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Sarcopenia is associated with significant liver fibrosis independently of obesity and insulin resistance in nonalcoholic fatty liver disease: Nationwide surveys (KNHANES 2008-2011)

 Yong-ho Lee  ;  Seung Up Kim  ;  Kijun Song  ;  Jun Yong Park  ;  Do Young Kim  ;  Sang Hoon Ahn  ;  Byung-Wan Lee  ;  Eun Seok Kang  ;  Bong-Soo Cha  ;  Kwang-Hyub Han 
 Hepatology, Vol.63(3) : 776-786, 2016 
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Adult ; Aged ; Body Mass Index ; Cross-Sectional Studies ; Female ; Fibrosis ; Humans ; Insulin Resistance ; Liver/pathology* ; Male ; Middle Aged ; Muscle, Skeletal/pathology ; Non-alcoholic Fatty Liver Disease/complications* ; Non-alcoholic Fatty Liver Disease/pathology ; Nutrition Surveys ; Sarcopenia/complications* ; Sarcopenia/pathology
Sarcopenia is associated with nonalcoholic fatty liver disease (NAFLD). This study investigated whether sarcopenia is associated with significant liver fibrosis in subjects with NAFLD. Data from the Korean National Health and Nutrition Examination Surveys 2008-2011 database were analyzed. NALFD was defined by NAFLD liver fat score, comprehensive NAFLD score, or hepatic steatosis index. Degree of liver fibrosis was assessed by NAFLD fibrosis score (NFS), FIB-4, and Forns index. Significant liver fibrosis was defined as FIB-4 ≥2.67 and the highest quartile values of NFS and Forns index. Sarcopenia index (= total appendicular skeletal muscle mass [kg]/body mass index (kg/m(2) ]) was calculated using dual-energy X-ray absorptiometry. Using the NAFLD liver fat score, NAFLD was identified in 2761 (28.5%) of 9676 subjects. Of subjects with NAFLD, sarcopenia was identified in 337 (12.2%). Sarcopenia was significantly associated with significant liver fibrosis assessed in fibrosis prediction models (all P < 0.05). In subgroups stratified according to body mass index and homeostasis model assessment of insulin resistance, a significant association between sarcopenia and significant liver fibrosis by NFS was consistently present (odds ratio = 1.76-2.68 depending on the subgroup, all P < 0.05). Multivariate logistic regression analysis demonstrated an independent association between SI and significant liver fibrosis by NFS after adjusting for other confounders (odds ratio = 0.52-0.67, all P < 0.01). Other NAFLD (comprehensive NAFLD score, hepatic steatosis index) and fibrosis prediction models (FIB-4 and Forns index) produced similar results.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
강은석(Kang, Eun Seok) ORCID logo https://orcid.org/0000-0002-0364-4675
김도영(Kim, Do Young)
김승업(Kim, Seung Up) ORCID logo https://orcid.org/0000-0002-9658-8050
박준용(Park, Jun Yong) ORCID logo https://orcid.org/0000-0001-6324-2224
송기준(Song, Ki Jun) ORCID logo https://orcid.org/0000-0003-2505-4112
안상훈(Ahn, Sang Hoon) ORCID logo https://orcid.org/0000-0002-3629-4624
이병완(Lee, Byung Wan) ORCID logo https://orcid.org/0000-0002-9899-4992
이용호(Lee, Yong Ho) ORCID logo https://orcid.org/0000-0002-6219-4942
차봉수(Cha, Bong Soo) ORCID logo https://orcid.org/0000-0003-0542-2854
한광협(Han, Kwang-Hyub) ORCID logo https://orcid.org/0000-0003-3960-6539
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