Skeletal muscle mass to visceral fat area ratio is an important determinant affecting hepatic conditions of non-alcoholic fatty liver disease
Abstract
Background
Not only obesity but also sarcopenia is associated with NAFLD. The influence of altered body composition on the pathophysiology of NAFLD has not been fully elucidated. The aim of this study is to determine whether skeletal muscle mass to visceral fat area ratio (SV ratio) affects NAFLD pathophysiology.
Methods
A total of 472 subjects were enrolled. The association between SV ratio and NAFLD pathophysiological factors was assessed in a cross-sectional nature by stratification analysis.
Results
When the SV ratio was stratified by quartiles (Q 1–Q 4), the SV ratio showed a negative relationship with the degree of body mass index, HOMA-IR, and liver stiffness (Q 1, 8.9 ± 7.5 kPa, mean ± standard deviation; Q 2, 7.5 ± 6.2; Q 3, 5.8 ± 3.7; Q 4, 5.0 ± 1.9) and steatosis (Q 1, 282 ± 57 dB/m; Q 2, 278 ± 58; Q 3, 253 ± 57; Q 4, 200 ± 42) measured by transient elastography. Levels of leptin and biochemical markers of liver cell damage, liver fibrosis, inflammation and oxidative stress, and hepatocyte apoptosis were significantly higher in subjects in Q 1 than in those in Q 2, Q 3, or Q 4. Moreover, fat contents in femoral muscles were significantly higher in subjects in Q 1 and the change was associated with weakened muscle strength. In logistic regression analysis, NAFLD subjects with the decreased SV ratio were likely to have an increased risk of moderate-to-severe steatosis and that of advanced fibrosis.
Conclusions
Decreased muscle mass coupled with increased visceral fat mass is closely associated with an increased risk for exacerbating NAFLD pathophysiology.
Keywords
Non-alcoholic fatty liver disease Skeletal muscle mass to visceral fat area ratio Liver steatosis Liver fibrosis PathophysiologyAbbreviations
- ALT
Alanine aminotransferase
- AST
Aspartate aminotransferase
- BMI
Body mass index
- CAP
Controlled attenuation parameter
- CEUS
Contrast-enhanced ultrasonography
- EMCL
Extra-myocellular lipid
- FFA
Free fatty acid
- FGF21
Fibroblast growth factor 21
- FPG
Fasting plasma glucose
- HDL-C
High-density lipoprotein-cholesterol
- HOMA-IR
Homeostasis model assessment-insulin resistance
- hs-CRP
High-sensitivity C-reactive protein
- IHL
Intrahepatic lipid
- IL-6
Interleukin-6
- IMCL
Intra-myocellular lipid
- LDL-C
Low-density lipoprotein-cholesterol
- LPS
Lipopolysaccharide
- LS
Liver stiffness
- 1H-MRS
Proton magnetic resonance spectroscopy
- MSTN
Myostatin
- NAFLD
Non-alcoholic fatty liver disease
- NASH
Non-alcoholic steatohepatitis
- Sep
Selenoprotein-P
- SV ratio
Skeletal muscle mass to visceral fat area ratio
- TBARS
2-Thiobarbituric acid reactive substances
- TG
Triglyceride
- TNF-α
Tumor necrosis factor-α
- γ-GT
gamma-Glutamyltransferase
- VFA
Visceral fat area
- VLDL
Very low density lipoprotein
- WFA+-M2BP
Wisteria floribunda agglutinin-positive Mac-2 binding protein
Notes
Compliance with ethical standards
Conflict of interest
All authors declare that they have no conflicts of interest.
Funding
This work was supported by in part by Grants-in-Aids for Scientific Research from the Ministry of Education, Culture, Sports, Science and Technology, Japan (Nos. 25282212, 26282191, 26293284, 26293297, 26670109, 15K15037, 15K15488, and 16K15188).
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