Differences among Three Skeletal Muscle Mass Indices in Predicting Non-Alcoholic Fatty Liver Disease: Korean Nationwide Population-Based Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population
2.2. Assessment of NAFLD
2.3. Assessment Body Composition
2.4. Three Different Definitions of Skeletal Muscle Mass Index
2.5. Data Collection
2.6. Statistical Analysis
3. Results
3.1. Clinical Characteristics of the Study Population
3.2. Comparison of Body Composition according to Three Different Definitions of LSMI
3.3. Relationship between Three Different Definitions of LSMI and NAFLD
3.4. Comparison of the Predictive Power of Three Different Definitions of SMI for NAFLD
3.5. Correlations between Three Different Definitions of SMI and HOMA-IR/NAFLD
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Men | Women | |||||
---|---|---|---|---|---|---|
Variables | Without NAFLD | With NAFLD | p | Without NAFLD | With NAFLD | p |
Unweighted number, n | 2311 | 916 | 3920 | 986 | ||
Age, years | 48.6 ± 0.5 | 47.3 ± 0.8 | 0.153 | 46.6 ± 0.4 | 54.5 ± 0.7 | <0.001 |
Height, m | 1.698 ± 0.002 | 1.702 ± 0.004 | 0.356 | 1.572 ± 0.002 | 1.555 ± 0.003 | <0.001 |
Weight, kg | 67.4 ± 0.3 | 74.4 ± 0.6 | <0.001 | 56.1 ± 0.2 | 62.0 ± 0.5 | <0.001 |
BMI, kg/m2 | 23.3 ± 0.1 | 25.6 ± 0.2 | <0.001 | 22.7 ± 0.1 | 25.6 ± 0.2 | <0.001 |
Waist circumference, cm | 82.3 ± 0.3 | 88.8 ± 0.4 | <0.001 | 76.3 ± 0.3 | 85.2 ± 0.5 | <0.001 |
Mean blood pressure, mmHg | 93.2 ± 0.3 | 95.4 ± 0.5 | 0.001 | 87.5 ± 0.4 | 93.6 ± 0.6 | <0.001 |
Smoking status, % (SE) | 0.030 | 0.134 | ||||
Never smoker | 21.7 (1.1) | 17.2 (1.6) | 90.0 (0.7) | 92.0 (1.3) | ||
Ex-smoker | 13.9 (1.2) | 17.9 (2.0) | 1.4 (0.3) | 0.7 (0.2) | ||
Current smoker | 64.4 (1.5) | 64.9 (2.3) | 8.6 (0.6) | 7.3 (1.3) | ||
Alcohol drinker, % (SE) | 73.1 (1.4) | 69.7 (2.1) | 0.151 | 39.8 (1.1) | 34.4 (2.1) | 0.033 |
Regular exercise, % (SE) | 27.6 (1.4) | 24.5 (1.7) | 0.145 | 21.2 (1.0) | 16.9 (1.8) | <0.001 |
Glucose, mg/dL | 95.7 ± 0.4 | 108.3 ± 1.2 | <0.001 | 92.5 ± 0.3 | 110.0 ± 1.3 | <0.001 |
Insulin, µIU/mLt | 8.3 ± 0.1 | 13.7 ± 0.3 | <0.001 | 8.7 ± 0.1 | 14.4 ± 0.3 | <0.001 |
HOMA-IR | 2.0 ± 0.0 | 3.7 ± 0.1 | <0.001 | 2.0 ± 0.0 | 3.9 ± 0.1 | <0.001 |
Total cholesterol, mg/dL | 186.1 ± 0.9 | 191.5 ± 1.7 | 0.006 | 185.5 ± 0.8 | 196.0 ± 1.7 | <0.001 |
AST, U/L | 21.5 ± 0.2 | 32.7 ± 1.4 | <0.001 | 18.7 ± 0.1 | 26.8 ± 0.7 | <0.001 |
ALT, U/L | 20.8 ± 0.3 | 42.9 ± 1.3 | <0.001 | 14.9 ± 0.1 | 29.1 ± 0.9 | <0.001 |
Total caloric intake, kcal/day | 2228.9 ± 28.6 | 2222.2 ± 39.7 | 0.879 | 1653.8 ± 14.8 | 1595.7 ± 33.3 | 0.096 |
Protein intake, % | 14.5 ± 0.1 | 14.7 ± 0.2 | 0.458 | 14.2 ± 0.1 | 14.1 ± 0.2 | 0.441 |
