Association of visceral fat obesity, sarcopenia, and myosteatosis with non-alcoholic fatty liver disease without obesity
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Background/Aims: To investigate whether non-alcoholic fatty liver disease (NAFLD) in individuals without generalized obesity is associated with visceral fat obesity (VFO), sarcopenia, and/or myosteatosis. Methods: This cross-sectional analysis included 14,400 individuals (7,470 men) who underwent abdominal computed tomography scans during routine health examinations. The total abdominal muscle area (TAMA) and skeletal muscle area (SMA) at the 3rd lumbar vertebral level were measured. The SMA was divided into the normal attenuation muscle area (NAMA) and low attenuation muscle area, and the NAMA/TAMA index was calculated. VFO was defined by visceral to subcutaneous fat ratio, sarcopenia by body mass index-adjusted SMA, and myosteatosis by the NAMA/TAMA index. NAFLD was diagnosed with ultrasonography. Results: Of the 14,400 individuals, 4,748 (33.0%) had NAFLD, and the prevalence of NAFLD among non-obese individuals was 21.4%. In regression analysis, both sarcopenia (men: odds ratio [OR] 1.41, 95% confidence interval [CI] 1.19–1.67, P<0.001; women: OR=1.59, 95% CI 1.40–1.90, P<0.001) and myosteatosis (men: OR=1.24, 95% CI 1.02–1.50, P=0,028; women: OR=1.23, 95% CI 1.04–1.46, P=0.017) were significantly associated with non-obese NAFLD after considering for VFO and other various risk factors, whereas VFO (men: OR=3.97, 95% CI 3.43–4.59 [adjusted for sarcopenia], OR 3.98, 95% CI 3.44–4.60 [adjusted for myosteatosis]; women: OR=5.42, 95% CI 4.53–6.42 [adjusted for sarcopenia], OR=5.33, 95% CI 4.51–6.31 [adjusted for myosteatosis]; all P<0.001) was strongly associated with non-obese NAFLD after adjustment with various known risk factors. Conclusions: In addition to VFO, sarcopenia and/or myosteatosis were significantly associated with non-obese NAFLD.
Abstract
Background/Aims: To investigate whether non-alcoholic fatty liver disease (NAFLD) in individuals without generalized obesity is associated with visceral fat obesity (VFO), sarcopenia, and/or myosteatosis. Methods: This cross-sectional analysis included 14,400 individuals (7,470 men) who underwent abdominal computed tomography scans during routine health examinations. The total abdominal muscle area (TAMA) and skeletal muscle area (SMA) at the 3rd lumbar vertebral level were measured. The SMA was divided into the normal attenuation muscle area (NAMA) and low attenuation muscle area, and the NAMA/TAMA index was calculated. VFO was defined by visceral to subcutaneous fat ratio, sarcopenia by body mass index-adjusted SMA, and myosteatosis by the NAMA/TAMA index. NAFLD was diagnosed with ultrasonography. Results: Of the 14,400 individuals, 4,748 (33.0%) had NAFLD, and the prevalence of NAFLD among non-obese individuals was 21.4%. In regression analysis, both sarcopenia (men: odds ratio [OR] 1.41, 95% confidence interval [CI] 1.19–1.67, P<0.001; women: OR=1.59, 95% CI 1.40–1.90, P<0.001) and myosteatosis (men: OR=1.24, 95% CI 1.02–1.50, P=0,028; women: OR=1.23, 95% CI 1.04–1.46, P=0.017) were significantly associated with non-obese NAFLD after considering for VFO and other various risk factors, whereas VFO (men: OR=3.97, 95% CI 3.43–4.59 [adjusted for sarcopenia], OR 3.98, 95% CI 3.44–4.60 [adjusted for myosteatosis]; women: OR=5.42, 95% CI 4.53–6.42 [adjusted for sarcopenia], OR=5.33, 95% CI 4.51–6.31 [adjusted for myosteatosis]; all P<0.001) was strongly associated with non-obese NAFLD after adjustment with various known risk factors. Conclusions: In addition to VFO, sarcopenia and/or myosteatosis were significantly associated with non-obese NAFLD.
