Skeletal muscle mass to visceral fat area ratio is an important determinant affecting hepatic conditions of non-alcoholic fatty liver disease

Sugiyama, Takashi; Akiyama, Kentaro; Oh, Sang‐Ha; Sawai, Akemi; Isobe, Takeshi; Okamoto, Yoshikazu; Ishige, Kazunori; Mizokami, Yuji; Yamagata, Kenji; Onizawa, Kojiro; Tanaka, Hironori; Iijima, Hiroko; Shoda, Junichi

doi:10.1007/s00535-017-1377-3

Cited by 65 publications

(90 citation statements)

References 40 publications

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“…Shida et al . indicated that changes in body composition were associated with a change in adipokines, myokines, and hepatokines, thus supporting our result that changes in the SF ratio were associated with ALT response. A reduction in body fat and an increase in skeletal muscle could have the greatest impact on liver histology.…”

Section: Discussionsupporting

confidence: 87%

“…Subjects with high fat mass and low muscle mass had worse clinical outcomes compared with subjects with sarcopenia or obesity alone . Actually, a reduction in skeletal muscle mass could synergistically increase visceral fat in overweight subjects with NAFLD . Although the mechanism underlying this synergy is still unclear, leptin, which stimulates fat degradation in skeletal muscle and improves insulin sensitivity, and inflammatory cytokines such as interleukin‐6 are thought to play a major role in this synergy .…”

Section: Discussionmentioning

confidence: 99%

“…40,41 Actually, a reduction in skeletal muscle mass could Validity of SF ratio in sarcopenic NAFLD 633 Hepatology Research 2019; 49: 627-636 synergistically increase visceral fat in overweight subjects with NAFLD. 42 Although the mechanism underlying this synergy is still unclear, leptin, which stimulates fat degradation in skeletal muscle and improves insulin sensitivity, 43 and inflammatory cytokines such as interleukin-6 are thought to play a major role in this synergy. 44,45 Shida et al indicated that changes in body composition were associated with a change in adipokines, myokines, and hepatokines, 42 thus supporting our result that changes in the SF ratio were associated with ALT response.…”

Section: W E Investigated the Features Of Severalmentioning

confidence: 99%

“…42 Although the mechanism underlying this synergy is still unclear, leptin, which stimulates fat degradation in skeletal muscle and improves insulin sensitivity, 43 and inflammatory cytokines such as interleukin-6 are thought to play a major role in this synergy. 44,45 Shida et al indicated that changes in body composition were associated with a change in adipokines, myokines, and hepatokines, 42 thus supporting our result that changes in the SF ratio were associated with ALT response. A reduction in body fat and an increase in skeletal muscle could have the greatest impact on liver histology.…”

Section: W E Investigated the Features Of Severalmentioning

confidence: 99%

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Clinical and pathological features of sarcopenia‐related indices in patients with non‐alcoholic fatty liver disease

Seko

Mizuno

Okishio

et al. 2019

Hepatology Research

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Background Sarcopenia is diagnosed with the skeletal muscle index (SMI) or the sarcopenia index (SI). We previously reported that the ratio of skeletal muscle mass to body fat mass (SF ratio) was a novel index of sarcopenia in patients with non‐alcoholic fatty liver disease (NAFLD). The aim of this retrospective study was to evaluate sarcopenia with these indices in patients with NAFLD. Methods One hundred and fifty‐six consecutive patients with biopsy‐proven NAFLD and alanine aminotransferase (ALT) >40 IU/L were enrolled. Liver function and body composition were evaluated in 121 patients after 12 months. We evaluated the relationship between histological findings, changes in liver function, and the SMI, SI, and SF ratio. Results Of the 156 patients enrolled, 13.5% and 26.3% were diagnosed with sarcopenia with the SMI and SI. In patients with hepatic fibrosis stage <2, the SI and the SF ratio were significantly greater than in patients with fibrosis stage ≥2. There was no difference in SMI between groups. In the cohort assessed at baseline and 12 months later, transaminase activity and SMI decreased significantly, and the SF ratio increased over time. A multivariate analysis revealed the presence of the PNPLA3 G allele and an increase in SF ratio (odds ratio, 7.406) as predictive factors of ALT reduction >30% from baseline. Conclusions Due to the high prevalence of obesity, we should consider both skeletal muscle mass and body fat mass in the diagnosis and treatment of NAFLD. The SF ratio could be a useful index in sarcopenic NAFLD.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Section: W E Investigated the Features Of Severalmentioning