Carbohydrate intake, % | 65.3 ± 0.4 | 64.9 ± 0.7 | 0.562 | 69.5 ± 0.3 | 71.2 ± 0.6 | 0.005 |
Fat intake, % | 17.2 ± 0.3 | 17.7 ± 0.5 | 0.301 | 16.7 ± 0.2 | 15.6 ± 0.4 | 0.028 |
Number of chronic diseases, % (SE) | <0.001 | <0.001 | ||||
0 | 86.34 (1.0) | 64.7 (2.2 | 89.8 (0.7) | 60.0 (2.3) | ||
1 | 10.7 (0.9) | 27.6 (2.1) | 9.0 (0.7) | 32.4 (2.2) | ||
≥2 | 2.9 (0.5) | 7.7 (1.5 | 1.2 (0.3) | 7.6 (1.3) | ||
NAFLD-liver fat score | −1.672 ± 0.018 | 0.465 ± 0.056 | <0.001 | −1.915 ± 0.015 | 0.257 ± 0.039 | <0.001 |
ASM, kg | 21.9 ± 0.1 | 23.0 ± 0.2 | <0.001 | 14.3 ± 0.1 | 15.0 ± 0.1 | <0.001 |
wSMI, % | 32.6 ± 0.1 | 31.0 ± 0.1 | <0.001 | 25.5 ± 0.1 | 24.3 ± 0.1 | <0.001 |
hSMI, kg/m2 | 7.6 ± 0.0 | 7.9 ± 0.1 | <0.001 | 5.8 ± 0.0 | 6.2 ± 0.0 | <0.001 |
bSMI, m2 | 0.944 ± 0.004 | 0.902 ± 0.006 | <0.001 | 0.640 ± 0.003 | 0.590 ± 0.004 | <0.001 |
LSMI Defined by wSMI | LSMI Defined by hSMI | LSMI Defined by bSMI | |||||||
---|---|---|---|---|---|---|---|---|---|
No | Yes | p | No | Yes | p | No | Yes | p | |
Men | |||||||||
Unweighted number, n | 3106 | 121 | 2463 | 764 | 2851 | 376 | |||
Appendicular skeletal muscle mass, kg | 22.3 ± 0.1 | 19.1 ± 0.4 | <0.001 | 23.3 ± 0.1 | 18.5 ± 0.1 | <0.001 | 22.6 ± 0.1 | 18.5 ± 0.2 | <0.001 |
Appendicular fat mass, kg | 5.9 ± 0.0 | 8.9 ± 0.2 | <0.001 | 6.2 ± 0.0 | 5.2 ± 0.1 | <0.001 | 5.9 ± 0.0 | 6.7 ± 0.2 | <0.001 |
Percentage of appendicular fat, % | 19.6 ± 0.2 | 30.3 ± 0.5 | <0.001 | 19.8 ± 0.2 | 20.7 ± 0.4 | 0.020 | 19.4 ± 0.2 | 25.0 ± 0.4 | <0.001 |
Subtotal skeletal muscle mass, kg * | 46.9 ± 0.2 | 42.9 ± 1.0 | <0.001 | 48.7 ± 0.2 | 39.8 ± 0.2 | <0.001 | 47.4 ± 0.2 | 40.9 ± 0.4 | <0.001 |
Subtotal fat mass, kg | 14.2 ± 0.1 | 22.8 ± 0.6 | <0.001 | 15.1 ± 0.2 | 12.5 ± 0.3 | <0.001 | 14.2 ± 0.2 | 17.4 ± 0.4 | <0.001 |
Percentage of subtotal fat, % | 22.1 ± 0.2 | 33.6 ± 0.4 | <0.001 | 22.5 ± 0.2 | 22.6 ± 0.4 | 0.667 | 21.8 ± 0.2 | 28.6 ± 0.4 | <0.001 |
Women | |||||||||
Unweighted number, n | 4677 | 229 | 3518 | 1388 | 4397 | 509 | |||
Appendicular skeletal muscle mass, kg | 14.5 ± 0.0 | 12.6 ± 0.3 | <0.001 | 15.1 ± 0.0 | 12.5 ± 0.1 | <0.001 | 14.6 ± 0.0 | 12.3 ± 0.1 | <0.001 |
Appendicular fat mass, kg | 8.4 ± 0.0 | 11.4 ± 0.3 | <0.001 | 8.8 ± 0.0 | 7.9 ± 0.0 | <0.001 | 8.5 ± 0.0 | 9.4 ± 0.2 | <0.001 |
Percentage of appendicular fat, % | 35.2 ± 0.1 | 45.4 ± 0.8 | <0.001 | 35.2 ± 0.1 | 36.8 ± 0.3 | <0.001 | 35.0 ± 0.1 | 41.3 ± 0.6 | <0.001 |
Subtotal skeletal muscle mass, kg * | 32.5 ± 0.1 | 30.4 ± 0.6 | 0.001 | 33.8 ± 0.1 | 28.8 ± 0.1 | <0.001 | 32.8 ± 0.1 | 29.4 ± 0.3 | <0.001 |
Subtotal fat mass, kg | 17.8 ± 0.1 | 26.2 ± 0.5 | <0.001 | 19.1 ± 0.1 | 15.8 ± 0.2 | <0.001 | 17.8 ± 0.1 | 22.0 ± 0.4 | <0.001 |
