat score, NAFLD was identified in 2761 (28.5%) of 9676 subjects. Of subjects with NAFLD, sarcopenia was identified in 337 (12.2%). Sarcopenia was significantly associated with significant liver fibrosis assessed in fibrosis prediction models (all P < 0.05). In subgroups stratified according to body mass index and homeostasis model assessment of insulin resistance, a significant association between sarcopenia and significant liver fibrosis by NFS was consistently present (odds ratio = 1.76-2.68 depending on the subgroup, all P < 0.05). Multivariate logistic regression analysis demonstrated an independent association between SI and significant liver fibrosis by NFS after adjusting for other confounders (odds ratio = 0.52-0.67, all P < 0.01). Other NAFLD (comprehensive NAFLD score, hepatic steatosis index) and fibrosis prediction models (FIB-4 and Forns index) produced similar results. Conclusion: Sarcopenia is associated with significant liver fibrosis in subjects with NAFLD, and the association is independent of obesity and insulin resistance.