Diabetes Metab J.  2013 Aug;37(4):278-285. 10.4093/dmj.2013.37.4.278.

The Role of Skeletal Muscle in Development of Nonalcoholic Fatty Liver Disease

• Moon JS
• Yoon JS
• Won KC
• Lee HW

• KMID: 2174269
• DOI: http://doi.org/10.4093/dmj.2013.37.4.278

Abstract

BACKGROUND
Nonalcoholic fatty liver disease (NAFLD) is closely correlated with abnormal accumulation of visceral fat, but the role of skeletal muscle remains unclear. The aim of this study was to elucidate the role of skeletal muscle in development of NAFLD.
METHODS
Among 11,116 subjects (6,242 males), we examined the effects of skeletal muscle mass and visceral fat area (VFA, by bioelectric impedance analysis) on NAFLD using by the fatty liver index (FLI).
RESULTS
Of the total subjects (9,565 total, 5,293 males) included, 1,848 were classified as having NALFD (FLI > or =60). Body mass index, lipid profile, fasting plasma glucose, hemoglobin A1c, prevalence of type 2 diabetes (DM), hypertension (HTN), and metabolic syndrome were higher in males than females, but FLI showed no significant difference. The low FLI group showed the lowest VFA and highest skeletal muscle mass of all the groups. Skeletal muscle to visceral fat ratio (SVR) and skeletal muscle index had inverse correlations with FLI, when adjusted for age and gender. In multivariate regression analysis, SVR was negatively associated with FLI. Among SVR quartiles, the highest quartile showed very low risk of NAFLD when adjusted for age, gender, lipid profile, DM, HTN, and high sensitivity C-reactive protein from the lowest quartiles (odds ratio, 0.037; 95% confidence interval, 0.029 to 0.049).
CONCLUSION
Skeletal muscle mass was inversely associated with visceral fat area, and higher skeletal muscle mass may have a beneficial effect in preventing NAFLD. These results suggest that further studies are needed to ameliorate or slow the progression of sarcopenia.

Keyword

Fatty liver index; Intra-abdominal fat; Muscle, skeletal; Non-alcoholic fatty liver disease

MeSH Terms

Body Mass Index
C-Reactive Protein
Electric Impedance
Fasting
Fatty Liver
Female
Glucose
Hemoglobins
Humans
Hypertension
Intra-Abdominal Fat
Male
Muscle, Skeletal
Plasma
Prevalence
Sarcopenia
C-Reactive Protein
Fatty Liver
Glucose
Hemoglobins

Figure

• 

  Fig. 1 Comparison of body composition indexes according to fatty liver disease (FLI). (A) Visceral fat area (VFA) was increased in higher FLI group compared with the low FLI group (FLI <20). (B) Skeletal muscle index (SMI) and (C) skeletal muscle to visceral fat ratio (SVR) were decreased in both the high FLI group (FLI ≥60) and the intermediated group (20≤FLI<60). aP<0.05; all variables were showed P<0.05, for trend in analysis of variance analysis.

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