Sarcopenia is associated with severe liver fibrosis in patients with non-alcoholic fatty liver disease

Petta, Salvatore; Ciminnisi, Stefania; Marco, V. Di; Cabibi, Daniela; Cammà, Calogero; Licata, Anna; Marchesini, Giulio; Craxı̀, Antonio

doi:10.1111/apt.13889

Cited by 177 publications

(174 citation statements)

References 42 publications

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“…(34) In a sample of Caucasians, a significant association was found between sarcopenia estimated by BIA and severe steatosis defined by liver biopsy (adjusted odds ratio = 2.02, 95% CI = 1.06-3.83). (22) Lee et al (11) reported that sarcopenia was associated with a 1.18-fold increased prevalence of NAFLD defined by HSI score independent of obesity and insulin resistance. Consistent with these results, the present 7-year longitudinal study confirmed these findings and suggested a causal link in a large sample size.…”

Section: Discussionmentioning

confidence: 99%

“…The BIA technique was validated for the assessment of body composition, showing good correlation with dual-energy x-ray absorptiometry, and applied to estimate ASM in several recent studies. (19)(20)(21)(22)(23) The skeletal muscle mass index (SMI) was calculated by dividing the sum of the ASM in the bilateral upper and lower four limbs (kg) by body weight (kg) and expressed as a percentage (= total ASM/body weight × 100%) as a modified formula from the study of Janssen et al (11,(23)(24)(25)(26) Change in SMI over the course of 1 year from baseline was calculated by subtracting baseline SMI from SMI at the 1-year follow-up visit. Also, change in SMI over a longer time was defined by subtracting baseline SMI from SMI at the follow-up visit.…”

Section: Measurement Of Appendicular Skeletal Muscle Mass and Definitmentioning

confidence: 99%

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Relationship Between Relative Skeletal Muscle Mass and Nonalcoholic Fatty Liver Disease: A 7‐Year Longitudinal Study

et al. 2018

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Nonalcoholic fatty liver disease (NAFLD) has been associated with relative skeletal muscle mass in several cross-sectional studies. We explored the effects of relative skeletal muscle mass and changes in relative muscle mass over time on the development of incident NAFLD or the resolution of baseline NAFLD in a large, longitudinal, population-based 7-year cohort study. We included 12,624 subjects without baseline NAFLD and 2943 subjects with baseline NAFLD who underwent health check-up examinations. A total of 10,534 subjects without baseline NAFLD and 2631 subjects with baseline NAFLD were included in analysis of changes in relative skeletal muscle mass over a year. Subjects were defined as having NAFLD by the hepatic steatosis index, a previously validated NAFLD prediction model. Relative skeletal muscle mass was presented using the skeletal muscle mass index (SMI), a measure of body weight-adjusted appendicular skeletal muscle mass, which was estimated by bioelectrical impedance analysis. Of the 12,624 subjects without baseline NAFLD, 1864 (14.8%) developed NAFLD during the 7-year follow-up period. Using Cox proportional hazard analysis, compared with the lowest sex-specific SMI tertile at baseline, the highest tertile was inversely associated with incident NAFLD (adjusted hazard ratio [AHR] = 0.44, 95% confidence interval [CI] = 0.38-0.51) and positively associated with the resolution of baseline NAFLD (AHR = 2.09, 95% CI = 1.02-4.28). Furthermore, compared with the lowest tertile of change in SMI over a year, the highest tertile exhibited a significant beneficial association with incident NAFLD (AHR = 0.69, 95% CI = 0.59-0.82) and resolution of baseline NAFLD (AHR = 4.17, 95% CI = 1.90-6.17) even after adjustment for baseline SMI. Conclusion: Increases in relative skeletal muscle mass over time may lead to benefits either in the development of NAFLD or the resolution of existing NAFLD.

