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Sarcopenia and non-alcoholic fatty liver disease (vitamin D not mentioned) – Sept 2013

The relationship between sarcopenia and non-alcoholic fatty liver disease The Korean sarcopenic obesity study

Hepatology; Vol. 58 Issue 3; DOI: 10.1002/hep.26716
Ho Cheol Hong 1,
Soon Young Hwang 2,
Hae Yoon Choi 1,
Hye Jin Yoo 1,
Ji A Seo 1,
Sin Gon Kim 1,
Nan Hee Kim 1,
Sei Hyun Baik 1,
Dong Seop Choi 1,
Kyung Mook Choi 1,*
1 Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Korea University, Seoul, Korea
2 Department of Biostatistics, College of Medicine, Korea University, Seoul, Korea
*Address all correspondence and reprint requests to: Dr. Kyung Mook Choi, Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University Guro Hospital, 80 Guro-Dong, Guro-Gu, Seoul 152-050, Korea. E-mail: medica7 at gmail.com, Tel.: 822-2626-3043, Fax: 822-2626-1096

Previous studies have shown that non-alcoholic fatty liver disease (NAFLD) and sarcopenia may share pathophysiological mechanisms, such as insulin resistance, inflammation, vitamin D deficiency, and decreased physical activity. However, their direct relationship has not been investigated. The association between NAFLD and sarcopenia was examined in 452 apparently healthy adults enrolled in the Korean Sarcopenic Obesity Study (KSOS), an ongoing prospective observational cohort study. The liver attenuation index (LAI), which measured using abdominal computed tomography (CT), was used as a parameter for the diagnosis of NAFLD. Sarcopenia was defined using a skeletal muscle mass index (SMI) [SMI (%) = total skeletal muscle mass (kg) / weight (kg) x 100] that was measured by dual energy X-ray absorptiometry (DXA). After adjusting for age and sex, both SMI and LAI were negatively correlated with the homeostasis model assessment of insulin resistance (HOMA-IR) (P<0.001) and high sensitivity C-reactive protein (hsCRP) (P<0.001) as well as brachial-ankle pulse wave velocity (baPWV), an indicator of arterial stiffness. Furthermore, SMI and LAI had positive relationships with HDL-cholesterol, but both had a negative relationship with triglyceride, alanine aminotransferase (ALT), and total body fat. In a multiple logistic regression analysis, the odds ratio for NAFLD risk was 5.16 (95% CI = 1.63-16.33) in the lowest quartile of SMI compared to the highest after adjusting for potential confounding factors.

Conclusion: Individuals with lower muscle mass exhibited increased risk of NAFLD.
This result may provide a novel insight into the mechanism linking between sarcopenia and NAFLD.

Copyright © 2013 American Association for the Study of Liver Diseases


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