Journal of Preventive Medicine and Public Health

  • 제54권6호
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  • Pages.412-421
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  • 2021
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  • 1975-8375(pISSN)
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  • 2233-4521(eISSN)
대한예방의학회 (The Korean Society for Preventive Medicine)
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Association Between Low Muscle Mass and Non-alcoholic Fatty Liver Disease Diagnosed Using Ultrasonography, Magnetic Resonance Imaging Derived Proton Density Fat Fraction, and Comprehensive NAFLD Score in Korea

  • Lee, Hun Ju (Department of Preventive Medicine, Yonsei Wonju University College of Medicine) ;
  • Chang, Jae Seung (Department of Physiology, Yonsei University Wonju College of Medicine) ;
  • Ahn, Jhii Hyun (Department of Radiology, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine) ;
  • Kim, Moon Young (Department of Internal Medicine, Yonsei University Wonju College of Medicine) ;
  • Park, Kyu-Sang (Department of Physiology, Yonsei University Wonju College of Medicine) ;
  • Ahn, Yeon-Soon (Department of Preventive Medicine, Yonsei Wonju University College of Medicine) ;
  • Koh, Sang Baek (Department of Preventive Medicine, Yonsei Wonju University College of Medicine)
  • 투고 : 2021.07.09
  • 심사 : 2021.09.15
  • 발행 : 2021.11.30
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초록

Objectives: Non-alcoholic fatty liver disease (NAFLD) is an increasingly prevalent metabolic disease. Muscle is known to influence NAFLD development. Therefore, this study aimed to determine the relationships among low muscle mass, NAFLD, and hepatic fibrosis using various definitions of low muscle mass and NAFLD diagnostic methods, including magnetic resonance imaging-based proton density fat fraction (MRI-PDFF). Methods: This cross-sectional study included 320 participants (107 males, 213 females) from the Korean Genome and Epidemiology Study on Atherosclerosis Risk of Rural Areas in the Korean General Population cohort. Muscle mass was assessed using whole-body dual-energy X-ray absorptiometry and adjusted for the height squared, body weight, and body mass index (BMI). NAFLD was diagnosed using ultrasonography (US), MRI-PDFF, and the comprehensive NAFLD score (CNS). Hepatic fibrosis was assessed using magnetic resonance elastography. Multivariable logistic and linear regression analyses were performed to determine the aforementioned associations. Results: According to US, 183 participants (57.2%) had NAFLD. Muscle mass adjusted for body weight was associated with NAFLD diagnosed using US (odds ratio [OR], 3.00; 95% confidence interval [CI], 1.70 to 5.31), MRI-PDFF (OR, 2.00; 95% CI, 1.13 to 3.53), and CNS (OR, 3.39; 95% CI, 1.73 to 6.65) and hepatic fibrosis (males: β=-0.070, p<0.01; females: β=-0.037, p<0.04). Muscle mass adjusted for BMI was associated with NAFLD diagnosed by US (OR, 1.71; 95% CI, 1.02 to 2.86) and CNS (OR, 1.95; 95% CI, 1.04 to 3.65), whereas muscle mass adjusted for height was not associated with NAFLD. Conclusions: Low muscle mass was associated with NAFLD and liver fibrosis; therefore, maintaining sufficient muscle mass is important to prevent NAFLD. A prospective study and additional consideration of muscle quality are needed to strengthen the findings regarding this association.

키워드

과제정보

This work was supported by a National Research Foundation of Korea (NRF) grant funded by the Korean government (MSIT) (No. 2017R1A5A2015369).

