Nonalcoholic fatty liver disease and sarcopenia in a Western population (NHANES III): The importance of sarcopenia definition

Tao-Chun Peng; Li-Wei Wu; Wei-Liang Chen; Fang-Yih Liaw; Yaw-Wen Chang; Tung-Wei Kao

doi:10.1016/j.clnu.2017.11.021

Nonalcoholic fatty liver disease and sarcopenia in a Western population (NHANES III): The importance of sarcopenia definition

Clin Nutr. 2019 Feb;38(1):422-428. doi: 10.1016/j.clnu.2017.11.021. Epub 2017 Dec 8.

Authors

Tao-Chun Peng¹, Li-Wei Wu², Wei-Liang Chen², Fang-Yih Liaw¹, Yaw-Wen Chang¹, Tung-Wei Kao³

Affiliations

¹ Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital and School of Medicine, National Defense Medical Center, Taipei, Taiwan; Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital and School of Medicine, National Defense Medical Center, Taipei, Taiwan.
² Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital and School of Medicine, National Defense Medical Center, Taipei, Taiwan; Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital and School of Medicine, National Defense Medical Center, Taipei, Taiwan; Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan.
³ Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital and School of Medicine, National Defense Medical Center, Taipei, Taiwan; Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital and School of Medicine, National Defense Medical Center, Taipei, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taiwan. Electronic address: ktw61916@yahoo.com.tw.

PMID: 29287676
DOI: 10.1016/j.clnu.2017.11.021

Abstract

Background: Recent epidemiological studies have shown that sarcopenia is associated with non-alcoholic fatty liver disease (NAFLD) and advanced fibrosis in an Asian population. We investigated whether NAFLD is associated with a higher risk of sarcopenia using a different definition in elderly patients.

Methods: A population-based cross-sectional survey of US patients was conducted, involving 2551 participants aged 60-75 years. NAFLD was measured by ultrasound. Sarcopenia was defined by both a low muscle mass and poor muscle function. In addition, the skeletal muscle index (SMI) was calculated as the absolute muscle mass (kilograms) divided by height² (meters) or total body mass (kilograms). A multivariable logistic regression was conducted to estimate the relationship between sarcopenia and NAFLD in the elderly.

Results: After adjusting for age, sex, and race/ethnicity, severe hepatic steatosis was associated with a decreased risk of sarcopenia as defined by the height-adjusted SMI (odds ratio (OR) 0.63; 95% confidence interval (CI) 0.46-0.87). In contrast, severe hepatic steatosis was associated with an increased risk of sarcopenia as defined by the weight-adjusted SMI (OR 1.73; 95% CI 1.31-2.28). These significant associations remained after further adjustments for other potential confounding variables.

Conclusions: NAFLD is associated with a lower risk of sarcopenia when using the height-adjusted SMI. In contrast, it showed the opposite result when using the weight-adjusted SMI. The definition of sarcopenia may be an important factor when examining its relationship with NAFLD.

Keywords: Elderly; Muscle mass; National Health and Nutrition Examination Survey; Nonalcoholic steatohepatitis; Skeletal muscle index.

MeSH terms

Aged
Comorbidity
Cross-Sectional Studies
Female
Geriatric Assessment / methods
Geriatric Assessment / statistics & numerical data*
Humans
Male
Middle Aged
Non-alcoholic Fatty Liver Disease / epidemiology*
Nutrition Surveys
Risk Factors
Sarcopenia / epidemiology*
United States