한빛사 논문
Ho Soo Chun1,2, Mi Na Kim3,4*, Jae Seung Lee5,6, Hye Won Lee5,6, Beom Kyung Kim5,6, Jun Yong Park5,6, Do Young Kim5,6, Sang Hoon Ahn5,6 & Seung Up Kim5,6*
1Department of Internal Medicine, Ewha Womans University Medical Center, Seoul, Korea;
2Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Korea;
3Division of Gastroenterology, Department of Internal Medicine, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea;
4Clinical and Translational Hepatology Laboratory, Seongnam, Korea;
5Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea;
6Yonsei Liver Center, Severance Hospital, Seoul, Korea
*Correspondence to: Seung Up Kim, Mi Na Kim
Abstract
Background
Sarcopenia is a significant indicator of the severity of non-alcoholic fatty liver disease. We investigated whether sarcopenia could identify subgroups with different risk of liver fibrosis and atherosclerotic cardiovascular disease (ASCVD) among subjects with metabolic dysfunction-associated fatty liver disease (MAFLD).
Methods
Subjects from the Korea National Health and Nutrition Examination Survey 2008–2011 were selected (n = 8361). Sarcopenia was defined using the sarcopenia index. Hepatic steatosis was defined as a fatty liver index ≥30. Significant liver fibrosis was defined as a fibrosis-4 index (FIB-4) ≥2.67 or the highest quartile of non-alcoholic fatty liver disease fibrosis score (NFS). High probability of ASCVD was defined as ASCVD risk score >10%.
Results
The mean age was 48.5 ± 15.6 years, and 42.6% of subjects were male. The prevalence of MAFLD was 37.3% (n = 3116 of 8361), and the proportion of sarcopenic subjects was 9.9% among those with MAFLD. After adjusting for confounders, the risk of significant liver fibrosis significantly increased from non-sarcopenic subjects with MAFLD [odds ratio (OR) = 1.57 by FIB-4 and 2.13 by NFS] to sarcopenic subjects with MAFLD (OR = 4.51 by FIB-4 and 5.72 by NFS), compared with subjects without MAFLD (all P < 0.001). The risk for high probability of ASCVD significantly increased from non-sarcopenic subjects with MAFLD (OR = 1.47) to sarcopenic subjects with MAFLD (OR = 4.08), compared with subjects without MAFLD (all P < 0.001).
Conclusions
The risks of significant liver fibrosis and ASCVD differed significantly according to sarcopenic status among subjects with MAFLD. An assessment of sarcopenia might be helpful in risk stratification among subjects with MAFLD.
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