Cargando…

Adverse muscle composition is linked to poor functional performance and metabolic comorbidities in NAFLD

BACKGROUND & AIMS: Sarcopenia and frailty are recognised as important factors in later stages of liver disease. However, their role in non-alcoholic fatty liver disease (NAFLD) is not yet fully understood. In this study we investigate the associations of MRI-measured adverse muscle composition (...

Descripción completa

Detalles Bibliográficos
Autores principales: Linge, Jennifer, Ekstedt, Mattias, Dahlqvist Leinhard, Olof
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7868647/
https://www.ncbi.nlm.nih.gov/pubmed/33598647
http://dx.doi.org/10.1016/j.jhepr.2020.100197
_version_ 1783648493141753856
author Linge, Jennifer
Ekstedt, Mattias
Dahlqvist Leinhard, Olof
author_facet Linge, Jennifer
Ekstedt, Mattias
Dahlqvist Leinhard, Olof
author_sort Linge, Jennifer
collection PubMed
description BACKGROUND & AIMS: Sarcopenia and frailty are recognised as important factors in later stages of liver disease. However, their role in non-alcoholic fatty liver disease (NAFLD) is not yet fully understood. In this study we investigate the associations of MRI-measured adverse muscle composition (AMC: low muscle volume and high muscle fat) with poor function, sarcopenia, and metabolic comorbidity within NAFLD in the large UK Biobank imaging study. METHODS: A total of 9,545 participants were included. Liver fat, fat-tissue free muscle volume, and muscle fat infiltration were quantified using a rapid MRI protocol and automated image analysis (AMRA® Researcher). For each participant, a personalised muscle volume z-score (sex- and body size-specific) was calculated and combined with muscle fat infiltration for AMC detection. The following outcomes were investigated: functional performance (hand grip strength, walking pace, stair climbing, falls) and metabolic comorbidities (coronary heart disease, type 2 diabetes). Sarcopenia was detected by combining MRI thresholds for low muscle quantity and low hand grip strength according to the European working group definition. RESULTS: The prevalence of sarcopenia in NAFLD (1.6%) was significantly lower (p <0.05) compared with controls without fatty liver (3.4%), whereas the prevalence of poor function and metabolic comorbidity was similar or higher. Of the 1,204 participants with NAFLD, 169 (14%) had AMC and showed 1.7–2.4× higher prevalence of poor function (all p <0.05) as well as 2.1× and 3.3× higher prevalence of type 2 diabetes and coronary heart disease (p <0.001), respectively, compared with those without AMC. CONCLUSIONS: AMC is a prevalent and highly vulnerable NAFLD phenotype displaying poor function and high prevalence of metabolic comorbidity. Sarcopenia guidelines can be strengthened by including cut-offs for muscle fat, enabling AMC detection. LAY SUMMARY: Today, it is hard to predict whether a patient with fatty liver disease will progress to more severe liver disease. This study shows that measuring muscle health (the patient's muscle volume and how much fat they have in their muscles) could help identify the more vulnerable patients and enable early prevention of severe liver disease.
format Online
Article
Text
id pubmed-7868647
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher Elsevier
record_format MEDLINE/PubMed
spelling pubmed-78686472021-02-16 Adverse muscle composition is linked to poor functional performance and metabolic comorbidities in NAFLD Linge, Jennifer Ekstedt, Mattias Dahlqvist Leinhard, Olof JHEP Rep Research Article BACKGROUND & AIMS: Sarcopenia and frailty are recognised as important factors in later stages of liver disease. However, their role in non-alcoholic fatty liver disease (NAFLD) is not yet fully understood. In this study we investigate the associations of MRI-measured adverse muscle composition (AMC: low muscle volume and high muscle fat) with poor function, sarcopenia, and metabolic comorbidity within NAFLD in the large UK Biobank imaging study. METHODS: A total of 9,545 participants were included. Liver fat, fat-tissue free muscle volume, and muscle fat infiltration were quantified using a rapid MRI protocol and automated image analysis (AMRA® Researcher). For each participant, a personalised muscle volume z-score (sex- and body size-specific) was calculated and combined with muscle fat infiltration for AMC detection. The following outcomes were investigated: functional performance (hand grip strength, walking pace, stair climbing, falls) and metabolic comorbidities (coronary heart disease, type 2 diabetes). Sarcopenia was detected by combining MRI thresholds for low muscle quantity and low hand grip strength according to the European working group definition. RESULTS: The prevalence of sarcopenia in NAFLD (1.6%) was significantly lower (p <0.05) compared with controls without fatty liver (3.4%), whereas the prevalence of poor function and metabolic comorbidity was similar or higher. Of the 1,204 participants with NAFLD, 169 (14%) had AMC and showed 1.7–2.4× higher prevalence of poor function (all p <0.05) as well as 2.1× and 3.3× higher prevalence of type 2 diabetes and coronary heart disease (p <0.001), respectively, compared with those without AMC. CONCLUSIONS: AMC is a prevalent and highly vulnerable NAFLD phenotype displaying poor function and high prevalence of metabolic comorbidity. Sarcopenia guidelines can be strengthened by including cut-offs for muscle fat, enabling AMC detection. LAY SUMMARY: Today, it is hard to predict whether a patient with fatty liver disease will progress to more severe liver disease. This study shows that measuring muscle health (the patient's muscle volume and how much fat they have in their muscles) could help identify the more vulnerable patients and enable early prevention of severe liver disease. Elsevier 2020-10-28 /pmc/articles/PMC7868647/ /pubmed/33598647 http://dx.doi.org/10.1016/j.jhepr.2020.100197 Text en © 2020 The Author(s) http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Research Article
Linge, Jennifer
Ekstedt, Mattias
Dahlqvist Leinhard, Olof
Adverse muscle composition is linked to poor functional performance and metabolic comorbidities in NAFLD
title Adverse muscle composition is linked to poor functional performance and metabolic comorbidities in NAFLD
title_full Adverse muscle composition is linked to poor functional performance and metabolic comorbidities in NAFLD
title_fullStr Adverse muscle composition is linked to poor functional performance and metabolic comorbidities in NAFLD
title_full_unstemmed Adverse muscle composition is linked to poor functional performance and metabolic comorbidities in NAFLD
title_short Adverse muscle composition is linked to poor functional performance and metabolic comorbidities in NAFLD
title_sort adverse muscle composition is linked to poor functional performance and metabolic comorbidities in nafld
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7868647/
https://www.ncbi.nlm.nih.gov/pubmed/33598647
http://dx.doi.org/10.1016/j.jhepr.2020.100197
work_keys_str_mv AT lingejennifer adversemusclecompositionislinkedtopoorfunctionalperformanceandmetaboliccomorbiditiesinnafld
AT ekstedtmattias adversemusclecompositionislinkedtopoorfunctionalperformanceandmetaboliccomorbiditiesinnafld
AT dahlqvistleinhardolof adversemusclecompositionislinkedtopoorfunctionalperformanceandmetaboliccomorbiditiesinnafld