Percentage of subtotal fat, % | 34.0 ± 0.1 | 45.0 ± 0.6 | <0.001 | 34.7 ± 0.2 | 34.0 ± 0.3 | 0.044 | 33.8 ± 0.1 | 41.5 ± 0.5 | <0.001 |
Men | Women | |||||
---|---|---|---|---|---|---|
NAFLD | NAFLD | |||||
No | Yes | No | Yes | |||
OR (95% CI) | p | OR (95% CI) | p | |||
LSMI defined by wSMI | ||||||
Unadjusted | 1 (Ref.) | 3.39 (1.92–5.97) | <0.001 | 1 (Ref.) | 2.37 (1.62–3.48) | <0.001 |
Model 1 | 1 (Ref.) | 3.67 (2.08–6.47) | <0.001 | 1 (Ref.) | 1.83 (1.27–2.62) | 0.001 |
Model 2 | 1 (Ref.) | 3.61(2.09–6.26) | <0.001 | 1 (Ref.) | 1.82 (1.27–2.63) | 0.001 |
Model 3 | 1 (Ref.) | 2.52 (1.20–5.30) | 0.015 | 1 (Ref.) | 1.98 (1.34–2.93) | 0.001 |
LSMI defined by hSMI | ||||||
Unadjusted | 1 (Ref.) | 0.55 (0.41–0.74) | <0.001 | 1 (Ref.) | 0.38 (0.29–0.50) | <0.001 |
Model 1 | 1 (Ref.) | 0.56 (0.42–0.75) | <0.001 | 1 (Ref.) | 0.44 (0.34–0.57) | <0.001 |
Model 2 | 1 (Ref.) | 0.55 (0.41–0.74) | <0.001 | 1 (Ref.) | 0.43 (0.33–0.56) | <0.001 |
Model 3 | 1 (Ref.) | 0.50 (0.36–0.71) | <0.001 | 1 (Ref.) | 0.48 (0.35–0.65) | <0.001 |
LSMI defined by bSMI | ||||||
Unadjusted | 1 (Ref.) | 1.88 (1.36–2.59) | <0.001 | 1 (Ref.) | 2.12 (1.59–2.84) | <0.001 |
Model 1 | 1 (Ref.) | 2.15 (1.53–3.02) | <0.001 | 1 (Ref.) | 1.35 (0.99–1.84) | 0.056 |
Model 2 | 1 (Ref.) | 2.06 (1.46–2.90) | <0.001 | 1 (Ref.) | 1.36 (1.00–1.85) | 0.054 |
Model 3 | 1 (Ref.) | 1.55 (1.03–2.33) | 0.001 | 1 (Ref.) | 1.30 (0.92–1.85) | 0.141 |
r | p * | p ** | ||
---|---|---|---|---|
Men | wSMI | −0.318 | <0.001 | Ref. |
hSMI | 0.192 | <0.001 | <0.001 | |
bSMI | −0.212 | <0.001 | <0.001 | |
Women | wSMI | −0.214 | <0.001 | Ref. |
hSMI | 0.290 | <0.001 | <0.001 | |
bSMI | −0.184 | <0.001 | <0.001 |
r | p * | p ** | ||
---|---|---|---|---|
Men | wSMI | −0.283 | <0.001 | Ref |
hSMI | 0.224 | <0.001 | 0.004 | |
bSMI | −0.182 | <0.001 | <0.001 | |
Women | wSMI | −0.237 | <0.001 | Ref |
hSMI | 0.302 | <0.001 | <0.001 | |
bSMI | −0.232 | <0.001 | 0.542 |
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Cho, A.-R.; Lee, J.-H.; Kwon, Y.-J. Differences among Three Skeletal Muscle Mass Indices in Predicting Non-Alcoholic Fatty Liver Disease: Korean Nationwide Population-Based Study. Life 2021, 11, 751. https://doi.org/10.3390/life11080751
Cho A-R, Lee J-H, Kwon Y-J. Differences among Three Skeletal Muscle Mass Indices in Predicting Non-Alcoholic Fatty Liver Disease: Korean Nationwide Population-Based Study. Life. 2021; 11(8):751. https://doi.org/10.3390/life11080751
Chicago/Turabian StyleCho, A-Ra, Jun-Hyuk Lee, and Yu-Jin Kwon. 2021. "Differences among Three Skeletal Muscle Mass Indices in Predicting Non-Alcoholic Fatty Liver Disease: Korean Nationwide Population-Based Study" Life 11, no. 8: 751. https://doi.org/10.3390/life11080751