The relationship between skeletal muscle mass to visceral fat area ratio and metabolic dysfunction-associated fatty liver disease subtypes in middle-aged and elderly population: a single-center retrospective study

Association between visceral fat area to skeletal muscle mass ratio and hyperuricemia among non-elderly US adults

BACKGROUND AND AIM

Sarcopenic visceral obesity is linked to an elevated metabolic risk. Our aim was to explore the possible link between visceral fat area to skeletal muscle mass ratio (VSR) and hyperuricemia risk in non-elderly U.S. adults.

METHODS AND RESULTS

This cross-sectional study evaluated 5519 non-elderly adults from the National Health and Nutrition Examination Survey (NHANES) database. Visceral fat area (VFA) and appendicular skeletal muscle mass (ASM) were measured using dual-energy X-ray absorptiometry (DXA). Hyperuricemia was identified by serum uric acid (SUA) levels of 7 mg/dL or more in males and 6 mg/dL or more in females. Logistic regression, restricted cubic spline (RCS), and subgroup analyses were applied to investigate the association between VSR and hyperuricemia risk. As VSR levels increase, the prevalence of hyperuricemia becomes more pronounced (6.35 % vs. 14.45 % vs. 14.68 % vs. 17.03 %, P < 0.001). After adjusting for confounding factors, elevated VSR levels are associated with an increased risk of hyperuricemia (OR = 1.136, 95 %CI:1.051-1.229, P = 0.001). Individuals in the fourth quartile of VSR exhibit a higher risk of developing hyperuricemia compared to those in the first quartile (OR = 2.299, 95 %CI:1.328-3.979, P = 0.003). No specific populations were identified in the subgroup analysis. RCS analysis further supports a dose-response relationship.

CONCLUSIONS

VSR could serve as an epidemiological instrument to assess the impact of sarcopenic visceral obesity on the risk of hyperuricemia.

The lean body mass to visceral fat mass ratio is negatively associated with cardiometabolic disorders: a cross-sectional study

The literature has documented conflicting and inconsistent associations between muscle-to-fat ratios and metabolic diseases. Additionally, different adipose tissues can have contrasting effects, with visceral adipose tissue being identified as particularly harmful. This study aimed to explore the relationship between the ratio of the lean mass index (LMI) to the visceral fat mass index (VFMI) and cardiometabolic disorders, including dyslipidemia, hypertension, and diabetes, as previous research on this topic is lacking. This cross-sectional study utilized data from the National Health and Nutrition Examination Survey (NHANES) conducted in the United States and included 10,867 individuals. Logistic regression was employed to explore the association between LMI/VFMI and cardiometabolic disorders. Generalized additive models were utilized to examine the nonlinear relationships between variables. Data analysis revealed a consistent inverse association between ln(LMI/VFMI) and dyslipidemia, hypertension, and diabetes. Each 2.7-fold increase in LMI/VFMI (one unit of ln[LMI/VFMI]) was associated with lower odds ratios (ORs) for these conditions. In men, the ORs were 0.21 (95% CI 0.17-0.25) for dyslipidemia, 0.37 (95% CI 0.30-0.45) for hypertension, and 0.16 (95% CI 0.10-0.23) for diabetes. Similarly, in women, the ORs were 0.22 (95% CI 0.19-0.26), 0.51 (95% CI 0.42-0.61), and 0.19 (95% CI 0.13-0.27). Quartile analysis showed that participants in the highest quartile (Q4) had significantly lower ORs compared to those in the lowest quartile (Q1). In men, Q4 ORs were 0.18 (95% CI 0.14-0.23) for dyslipidemia, 0.30 (95% CI 0.23-0.39) for hypertension, and 0.11 (95% CI 0.06-0.20) for diabetes. In women, Q4 ORs were 0.12 (95% CI 0.10-0.15), 0.39 (95% CI 0.29-0.52), and 0.12 (95% CI 0.06-0.25), respectively. Dyslipidemia and diabetes demonstrated nonlinear patterns, while a linear association was found for hypertension. Subgroup analyses across various characteristics confirmed these findings with no substantial directional changes. Maintaining an appropriate ratio of LMI to VFMI may be associated with favorable metabolic health.

Body Composition and Progression of Biopsy-Proven Non-Alcoholic Fatty Liver Disease in Patients With Obesity

BACKGROUND

Obesity is a significant risk factor for the progression of non-alcoholic fatty liver disease (NAFLD). However, a convenient and efficacious non-invasive test for monitoring NAFLD progression in patients with obesity is currently lacking. This study aims to investigate the associations between CT-based body composition and the progression of biopsy-proven NAFLD in patients with obesity.

METHODS

Liver biopsy was conducted in patients with obesity, and the progression of NAFLD was evaluated by the NAFLD activity score (NAS). Body composition was assessed through abdominal computed tomography (CT) scans.