참고문헌

  1. Chalasani N, Younossi Z, Lavine JE, Diehl AM, Brunt EM, Cusi K, et al. The diagnosis and management of non-alcoholic fatty liver disease: practice Guideline by the American Association for the Study of Liver Diseases, American College of Gastroenterology, and the American Gastroenterological Association. Hepatology 2012;55(6):2005-2023. https://doi.org/10.1002/hep.25762
  2. Browning JD, Szczepaniak LS, Dobbins R, Nuremberg P, Horton JD, Cohen JC, et al. Prevalence of hepatic steatosis in an urban population in the United States: impact of ethnicity. Hepatology 2004;40(6):1387-1395. https://doi.org/10.1002/hep.20466
  3. Im HJ, Ahn YC, Wang JH, Lee MM, Son CG. Systematic review on the prevalence of nonalcoholic fatty liver disease in South Korea. Clin Res Hepatol Gastroenterol 2021;45(4):101526. https://doi.org/10.1016/j.clinre.2020.06.022
  4. Delmonico MJ, Harris TB, Visser M, Park SW, Conroy MB, Velasquez-Mieyer P, et al. Longitudinal study of muscle strength, quality, and adipose tissue infiltration. Am J Clin Nutr 2009;90(6):1579-1585. https://doi.org/10.3945/ajcn.2009.28047
  5. Shafiee G, Keshtkar A, Soltani A, Ahadi Z, Larijani B, Heshmat R. Prevalence of sarcopenia in the world: a systematic review and meta- analysis of general population studies. J Diabetes Metab Disord 2017;16:21. https://doi.org/10.1186/s40200-017-0302-x
  6. Chen LK, Woo J, Assantachai P, Auyeung TW, Chou MY, Iijima K, et al. Asian Working Group for Sarcopenia: 2019 consensus update on sarcopenia diagnosis and treatment. J Am Med Dir Assoc 20200;21(3):300-307. https://doi.org/10.1016/j.jamda.2019.12.012
  7. Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyere O, Cederholm T, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing 2019;48(1):16-31. https://doi.org/10.1093/ageing/afy169
  8. Pacifico L, Perla FM, Andreoli G, Grieco R, Pierimarchi P, Chiesa C. Nonalcoholic fatty liver disease is associated with low skeletal muscle mass in overweight/obese youths. Front Pediatr 2020;8:158. https://doi.org/10.3389/fped.2020.00158
  9. Wang YM, Zhu KF, Zhou WJ, Zhang Q, Deng DF, Yang YC, et al. Sarcopenia is associated with the presence of nonalcoholic fatty liver disease in Zhejiang Province, China: a cross-sectional observational study. BMC Geriatr 2021;21(1):55. https://doi.org/10.1186/s12877-020-01910-3
  10. Alferink LJ, Trajanoska K, Erler NS, Schoufour JD, de Knegt RJ, Ikram MA, et al. Nonalcoholic fatty liver disease in the Rotterdam study: about muscle mass, sarcopenia, fat mass, and fat distribution. J Bone Miner Res 2019;34(7):1254-1263. https://doi.org/10.1002/jbmr.3713
  11. Sinclair M, Gow PJ, Grossmann M, Angus PW. Review article: sarcopenia in cirrhosis--aetiology, implications and potential therapeutic interventions. Aliment Pharmacol Ther 2016;43(7):765-777. https://doi.org/10.1111/apt.13549
  12. Lee SW, Youm Y, Lee WJ, Choi W, Chu SH, Park YR, et al. Appendicular skeletal muscle mass and insulin resistance in an elderly Korean population: the Korean social life, health and aging project-health examination cohort. Diabetes Metab J 2015;39(1):37-45. https://doi.org/10.4093/dmj.2015.39.1.37
  13. Kim G, Lee SE, Lee YB, Jun JE, Ahn J, Bae JC, et al. Relationship between relative skeletal muscle mass and nonalcoholic fatty liver disease: a 7-year longitudinal study. Hepatology 2018;68(5):1755-1768. https://doi.org/10.1002/hep.30049
  14. Hong KS, Kim MC, Ahn JH. Sarcopenia Is an independent risk factor for NAFLD in COPD: a nationwide survey (KNHANES 2008-2011). Int J Chron Obstruct Pulmon Dis 2020;15:1005-1014. https://doi.org/10.2147/COPD.S249534
  15. Peng TC, Wu LW, Chen WL, Liaw FY, Chang YW, Kao TW. Nonalcoholic fatty liver disease and sarcopenia in a Western population (NHANES III): the importance of sarcopenia definition. Clin Nutr 2019;38(1):422-428. https://doi.org/10.1016/j.clnu.2017.11.021
