1. Sex influences the association between appendicular skeletal muscle mass to visceral fat area ratio and non-alcoholic steatohepatitis in patients with biopsy-proven non-alcoholic fatty liver disease
- Author
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Xin-Xin Wang, Christopher D. Byrne, Giovanni Targher, Gang Li, Hong-Lei Ma, Kenneth I. Zheng, Liang-Jie Tang, Ming-Hua Zheng, Xiao-Yan Pan, Yi Jin, Ou-Yang Huang, Yue Yu, and Rafael S Rios
- Subjects
Male ,Liver Cirrhosis ,medicine.medical_specialty ,Biopsy ,Appendicular skeletal muscle mass ,Medicine (miscellaneous) ,030209 endocrinology & metabolism ,Intra-Abdominal Fat ,digestive system ,Gastroenterology ,Presence of fibrosis ,03 medical and health sciences ,0302 clinical medicine ,Fibrosis ,Internal medicine ,medicine ,Humans ,Sarcopenic obesity ,Obesity ,Risk factor ,Muscle, Skeletal ,Non-alcoholic steatohepatitis ,Abdominal obesity ,Nutrition and Dietetics ,medicine.diagnostic_test ,business.industry ,Fatty liver ,nutritional and metabolic diseases ,Middle Aged ,medicine.disease ,digestive system diseases ,Visceral fat area ,Obesity, Abdominal ,Cohort ,Female ,030211 gastroenterology & hepatology ,medicine.symptom ,business ,Bioelectrical impedance analysis ,Non-alcoholic fatty liver disease - Abstract
Sarcopenic obesity is regarded as a risk factor for the progression and development of non-alcoholic fatty liver disease (NAFLD). Since male sex is a risk factor for NAFLD and skeletal muscle mass markedly varies between the sexes, we examined whether sex influences the association between appendicular skeletal muscle mass to visceral fat area ratio (SVR), that is, an index of skeletal muscle mass combined with abdominal obesity, and the histological severity of NAFLD. The SVR was measured by bioelectrical impedance in a cohort of 613 (M/F = 443/170) Chinese middle-aged individuals with biopsy-proven NAFLD. Multivariable logistic regression and subgroup analyses were used to test the association between SVR and the severity of NAFLD (i.e. non-alcoholic steatohepatitis (NASH) or NASH with the presence of any stage of liver fibrosis). NASH was identified by a NAFLD activity score ≥5, with a minimum score of 1 for each of its categories. The presence of fibrosis was classified as having a histological stage ≥1. The SVR was inversely associated with NASH in men (adjusted OR 0·62; 95 % CI 0·42, 0·92, P = 0·017 for NASH, adjusted OR 0·65; 95 % CI 0·43, 0·99, P = 0·043 for NASH with the presence of fibrosis), but not in women (1·47 (95 % CI 0·76, 2·83), P = 0·25 for NASH, and 1·45 (95 % CI 0·74, 2·83), P = 0·28 for NASH with the presence of fibrosis). There was a significant interaction for sex and SVR (Pinteraction = 0·017 for NASH and Pinteraction = 0·033 for NASH with the presence of fibrosis). Our findings show that lower skeletal muscle mass combined with abdominal obesity is strongly associated with the presence of NASH only in men.
- Published
- 2021
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