참고문헌 (48)
- Younossi ZM, "Global epidemiology of nonalcoholic fatty liver disease-Metaanalytic assessment of prevalence, incidence, and outcomes", Hepatology, 64, pp.73~84 (2016)
- Peter Konyn, "Causes and risk profiles of mortality among individuals with nonalcoholic fatty liver disease", Clinical and Molecular Hepatology, 29, pp.43~57 (2023), 대한간학회
- Li J, "Prevalence, incidence, and outcome of non-alcoholic fatty liver disease in Asia, 1999-2019 : a systematic review and meta-analysis", Lancet Gastroenterol Hepatol, 4, pp.389~398 (2019)
- Kim D, "Nonobese fatty liver disease", Clin Gastroenterol Hepatol, 15, pp.474~485 (2017)
- Ha Y, "Intimate association of visceral obesity with non-alcoholic fatty liver disease in healthy Asians : A case-control study", J Gastroenterol Hepatol, 30, pp.1666~1672 (2015)
- Lee S, "Visceral adiposity as a risk factor for lean non-alcoholic fatty liver disease in potential living liver donors", J Gastroenterol Hepatol, 36, pp.3212~3218 (2021)
- Eunji Ko, "Risk factors in nonalcoholic fatty liver disease", Clinical and Molecular Hepatology, 29, pp.79~85 (2023), 대한간학회
- 정찬희, "Visceral-to-Subcutaneous Abdominal Fat Ratio Is Associated with Nonalcoholic Fatty Liver Disease and Liver Fibrosis", Endocrinology and Metabolism, 35(1), pp.165~176 (2020), 대한내분비학회
- Koo BK, "Sarcopenia is an independent risk factor for non-alcoholic steatohepatitis and significant fibrosis", J Hepatol, 66, pp.123~131 (2017)
- Lee YH, "Sarcopenia is associated with significant liver fibrosis independently of obesity and insulin resistance in nonalcoholic fatty liver disease : Nationwide surveys(KNHANES 2008-2011)", Hepatology, 63, pp.776~786 (2016)
- Chun HS, "Risk stratification for sarcopenic obesity in subjects with nonalcoholic fatty liver disease", Clin Gastroenterol Hepatol (2022)[DOI]
- Shida T, "Clinical and anthropometric characteristics of non-obese nonalcoholic fatty liver disease subjects in Japan", Hepatol Res, 50, pp.1032~1046 (2020)
- Nachit M, "Muscle fat content is strongly associated with NASH : A longitudinal study in patients with morbid obesity", J Hepatol, 75, pp.292~301 (2021)
- Min Jung Lee, "Age-Related Decrease in Skeletal Muscle Mass Is an Independent Risk Factor for Incident Nonalcoholic Fatty Liver Disease: A 10-Year Retrospective Cohort Study", Gut and Liver, 13(1), pp.67~76 (2019), 거트앤리버 소화기연관학회협의회[DOI]
- Choe EK, "The association between nonalcoholic fatty liver disease and CT-measured skeletal muscle mass", J Clin Med, 7, pp.310~ (2018)
- Addison O, "Intermuscular fat : a review of the consequences and causes", Int J Endocrinol, 2014, pp.309570~ (2014)
- Shulman GI, "Ectopic fat in insulin resistance, dyslipidemia, and cardiometabolic disease", N Engl J Med, 371, pp.1131~1141 (2014)
- Addison O, "Hip but not thigh intramuscular adipose tissue is associated with poor balance and increased temporal gait variability in older adults", Curr Aging Sci, 7, pp.137~143 (2014)
- Kim HK, "Comparison of muscle mass and quality between metabolically healthy and unhealthy phenotypes", Obesity(Silver Spring), 29, pp.1375~1386 (2021)
- Lee MJ, "Association between muscle quality measured by abdominal computed tomography and subclinical coronary atherosclerosis", Arterioscler Thromb Vasc Biol, 41, pp.e128~e140 (2021)
- 김홍규, "Quality Matters as Much as Quantity of Skeletal Muscle: Clinical Implications of Myosteatosis in Cardiometabolic Health", Endocrinology and Metabolism, 36(6), pp.1161~1174 (2021), 대한내분비학회[DOI]
- Kim EH, "Reference data and t-scores of lumbar skeletal muscle area and its skeletal muscle indices measured by CT scan in a healthy Korean population", J Gerontol A Biol Sci Med Sci, 76, pp.265~271 (2021)
- Kim HK, "Age-related changes in muscle quality and development of diagnostic cutoff points for myosteatosis in lumbar skeletal muscles measured by CT scan", Clin Nutr, 40, pp.4022~4028 (2021)
- Angulo P, "Nonalcoholic fatty liver disease", N Engl J Med, 346, pp.1221~1231 (2002)
