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Kyu-Sang Park 1 Article
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
Hun Ju Lee, Jae Seung Chang, Jhii Hyun Ahn, Moon Young Kim, Kyu-Sang Park, Yeon-Soon Ahn, Sang Baek Koh
J Prev Med Public Health. 2021;54(6):412-421.   Published online October 22, 2021
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AbstractAbstract AbstractSummary PDFSupplementary Material
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).
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.
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.
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.
Korean summary
비알콜성 간질환은 대사질환 중 하나로 적은 근육양과의 연관성이 지속적으로 제시되었으나, 기존 연구들에서 일관되지 않은 결과를 보여주었다. KoGES-ARIRANG 코호트의 320명을 대상으로 초음파·MRI-PDFF·CNS 진단기준을 사용하여 단면연구를 수행한 결과, 세 진단기준에서 모두 적은 근육량과 비알콜성 간질환 사이에 연관성이 나타났다.


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JPMPH : Journal of Preventive Medicine and Public Health