confidence: 99%

Section: W E Investigated the Features Of Severalmentioning

confidence: 99%

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Clinical and pathological features of sarcopenia‐related indices in patients with non‐alcoholic fatty liver disease

Seko

Mizuno

Okishio

et al. 2019

Hepatology Research

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“…The pathogenesis of sarcopenic obesity in cirrhosis is multifaceted, with further research required to gain clarity around both clinical and molecular aspects as well as whether sarcopenia or fatty liver is the primary instigator in the muscle‐liver‐adipose tissue axis . Recent reviews have evaluated the pathophysiology of sarcopenia and obesity in cirrhosis and sarcopenic obesity in the general population . Some of the proposed contributing mechanisms are summarized in Figure and include increased pro‐inflammatory markers, decreased physical activity, reduced protein intake, disease‐related reductions in testosterone and growth hormone levels, and ageing …”

Section: Pathophysiology Of Sarcopenic Obesity In Cirrhosismentioning

confidence: 99%

Sarcopenic obesity in cirrhosis—The confluence of 2 prognostic titans

Eslamparast

Montano‐Loza

Raman

et al. 2018

Liver International

122

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Sarcopenia and obesity are 2 major health conditions with a growing prevalence in cirrhosis. The concordance of these 2 conditions, sarcopenic obesity, is associated with higher rates of mortality and impact on the metabolic profile and physical function than either condition alone. To date, there is little consensus surrounding the diagnostic criteria for sarcopenia, obesity or as a result, sarcopenic obesity in patients with cirrhosis. Cross-sectional imaging, although the most accurate diagnostic technique, has practical limitations for routine use in clinical practice. Management strategies are focused on increasing muscle mass and strength. The present review provides an overview of the diagnosis, pathophysiology, prognostic implications and management strategies available for sarcopenic obesity in cirrhosis. We also discuss the associated condition myosteatosis, the pathological accumulation of fat in skeletal muscle. Much work needs to be done to advance both clinical care and research in this area. Future directions require consensus definitions for sarcopenia, obesity and sarcopenic obesity, an expansion of our understanding of the complex pathogenesis of the muscle-liver-adipose tissue axis in cirrhosis and evidence to support management recommendations for nutrition, exercise and pharmacological therapies.

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Skeletal muscle mass to visceral fat area ratio as a predictor of NAFLD in lean and overweight men and women with effect modification by sex

et al. 2022

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Background and Aims:The effect of sarcopenic visceral obesity on risk of nonalcoholic fatty liver disease (NAFLD) is uncertain. We investigated whether: a) the skeletal muscle mass to visceral fat area ratio (SV ratio), as a measure of sarcopenic visceral obesity, is a risk factor for NAFLD; and b) the SV ratio adds to conventional adiposity measures to improve prediction of incident NAFLD.Methods: Adults without NAFLD (n=151,017) were followed up for a median of 3.7 years.

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Skeletal muscle mass to visceral fat area ratio is an important determinant affecting hepatic conditions of non-alcoholic fatty liver disease

Abstract: Decreased muscle mass coupled with increased visceral fat mass is closely associated with an increased risk for exacerbating NAFLD pathophysiology.

Cited by 65 publications

References 40 publications

Clinical and pathological features of sarcopenia‐related indices in patients with non‐alcoholic fatty liver disease

Clinical and pathological features of sarcopenia‐related indices in patients with non‐alcoholic fatty liver disease

Sarcopenic obesity in cirrhosis—The confluence of 2 prognostic titans

Skeletal muscle mass to visceral fat area ratio as a predictor of NAFLD in lean and overweight men and women with effect modification by sex

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