Sarcopaenia is associated with NAFLD independently of obesity and insulin resistance: Nationwide surveys (KNHANES 2008-2011)
Sarcopaenia is associated with NAFLD independently of obesity and insulin resistance: Nationwide surveys (KNHANES 2008-2011)
复制标题
DOI：
10.1016/j.jhep.2015.02.051
复制
发表时间：
2015-08-01
影响因子：
25.7
通讯作者：
Cha, Bong-Soo
中科院分区：
文献类型：
--
作者：
Lee, Yong-ho;Jung, Kyu Sik;Cha, Bong-Soo
背景和目标：虽然Sarcopaenia与肥胖相关的合并症有关，但其对非酒精性脂肪性肝病（NAFLD）或脂肪性肝炎的影响尚未完全确定。我们的目的是调查Sarcopaenia和NAFLD或脂肪性hepatitis在一般population.Methods的直接关系：我们进行了一项横断面研究，使用全国代表性样本的15,132名受试者从韩国国家健康和营养检查调查2008-2011。当受试者具有来自先前验证的NAFLD预测模型的较高评分时，如肝脂肪变性指数、综合NAFLD评分和NAFLD肝脏脂肪评分，则将受试者定义为患有NAFLD。BARD和FIB-4评分用于定义NAFLD受试者的晚期纤维化。采用双能X线骨密度仪测量的骨骼肌指数（SMI）[SMI（%）=围壁骨骼肌总质量（kg）/体重（kg）× 100]诊断Sarcopaenia，男性和女性的分界点分别为32.2%和25.5%。分层后，无论是否肥胖（比值比[OR] = 1.55至3.02，取决于模型;所有P < 0.001）或代谢综合征（OR = 1.63至4.00，所有P <0.001），Sarcopaenic受试者的NAFLD风险均增加。多因素Logistic回归分析也表明，在调整肥胖或胰岛素抵抗相关的混杂因素后，Sarcopaenia和NAFLD之间存在独立的相关性（OR = 1.18至1.22，所有P < 0.001）。此外，在NAFLD人群中，与非肉瘤患者相比，SMI较低的受试者可能患有晚期纤维化（BARD和FIB-4：OR分别为1.83和1.69;均P < 0.001）。与不锻炼的受试者相比，经常锻炼的人患NAFLD的风险较低（p < 0.001），特别是在肌肉质量保存良好的肥胖人群中。结论：Sarcopaenia与NAFLD和晚期纤维化的风险增加相关，与肥胖或代谢控制无关。(C)2015年欧洲肝脏研究协会。Elsevier B. V.出版，保留所有权利。
Background & Aims: Although sarcopaenia is associated with obesity-related comorbidities, its influence on non-alcoholic fatty liver disease (NAFLD) or steatohepatitis has not been fully determined. We aimed to investigate the direct relationship between sarcopaenia and NAFLD or steatohepatitis in the general population.Methods: We conducted a cross-sectional study using nationally representative samples of 15,132 subjects from the Korea National Health and Nutrition Examination Surveys 2008-2011. Subjects were defined as having NAFLD when they had higher scores from previously validated NAFLD prediction models such as the hepatic steatosis index, comprehensive NAFLD score and NAFLD liver fat score. BARD and FIB-4 scores were used to define advanced fibrosis in subjects with NAFLD. The skeletal muscle index (SMI) [SMI(%) = total appendicular skeletal muscle mass (kg)/weight (kg) x 100] measured by dual-energy X-ray absorptiometry was used to diagnose sarcopaenia with cut points of 32.2% for men and 25.5% for women.Results: SMI was inversely correlated with all NAFLD predicting scores (Ps < 0.001). After stratification, sarcopaenic subjects had an increased risk of NAFLD regardless of obesity (odds ratios [ORs] = 1.55 to 3.02, depending on models; all Ps < 0.001) or metabolic syndrome (ORs = 1.63 to 4.00, all Ps < 0.001). Multiple logistic regression analysis also demonstrated this independent association between sarcopaenia and NAFLD after adjusting for confounding factors related to obesity or insulin resistance (ORs = 1.18 to 1.22, all Ps < 0.001). Furthermore, among the NAFLD population, subjects with lower SMIs were likely to have advanced fibrosis compared with non-sarcopaenic individuals (BARD and FIB-4: ORs = 1.83 and 1.69, respectively; both Ps < 0.001). Compared with non-exercised subjects, individuals who exercised regularly had a lower risk of NAFLD (p < 0.001), particularly among obese people with well-preserved muscle mass.Conclusions: Sarcopaenia is associated with increased risks of NAFLD and advanced fibrosis, independent of obesity or metabolic control. (C) 2015 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.