Body Composition and Progression of Biopsy-Proven Non-Alcoholic Fatty Liver Disease in Patients With Obesity

IF 9.1 1区医学 Q1 GERIATRICS & GERONTOLOGY Journal of Cachexia Sarcopenia and Muscle Pub Date : 2024-10-10 DOI:10.1002/jcsm.13605

Qianyi Wan, Xingzhu Liu, Jinghao Xu, Rui Zhao, Shiqin Yang, Jianrong Feng, Zhan Cao, Jingru Li, Xiaopeng He, Haiou Chen, Jinbao Ye, Haiyang Chen, Yi Chen

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Abstract

Background

Obesity is a significant risk factor for the progression of non-alcoholic fatty liver disease (NAFLD). However, a convenient and efficacious non-invasive test for monitoring NAFLD progression in patients with obesity is currently lacking. This study aims to investigate the associations between CT-based body composition and the progression of biopsy-proven NAFLD in patients with obesity.

Methods

Liver biopsy was conducted in patients with obesity, and the progression of NAFLD was evaluated by the NAFLD activity score (NAS). Body composition was assessed through abdominal computed tomography (CT) scans.

Results

A total of 602 patients with an average age of 31.65 (±9.33) years old were included, comprising 217 male patients and 385 female patients. The wall skeletal muscle index (SMI), total SMI, and visceral fat index (VFI) were positively correlated with NAS in both male and female patients. Multivariate regression analysis demonstrated significant associations between high liver steatosis and wall SMI (HR: 1.60, 95% CI: 1.12 to 2.30), total SMI (HR: 1.50, 95% CI: 1.02 to 2.08), VSI (HR: 2.16, 95% CI: 1.48 to 3.14), visceral fat to muscle ratio (HR: 1.51, 95% CI: 1.05 to 2.18), and visceral to subcutaneous fat ratio (HR: 1.51, 95% CI: 1.07 to 2.12). Non-alcoholic steatohepatitis (NASH) was significantly associated with wall SMI (HR: 1.52, 95% CI: 1.06 to 2.19) and VSI (HR: 1.50, 95% CI: 1.03 to 2.17). Liver fibrosis ≥ F2 was significantly associated with psoas muscle index (HR: 0.64, 95% CI: 0.44 to 0.93) and psoas skeletal muscle density (HR: 0.61, 95% CI: 0.41 to 0.89).

Conclusions

Our study suggested that certain CT-based body composition indicators, notably high VFI, were significantly associated with the progression of NAFLD in patients with obesity. Great attentions and timely managements should be given to these patients with body composition characteristics associated with the risk of NAFLD progression.

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肥胖症患者的身体成分与活检证实的非酒精性脂肪肝的进展。

背景：肥胖是非酒精性脂肪肝（NAFLD）恶化的一个重要风险因素。然而，目前尚缺乏一种方便有效的非侵入性检测方法来监测肥胖患者非酒精性脂肪肝的进展情况。本研究旨在探讨基于 CT 的身体成分与肥胖症患者活检证实的非酒精性脂肪肝进展之间的关联：方法：对肥胖症患者进行肝活检，并通过非酒精性脂肪肝活动评分（NAS）评估非酒精性脂肪肝的进展情况。通过腹部计算机断层扫描（CT）评估身体成分：共纳入 602 名患者，其中男性 217 名，女性 385 名，平均年龄为 31.65 (±9.33) 岁。在男性和女性患者中，壁骨骼肌指数（SMI）、总SMI和内脏脂肪指数（VFI）与NAS呈正相关。多变量回归分析表明，高肝脏脂肪变性与壁骨骼肌指数（HR：1.60，95% CI：1.12 至 2.30）、总骨骼肌指数（HR：1.50，95% CI：1.02至2.08）、VSI（HR：2.16，95% CI：1.48至3.14）、内脏脂肪与肌肉比率（HR：1.51，95% CI：1.05至2.18）以及内脏脂肪与皮下脂肪比率（HR：1.51，95% CI：1.07至2.12）。非酒精性脂肪性肝炎（NASH）与肝壁 SMI（HR：1.52，95% CI：1.06 至 2.19）和 VSI（HR：1.50，95% CI：1.03 至 2.17）显著相关。肝纤维化≥F2与腰肌指数（HR：0.64，95% CI：0.44-0.93）和腰肌骨骼肌密度（HR：0.61，95% CI：0.41-0.89）显著相关：我们的研究表明，某些基于 CT 的身体成分指标，尤其是高 VFI，与肥胖患者非酒精性脂肪肝的进展有显著相关性。我们的研究表明，某些基于 CT 的身体成分指标，尤其是高 VFI，与肥胖症患者非酒精性脂肪肝的进展密切相关，因此应高度重视并及时处理这些具有与非酒精性脂肪肝进展风险相关的身体成分特征的患者。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Cachexia Sarcopenia and Muscle MEDICINE, GENERAL & INTERNAL-

CiteScore

13.30

自引率

12.40%

发文量

234

审稿时长

16 weeks

期刊介绍： The Journal of Cachexia, Sarcopenia and Muscle is a peer-reviewed international journal dedicated to publishing materials related to cachexia and sarcopenia, as well as body composition and its physiological and pathophysiological changes across the lifespan and in response to various illnesses from all fields of life sciences. The journal aims to provide a reliable resource for professionals interested in related research or involved in the clinical care of affected patients, such as those suffering from AIDS, cancer, chronic heart failure, chronic lung disease, liver cirrhosis, chronic kidney failure, rheumatoid arthritis, or sepsis.