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Section: Discussionmentioning

confidence: 99%

Section: Measurement Of Appendicular Skeletal Muscle Mass and Definitmentioning

confidence: 99%

Relationship Between Relative Skeletal Muscle Mass and Nonalcoholic Fatty Liver Disease: A 7‐Year Longitudinal Study

et al. 2018

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“…Thus far, there are only two studies looking at the association between sarcopenia and NAFLD in non-Asian populations. (50,51) An Italian study showed that sarcopenia was associated with both visceral obesity and IR. (50) This study also showed an increase in the prevalence of sarcopenia with worsening fibrosis, independent of obesity and IR.…”

Section: Impact Of Sarcopenia In Nashmentioning

confidence: 99%

Sarcopenia in hiding: The risk and consequence of underestimating muscle dysfunction in nonalcoholic steatohepatitis

Bhanji¹,

Narayanan

Allen³

et al. 2017

Hepatology

203

212

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Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease worldwide. Up to one third of individuals with NAFLD will develop nonalcoholic steatohepatitis (NASH), which is associated with progression to cirrhosis and is rapidly becoming the leading indication for liver transplantation. Sarcopenia is defined as a progressive and generalized loss of skeletal muscle mass, strength, and function. It is observed in up to 60% of patients with end-stage liver disease and portends a poor prognosis. Recent studies have shown that sarcopenia is a novel risk factor for developing NAFLD. Pathophysiological mechanisms relating sarcopenia and NASH may include insulin resistance (IR) and increased inflammation. IR leads to accumulation of triglycerides in both muscle tissue and the liver. It also exacerbates proteolysis and leads to muscle depletion. Chronic inflammation leads to liver injury and progression of fibrosis. The inflammatory milieu also stimulates protein catabolism. Viewing skeletal muscle as an endocrine organ that secretes various salutary myokines may help us understand its role in the development of steatosis. A better understanding of the pathophysiology will aid in developing physical and pharmacological therapeutic interventions. In this review, we will explore the complex inter-relationships between sarcopenia and NASH. We will discuss the impact of sarcopenia in patients with NASH and therapeutic options for the management of sarcopenia. (Hepatology 2017;66:2055-2065).

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“…Several reports showing that the proportion of decreased skeletal muscle mass (D-SMI) demonstrated a linear increment with liver fibrosis progression in non-alcoholic fatty liver disease (NAFLD) or non-alcoholic steatohepatitis (NASH) patients support our hypothesis [33,34,35]. However, an extensive literature search has not shown the relationship between skeletal muscle mass and the liver fibrosis markers in CLD patients, and these clinical questions should be fully addressed.…”

Section: Introductionmentioning

confidence: 60%

Impact of Virtual Touch Quantification in Acoustic Radiation Force Impulse for Skeletal Muscle Mass Loss in Chronic Liver Diseases

et al. 2017

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Background and aims: We sought to clarify the relationship between virtual touch quantification (VTQ) in acoustic radiation force impulse and skeletal muscle mass as assessed by bio-electronic impedance analysis in patients with chronic liver diseases (CLDs, n = 468, 222 males and 246 females, median age = 62 years). Patients and methods: Decreased skeletal muscle index (D-SMI) was defined as skeletal muscle index (SMI) <7.0 kg/m2 for males and as SMI <5.7 kg/m2 for females, according to the recommendations in current Japanese guidelines. We examined the correlation between SMI and VTQ levels and investigated factors linked to D-SMI in the univariate and multivariate analyses. The area under the receiver operating curve (AUROC) for the presence of D-SMI was also calculated. Results: In patients with D-SMI, the median VTQ level was 1.64 meters/second (m/s) (range, 0.93–4.32 m/s), while in patients without D-SMI, the median VTQ level was 1.11 m/s (range, 0.67–4.09 m/s) (p < 0.0001). In the multivariate analysis, higher VTQ was found to be an independent predictor linked to the presence of D-SMI (p < 0.0001). In receiver operating characteristic analysis, body mass index had the highest AUROC (0.805), followed by age (0.721) and VTQ (0.706). Conclusion: VTQ levels can be useful for predicting D-SMI in patients with CLDs.

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Sarcopenia is associated with severe liver fibrosis in patients with non-alcoholic fatty liver disease

Cited by 177 publications

References 42 publications

Relationship Between Relative Skeletal Muscle Mass and Nonalcoholic Fatty Liver Disease: A 7‐Year Longitudinal Study

Relationship Between Relative Skeletal Muscle Mass and Nonalcoholic Fatty Liver Disease: A 7‐Year Longitudinal Study

Sarcopenia in hiding: The risk and consequence of underestimating muscle dysfunction in nonalcoholic steatohepatitis

Impact of Virtual Touch Quantification in Acoustic Radiation Force Impulse for Skeletal Muscle Mass Loss in Chronic Liver Diseases

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