Metabolic-associated fatty liver disease is associated with low muscle mass and strength in patients with chronic hepatitis B

Abstract

BACKGROUND Although the prognostic relevance of sarcopenia has been increasingly recognised in the context of liver disease, there is a paucity of data evaluating body composition in patients with chronic hepatitis B (CHB). Beyond virus-related factors, nutritional and metabolic aspects can be associated with skeletal muscle abnormalities in these patients and should not be disregarded. AIM To evaluate the association between components of sarcopenia and demographic, clinical, lifestyle, nutritional, and biochemical variables in CHB patients. METHODS Dual-energy X-ray absorptiometry (DXA) was used to assess muscle mass by quantifying appendicular lean mass (ALM) adjusted for body mass index (ALM BMI ). Muscle function was evaluated by hand grip strength (HGS) and the timed up and go test. Metabolic-associated fatty liver disease (MAFLD) was defined according to the criteria proposed by an international expert panel. A body shape index and the International Physical Activity Questionnaire were used to assess central obesity and physical activity level, respectively. RESULTS This cross-sectional study included 105 CHB outpatients followed at the tertiary care ambulatory centre (mean age, 48.5 ± 12.0 years; 58.1% males; 76.2% without cirrhosis; 23.8% with compensated cirrhosis). The DXA-derived fat mass percentage was inversely correlated with the ALM BMI ( r = - 0.87) and HGS ( r = - 0.63). In the multivariable analysis, MAFLD, sedentarism and central obesity were positively and independently associated with low ALM BMI . MAFLD and central obesity were independently associated with low HGS. CONCLUSION MAFLD and central obesity were associated with low muscle mass and strength in patients with chronic hepatitis B, independent of the liver disease stage.

Body Composition in Chronic Liver Disease

“…IR and body fat mass are significantly interrelated in MAFLD patients [45]. A close correlation between MAFLD and low skeletal muscle mass has also been reported in patients with hepatitis B [46].…”

Low Muscle Strength as Risk Factor for Non-Alcoholic Fatty Liver Disease in Different Metabolic Conditions

“…Few studies have evaluated the association between muscle strength and NAFLD. The single-institution cross-sectional study by Santos et al [ 7 ] found that a low HGS was associated with metabolic-associated fatty liver disease in patients with chronic hepatitis B. However, because many metabolic risk factors are correlated with muscle strength and NAFLD, it was difficult to properly exclude them.…”

Association of low muscle strength with metabolic dysfunction-associated fatty liver disease: A nationwide study

“…Although the body of evidence is evolving, it is worth noting that only a few cross-sectional studies have shown that sarcopenia, measured using dual-energy X-ray absorptiometry and mid-upper arm circumference, was associated with liver fibrosis in patients with MAFLD[ 15 , 16 ]. Limited evidence exists on the association between muscle strength and the prevalence of MAFLD and liver fibrosis in MAFLD in the general population[ 17 ]. In light of the public health burden of MAFLD in Asia, we investigated the association between muscle strength and MAFLD using a Korean nationally representative database.…”