Sarcopenia is significantly associated with presence and severity of nonalcoholic fatty liver disease

Abstract

Background: The association between nonalcoholic fatty liver disease (NAFLD) and sarcopenia has been suggested. We investigated the association between sarcopenia and NAFLD independent of visceral adiposity and searched for the clinical characteristics that affect this association. Methods: We performed a retrospective study including of 5,989 subjects (mean age, 53.2 years; men, 57.3%) who underwent bioelectrical impedance analysis (BIA) and abdominal ultrasonography in 2012. The appendicular skeletal muscle mass (ASM) was assessed by BIA method. Sarcopenia was defined as ASM/weight (ASM%) < 2 standard deviation of the mean for healthy young reference population. NAFLD was diagnosed by ultrasonography. Results: The prevalence of sarcopenia was 5.3%. The prevalence of NAFLD was significantly higher in subjects with sarcopenia than in those without (69.5% vs. 36.5%, P< 0.001). After adjusting with age, sex, visceral fat area, hypertension, diabetes, total and low-density lipoprotein cholesterol, subjects with sarcopenia showed significantly high odds of NAFLD (odds ratio [OR], 1.37; 95% confidence interval [CI], 1.02–1.84; P= 0.036). Subjects with sarcopenia have more likely severe grade of NAFLD compared to non-sarcopenic group (OR, 1.58; 95% CI, 1.25–2.00; P< 0.001). There was significant interaction for effect modification in the association between sarcopenia and NAFLD by age (P of interaction for effect modification, 0.007). Conclusion: Sarcopenia was significantly associated with the presence and the severity of ultrasonography-graded NAFLD in our study population independent of visceral fatness and other metabolic confounder. Younger age showed greater magnitude of association between sarcopenia and NAFLD.