  16. Kim Y, Han BG; KoGES group. Cohort profile: the Korean Genome and Epidemiology Study (KoGES) consortium. Int J Epidemiol 2017;46(2):e20. https://doi.org/10.1093/ije/dyv316
  17. Koh SB, Park JK, Yoon JH, Chang SJ, Oh SS, Kim JY, et al. Preliminary report: a serious link between adiponectin levels and metabolic syndrome in a Korean nondiabetic population. Metabolism 2010;59(3):333-337. https://doi.org/10.1016/j.metabol.2009.07.031
  18. Middleton MS, Heba ER, Hooker CA, Bashir MR, Fowler KJ, Sandrasegaran K, et al. Agreement between magnetic resonance imaging proton density fat fraction measurements and pathologist-assigned steatosis grades of liver biopsies from adults with nonalcoholic steatohepatitis. Gastroenterology 2017;153(3):753-761. https://doi.org/10.1053/j.gastro.2017.06.005
  19. Lee YH, Bang H, Park YM, Bae JC, Lee BW, Kang ES, et al. Non-laboratory-based self-assessment screening score for non-alcoholic fatty liver disease: development, validation and comparison with other scores. PLoS One 2014;9(9):e107584. https://doi.org/10.1371/journal.pone.0107584
  20. Chen LK, Liu LK, Woo J, Assantachai P, Auyeung TW, Bahyah KS, et al. Sarcopenia in Asia: consensus report of the Asian Working Group for Sarcopenia. J Am Med Dir Assoc 2014;15(2):95-101. https://doi.org/10.1016/j.jamda.2013.11.025
  21. Kim YS, Lee Y, Chung YS, Lee DJ, Joo NS, Hong D, et al. Prevalence of sarcopenia and sarcopenic obesity in the Korean population based on the Fourth Korean National Health and Nutritional Examination Surveys. J Gerontol A Biol Sci Med Sci 2012;67(10):1107-1113. https://doi.org/10.1093/gerona/gls071
  22. Studenski SA, Peters KW, Alley DE, Cawthon PM, McLean RR, Harris TB, et al. The FNIH sarcopenia project: rationale, study description, conference recommendations, and final estimates. J Gerontol A Biol Sci Med Sci 2014;69(5):547-558. https://doi.org/10.1093/gerona/glu010
  23. Altajar S, Baffy G. Skeletal muscle dysfunction in the development and progression of nonalcoholic fatty liver disease. J Clin Transl Hepatol 2020;8(4):414-423.
  24. Kaser S, Moschen A, Cayon A, Kaser A, Crespo J, Pons-Romero F, et al. Adiponectin and its receptors in non-alcoholic steatohepatitis. Gut 2005;54(1):117-121. https://doi.org/10.1136/gut.2003.037010
  25. Aleffi S, Petrai I, Bertolani C, Parola M, Colombatto S, Novo E, et al. Upregulation of proinflammatory and proangiogenic cytokines by leptin in human hepatic stellate cells. Hepatology 2005;42(6):1339-1348. https://doi.org/10.1002/hep.20965
  26. Pedersen BK, Febbraio MA. Muscles, exercise and obesity: skeletal muscle as a secretory organ. Nat Rev Endocrinol 2012;8(8):457-465. https://doi.org/10.1038/nrendo.2012.49
  27. Batsis JA, Villareal DT. Sarcopenic obesity in older adults: aetiology, epidemiology and treatment strategies. Nat Rev Endocrinol 2018;14(9):513-537. https://doi.org/10.1038/s41574-018-0062-9
  28. Hamrick MW, McGee-Lawrence ME, Frechette DM. Fatty infiltration of skeletal muscle: mechanisms and comparisons with bone marrow adiposity. Front Endocrinol (Lausanne) 2016;7:69.
  29. Lim S, Kim JH, Yoon JW, Kang SM, Choi SH, Park YJ, et al. Sarcopenic obesity: prevalence and association with metabolic syndrome in the Korean Longitudinal Study on Health and Aging (KLoSHA). Diabetes Care 2010;33(7):1652-1654. https://doi.org/10.2337/dc10-0107
  30. Caussy C, Reeder SB, Sirlin CB, Loomba R. Noninvasive, quantitative assessment of liver fat by MRI-PDFF as an endpoint in NASH trials. Hepatology 2018;68(2):763-772. https://doi.org/10.1002/hep.29797
  31. Yodoshi T, Orkin S, Arce Clachar AC, Bramlage K, Sun Q, Fei L, et al. Muscle mass is linked to liver disease severity in pediatric nonalcoholic fatty liver disease. J Pediatr 2020;223:93-99. https://doi.org/10.1016/j.jpeds.2020.04.046
  32. Linge J, Ekstedt M, Dahlqvist Leinhard O. Adverse muscle composition is linked to poor functional performance and metabolic comorbidities in NAFLD. JHEP Rep 2020;3(1):100197.