Risk stratification using sarcopenia status among subjects with metabolic dysfunction-associated fatty liver disease.
Risk stratification using sarcopenia status among subjects with metabolic dysfunction-associated fatty liver disease.
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DOI：
10.1002/jcsm.12754
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发表时间：
2021-10
期刊：
影响因子：
--
通讯作者：
Kim SU
中科院分区：
文献类型：
--
作者：
Chun HS;Kim MN;Lee JS;Lee HW;Kim BK;Park JY;Kim DY;Ahn SH;Kim SU
肌肉减少症是非酒精性脂肪肝严重程度的重要指标。我们研究了肌少症是否可以在代谢功能障碍相关脂肪肝病（MAFLD）受试者中识别具有不同肝纤维化和动脉粥样硬化性心血管疾病（ASCVD）风险的亚组。受试者选自 2008-2011 年韩国国家健康和营养检查调查 (n = 8361)。肌肉减少症是使用肌肉减少症指数来定义的。肝脂肪变性定义为脂肪肝指数≥30。显着肝纤维化被定义为纤维化-4指数（FIB-4）≥2.67或非酒精性脂肪性肝病纤维化评分（NFS）的最高四分位数。 ASCVD 高概率定义为 ASCVD 风险评分 >10%。平均年龄为 48.5 ± 15.6 岁，42.6% 的受试者为男性。 MAFLD 的患病率为 37.3%（n = 8361 人中的 3116 人），MAFLD 患者中肌少症受试者的比例为 9.9%。调整混杂因素后，与无 MAFLD 的受试者相比，患有 MAFLD 的非肌少症受试者 [FIB-4 的比值比 (OR) = 1.57，NFS 的比值比 (OR) = 1.57，NFS 的 2.13] 到 MAFLD 的肌少症受试者（FIB-4 的 OR = 4.51，NFS 的 5.72），显着肝纤维化的风险显着增加（所有 P < 0.001）。与无 MAFLD 的受试者相比，从患有 MAFLD 的非肌少症受试者 (OR = 1.47) 到患有 MAFLD 的肌少症受试者 (OR = 4.08)，发生 ASCVD 高概率的风险显着增加（所有 P < 0.001）。根据 MAFLD 受试者的肌少状态，显着肝纤维化和 ASCVD 的风险存在显着差异。肌肉减少症的评估可能有助于 MAFLD 受试者的风险分层。
Sarcopenia is a significant indicator of the severity of non‐alcoholic fatty liver disease. We investigated whether sarcopenia could identify subgroups with different risk of liver fibrosis and atherosclerotic cardiovascular disease (ASCVD) among subjects with metabolic dysfunction‐associated fatty liver disease (MAFLD). Subjects from the Korea National Health and Nutrition Examination Survey 2008–2011 were selected (n = 8361). Sarcopenia was defined using the sarcopenia index. Hepatic steatosis was defined as a fatty liver index ≥30. Significant liver fibrosis was defined as a fibrosis‐4 index (FIB‐4) ≥2.67 or the highest quartile of non‐alcoholic fatty liver disease fibrosis score (NFS). High probability of ASCVD was defined as ASCVD risk score >10%. The mean age was 48.5 ± 15.6 years, and 42.6% of subjects were male. The prevalence of MAFLD was 37.3% (n = 3116 of 8361), and the proportion of sarcopenic subjects was 9.9% among those with MAFLD. After adjusting for confounders, the risk of significant liver fibrosis significantly increased from non‐sarcopenic subjects with MAFLD [odds ratio (OR) = 1.57 by FIB‐4 and 2.13 by NFS] to sarcopenic subjects with MAFLD (OR = 4.51 by FIB‐4 and 5.72 by NFS), compared with subjects without MAFLD (all P < 0.001). The risk for high probability of ASCVD significantly increased from non‐sarcopenic subjects with MAFLD (OR = 1.47) to sarcopenic subjects with MAFLD (OR = 4.08), compared with subjects without MAFLD (all P < 0.001). The risks of significant liver fibrosis and ASCVD differed significantly according to sarcopenic status among subjects with MAFLD. An assessment of sarcopenia might be helpful in risk stratification among subjects with MAFLD.
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