Liver and Bile
Hepatology. 2022;76(6):1746–54
Non-alcoholic fatty liver disease and accelerated loss of skeletal muscle mass: A longitudinal cohort study
Background and aims: Whether subjects with non-alcoholic fatty liver disease (NAFLD) are at increased risk of sarcopenia is not well established.
Approach and results: This is a cohort study of 52,815 men and women of 20 years of age or older who underwent at least 2 health check-up exams with bioelectrical impedance analysis and abdominal ultrasound imaging. Bioelectrical impedance analysis was used to calculate appendicular skeletal muscle mass (ASM). NAFLD was assessed by ultrasonography, and its severity was assessed by the NAFLD fibrosis score (NFS). The authors estimated the 5-year change in ASM comparing participants with and without NAFLD at baseline using mixed linear models. The 5-year change in ASM in participants without and with NAFLD was -225.2 g (95% confidence interval [CI]: -232.3 to -218.0) and -281.3 g (95% CI: -292.0 to -270.6), respectively (p < 0.001). In multivariable adjusted analysis, the difference in 5-year change in ASM comparing participants with and without NAFLD was -39.9 g (95% CI: -53.1 to -26.8). When participants with NAFLD were further divided by NAFLD severity, ASM loss was much faster in participants with NAFLD with intermediate to high NFS than in those with low NFS.
Conclusions: Participants with non-alcoholic fatty liver disease (NAFLD) were at increased risk of sarcopenia, indicated by faster loss of skeletal muscle mass. Patients with NAFLD may need screening and early intervention to mitigate skeletal muscle mass loss.