Sarcopenia is associated with non-alcoholic fatty liver disease in men with type 2 diabetes - 13/11/19

Doi : 10.1016/j.diabet.2019.10.004

D.H. Seo ^a,^b, Y.-h. Lee ^b,^c,^d, S.W. Park ^c, Y.J. Choi ^e, B.W. Huh ^e, E. Lee ^b,^c,^d, K.B. Huh ^e, S.H. Kim ^a,⁎ , B.-S. Cha ^b,^c,^d,^⁎
^a Department of Endocrinology and Metabolism, Inha University School of Medicine, 22332 Incheon, South Korea
^b Graduate School, Yonsei University College of Medicine, 06273 Seoul, South Korea
^c Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, 06273 Seoul, South Korea
^d Institute of Endocrine Research, Yonsei University College of Medicine, 06273 Seoul, South Korea
^e Huh's Diabetes Center, 04101 Seoul, South Korea

^⁎Corresponding author. Department of Endocrinology and Metabolism, Inha University School of Medicine, Incheon, South Korea.Department of Endocrinology and Metabolism, Inha University School of MedicineIncheonSouth Korea^⁎⁎Co-corresponding author. Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea.Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of MedicineSeoulSouth Korea

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Abstract

Aims

Recent epidemiological studies have suggested an association between sarcopenia and non-alcoholic fatty liver disease (NAFLD) in the general population, prompting our investigation into the gender-specific association between sarcopenia and NAFLD in patients with type 2 diabetes mellitus (T2DM).

Methods

In this cross-sectional study, 4210 patients with T2DM were recruited from the Seoul Metabolic Syndrome Cohort. Appendicular skeletal muscle mass (ASM) was estimated from bioimpedance analysis measurements, and the skeletal muscle mass index (SMI) was calculated by dividing the sum of ASM by body weight. Sarcopenia was defined as a gender-specific SMI value>2 standard deviations (SDs) below the mean for healthy young adults. NAFLD was defined as the presence of hepatic steatosis on ultrasonography with no other causes of chronic liver disease.

Results

Among the entire study population (mean age: 57.4±10.8 years), 1278 (30.4%) had NAFLD and 1240 (29.5%) had sarcopenia, and the prevalence of NAFLD was significantly higher in those with sarcopenia: 46.2% vs 25.1% (P<0.001) in men; 38.3% vs 25.4% (P<0.001) in women. Sarcopenia was significantly associated with higher risk of NAFLD in men (adjusted odds ratio [OR]: 1.58, 95% confidence interval [CI]: 1.15–2.17), whereas the association was attenuated in women after adjusting for clinical risk factors.