- Bedogni G, "The fatty liver index : a simple and accurate predictor of hepatic steatosis in the general population", BMC Gastroenterol, 6, pp.33~ (2006)
- Sterling RK, "Development of a simple noninvasive index to predict significant fibrosis in patients with HIV", HCV coinfection, 2006, pp.43, 1317~1325
- Aubrey J, "Measurement of skeletal muscle radiation attenuation and basis of its biological variation", Acta Physiol(Oxf), 210, pp.489~497 (2014)
- WHO Expert Consultation, "Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies", Lancet, 363, pp.157~163 (2004)
- 김은희, "Sex Differences of Visceral Fat Area and Visceral-to-Subcutaneous Fat Ratio for the Risk of Incident Type 2 Diabetes Mellitus", Diabetes and Metabolism Journal, 46(3), pp.486~498 (2022), 대한당뇨병학회[DOI]
- Ye Q, "Global prevalence, incidence, and outcomes of non-obese or lean non-alcoholic fatty liver disease : a systematic review and meta-analysis", Lancet Gastroenterol Hepatol, 5, pp.739~752 (2020)
- Neeland IJ, "Visceral and ectopic fat, atherosclerosis, and cardiometabolic disease : a position statement", Lancet Diabetes Endocrinol, 7, pp.715~725 (2019)
- Després JP, "Body fat distribution and risk of cardiovascular disease : an update", Circulation, 126, pp.1301~1313 (2012)
- Eguchi Y, "Visceral fat accumulation and insulin resistance are important factors in nonalcoholic fatty liver disease", J Gastroenterol, 41, pp.462~469 (2006)
- Park BJ, "Visceral adipose tissue area is an independent risk factor for hepatic steatosis", J Gastroenterol Hepatol, 23, pp.900~907 (2008)
- Kim D, "Body fat distribution and risk of incident and regressed nonalcoholic fatty liver disease", Clin Gastroenterol Hepatol, 14, pp.132~138 (2016)
- Cai C, "Relationship between relative skeletal muscle mass and nonalcoholic fatty liver disease : a systematic review and meta-analysis", Hepatol Int, 14, pp.115~126 (2020)
- Sae Kyung Joo, "Interaction between sarcopenia and nonalcoholic fatty liver disease", Clinical and Molecular Hepatology, 29, pp.68~78 (2023), 대한간학회
- Tanaka M, "Relationship between nonalcoholic fatty liver disease and muscle quality as well as quantity evaluated by computed tomography", Liver Int, 40, pp.120~130 (2020)
- Hsieh YC, "Myosteatosis, but not sarcopenia, predisposes NAFLD subjects to early steatohepatitis and fibrosis progression", Clin Gastroenterol Hepatol, 21, pp.388~397 (2023)
- Hak Chul Jang, "How to Diagnose Sarcopenia in Korean Older Adults?", Annals of geriatric medicine and research, 22(2), pp.73~79 (2018), 대한노인병학회[DOI]
- Cawthon PM, "Cutpoints for low appendicular lean mass that identify older adults with clinically significant weakness", J Gerontol A Biol Sci Med Sci, 69, pp.567~575 (2014)
- 김휘승, "Association of Myosteatosis with Nonalcoholic Fatty Liver Disease, Severity, and Liver Fibrosis Using Visual Muscular Quality Map in Computed Tomography", Diabetes and Metabolism Journal, 47(1), pp.104~117 (2023), 대한당뇨병학회[DOI]
- Hsieh YC, "Muscle alterations are independently associated with significant fibrosis in patients with nonalcoholic fatty liver disease", Liver Int, 41, pp.494~504 (2021)
- Chang Y, "Weight gain within the normal weight range predicts ultrasonographically detected fatty liver in healthy Korean men", Gut, 58, pp.1419~1425 (2009)
- Wong VW, "Beneficial effects of lifestyle intervention in non-obese patients with non-alcoholic fatty liver disease", J Hepatol, 69, pp.1349~1356 (2018)
- Chun HS, "Association of physical activity with risk of liver fibrosis, sarcopenia, and cardiovascular disease in nonalcoholic fatty liver disease", Clin Gastroenterol Hepatol, 21, pp.358~369 (2023)
- 김홍규, "Longitudinal Changes of Body Composition Phenotypes and Their Association with Incident Type 2 Diabetes Mellitus during a 5-Year Follow-up in Koreans", Diabetes and Metabolism Journal, 43(5), pp.627~639 (2019), 대한당뇨병학회[DOI]
- Kim YS, "Prevalence of sarcopenia and sarcopenic obesity in the Korean population based on the Fourth Korean National Health and Nutritional Examination Surveys", J Gerontol A Biol Sci Med Sci, 67, pp.1107~1113 (2012)
