Appendicular Skeletal Muscle Index and HbA1c Evaluate Liver Steatosis in Patients With Metabolic Associated Fatty Liver Disease

Abstract

Background and Aim(s)Liver steatosis, as the main feature of metabolic associated fatty liver disease (MAFLD), was associated with the progression of liver fibrosis and metabolic syndrome, which needed to be estimated accurately. In this study, we explored the significance of appendicular skeletal muscle index (ASMI) in evaluating liver steatosis of MAFLD patients.MethodsEight hundred and ninety-nine cases with MAFLD from 2017 to 2018 National Health and Nutrition Examination Surveys (NHANES) database were included. All the analyzed data were obtained from NHANES database. The association between ASMI and liver steatosis were evaluated using R and EmpowerStats.ResultsMAFLD individuals were randomly divided into a training (n = 450) and validation cohort (n = 449). In univariate analysis, HbA1c, arms fat, arms lean mass, legs lean mass, trunk lean mass, total fat, total lean mass and ASMI were significantly associated with liver steatosis (p < 0.05). Multivariate analysis showed that HbA1c (OR: 1.6732; 95% CI: 1.2753–2.1929, p = 0.0002) and ASMI (OR: 1.6723; 95% CI: 1.1760–2.5204, p = 0.0052) were independently associated with severe liver steatosis. ASMI accurately evaluated severe liver steatosis with an AUROC of 0.73 and 0.81 in training and validation cohort, respectively. Compared with ASMI only, ASMI combined with HbA1c improved the AUROC to 0.85 and 0.88. Furthermore, the AUROC of our model was superior to FLI in the evaluation of liver steatosis.ConclusionASMI combined with HbA1c has good evaluation value for liver steatosis in MAFLD patients, which might be beneficial for the management of MAFLD clinically.

The Correlation Between Leg Muscle Mass Index and Non-Alcoholic Fatty Liver Disease in Patients with Type 2 Diabetes Mellitus

“… 18 By altering the metabolism of fat muscles and IR, loss of muscle mass and obesity primarily encourage lipotoxic effects and have a negative impact on NAFLD onset and progression. 19 Sarcopenia and obesity increase the risk of NAFLD 20 and all-cause mortality compared to obesity alone. 21 In the present study, the NAFLD group had greater BMI and VFA and lower ASMI and LSMI than the non-NAFLD group.…”

The association between appendicular skeletal muscle index and bone mineral density in children and adolescents with chronic kidney disease: A cross-sectional study

“…Subsequently, the ASMI measure was computed through dividing ASM by the height squared, as indicated by the formula: ASMI = ASM/height 2 . [ 18 ]…”

“…Subsequently, the ASMI measure was computed through dividing ASM by the height squared, as indicated by the formula: ASMI = ASM/height 2 . [18] For this investigation, we employed total bone mineral density as the outcome variable. Qualified radiology technologists employed DXA to determine BMD.…”

Body Composition in Chronic Liver Disease

“…A Korean report on MAFLD and muscle mass showed that MAFLD and a loss of skeletal muscle mass were closely correlated, with diabetes-associated MAFLD being associated with the greatest loss of skeletal muscle mass, and patients with advanced liver fibrosis had a significantly higher rate of loss of skeletal muscle mass than those without the advanced disease [43]. Combining appendicular skeletal muscle mass and diabetes can also predict the degree of hepatic steatosis in MAFLD [44]. IR and body fat mass are significantly interrelated in MAFLD patients [45].…”