The relationship between non-alcoholic fatty liver and skeletal muscle mass to visceral fat area ratio in women with type 2 diabetes

BACKGROUND: Sarcopenic obesity, central obesity combined with decreased skeletal muscle mass, is identified to be associated with metabolic syndrome and cardiovascular diseases; however, its role in the occurrence of non-alcoholic fatty liver disease (NAFLD) among patients with type 2 diabetes mellitus (T2DM) remains unclear. Therefore, this study aimed to investigate the value of the skeletal-to-visceral ratio (SVR) in the prediction of NAFLD in T2DM. METHODS: T2DM patients (n = 445) were recruited into the current study. Hepatic steatosis was diagnosed based on ultrasonic results, while skeletal muscle mass as well as visceral fat area (VFA) was estimated based on bioimpedance analysis measurements. RESULTS: NAFLD prevalence increased with the decreased SVR tertiles: statistically significant differences were observed in the highest tertiles (21.5% in men, and 30.4% in women) and the lowest tertiles (53.9% in men and 60.0% in women) (both P < 0.01). The decreased SVR tertiles were independently associated with the presence of NAFLD in female T2DM patients, with the odds ratio (OR) of 3.43 and 2.31 in the lowest and middle tertiles, respectively. Besides, the areas under the curve (AUC) for identifying NAFLD were 0.675 and 0.63 in men and women, respectively (P < 0.05). CONCLUSIONS: T2DM patients who have lower SVR levels are associated with higher risks of developing the NAFLD-related complications. Besides, SVR shows independent correlation with NAFLD in female T2DM patients, suggesting that SVR may be a useful index to predict the high risk of hepatic steatosis in T2DM.