RESULTS

A total of 602 patients with an average age of 31.65 (±9.33) years old were included, comprising 217 male patients and 385 female patients. The wall skeletal muscle index (SMI), total SMI, and visceral fat index (VFI) were positively correlated with NAS in both male and female patients. Multivariate regression analysis demonstrated significant associations between high liver steatosis and wall SMI (HR: 1.60, 95% CI: 1.12 to 2.30), total SMI (HR: 1.50, 95% CI: 1.02 to 2.08), VSI (HR: 2.16, 95% CI: 1.48 to 3.14), visceral fat to muscle ratio (HR: 1.51, 95% CI: 1.05 to 2.18), and visceral to subcutaneous fat ratio (HR: 1.51, 95% CI: 1.07 to 2.12). Non-alcoholic steatohepatitis (NASH) was significantly associated with wall SMI (HR: 1.52, 95% CI: 1.06 to 2.19) and VSI (HR: 1.50, 95% CI: 1.03 to 2.17). Liver fibrosis ≥ F2 was significantly associated with psoas muscle index (HR: 0.64, 95% CI: 0.44 to 0.93) and psoas skeletal muscle density (HR: 0.61, 95% CI: 0.41 to 0.89).

CONCLUSIONS

Our study suggested that certain CT-based body composition indicators, notably high VFI, were significantly associated with the progression of NAFLD in patients with obesity. Great attentions and timely managements should be given to these patients with body composition characteristics associated with the risk of NAFLD progression.

The nonlinear connection between relative fat mass and non-alcoholic fatty liver disease in the Japanese population: an analysis based on data from a cross-sectional study

BACKGROUND

Relative fat mass (RFM) is a newly developed, sex-specific anthropometric formula designed to estimate total body fat percentage. However, research investigating the correlation between RFM and the risk of non-alcoholic fatty liver disease (NAFLD) remains limited. This study evaluates the association between RFM and the risk of NAFLD within the Japanese population.

METHODS

This study including 14,250 Japanese adults who underwent physical examinations at Murakami Memorial Hospital between 2004 and 2015. We employed binary logistic regression to elucidate the direct relationship between RFM levels and the incidence of NAFLD. Additionally, a generalized additive model (GAM) coupled with smooth curve fitting techniques was utilized to map the non-linear association.

RESULTS

The cohort had an average age of 43.53 ± 8.89 years, with a male majority of 52.00%. NAFLD was identified in 17.59% of the participants. After adjusting for confounding factors, a significant positive correlation between RFM and NAFLD risk was observed (OR: 1.15, 95%CI: 1.10-1.21, P < 0.0001 for females; OR: 1.15, 95%CI: 1.10-1.19, P < 0.0001 for males). Additionally, a non-linear relationship between RFM and the incidence of NAFLD was detected in both genders. The RFM threshold was identified as 34.95 for women and 23.40 for men. RFM was positively associated with the risk of NAFLD when RFM was below the respective threshold (OR: 1.29, 95%CI: 1.19-1.40, P < 0.0001 for females; OR: 1.23, 95%CI: 1.17-1.29, P < 0.0001 for males), whereas no significant association was found when RFM was above the threshold (OR: 1.05, 95%CI: 0.98-1.12, P = 0.1829 for females; OR: 1.01, 95%CI: 0.95-1.08, P = 0.7392 for males).

CONCLUSION

Our findings suggest a positive, nonlinear relationship between RFM and the risk of NAFLD, with a saturation effect. These results imply that maintaining RFM at a lower level may be advantageous in mitigating the risk of NAFLD.

Association between the skeletal muscle mass to visceral fat area ratio and metabolic dysfunction-associated fatty liver disease: A cross-sectional study of NHANES 2017-2018

BACKGROUND AND AIMS

Previous studies have shown that sarcopenic obesity (SO) was associated with nonalcoholic fatty liver disease (NAFLD). However, research is limited in the context of the NAFLD renamed as metabolic dysfunction-associated steatotic liver disease (MASLD) defined by updated diagnostic criteria. The aim of this study was to use the index skeletal muscle mass to visceral fat area ratio (SVR) to describe SO in a large and representative US population (National Health and Nutrition Examination Survey 2017-2018) of adults and investigate their association with MASLD.

METHODS

A total of 2087 individuals were included in the analysis. SVR was calculated according to the measurement of dual-energy x-ray absorptiometry and MASLD was diagnosed with controlled attenuation parameter scores and cardiometabolic risk factors. SVR was divided into tertiles. Logistic regression adjusted for confounders was used to evaluate the association between SVR and MASLD. Several sensitivity analyses were performed to test the robustness of our findings.

RESULTS

In a multivariate logistic regression analysis, a significant association between SVR and MASLD was shown (odds ratio [OR]: 3.11, 95% confidence interval [CI]: 1.31-7.39, p = .010 for middle levels of SVR; OR: 3.82, 95% CI: 1.45-10.08, p = .007 for lowest levels of SVR). The sensitivity analyses confirmed that the association was robust.

CONCLUSION

Our findings imply that decreased SVR is linked to MASLD.

Increased visceral fat area to skeletal muscle mass ratio is positively associated with the risk of metabolic dysfunction-associated steatotic liver disease in a Chinese population

BACKGROUND

The diagnosis and comprehension of nonalcoholic fatty liver disease (NAFLD), recently redefined as metabolic dysfunction-associated steatotic liver disease (MASLD) are gaining a better understanding. In this study, we examined the association between visceral fat area and skeletal muscle mass ratio (VSR) and the prevalence of MASLD in a Chinese population.

METHODS

A cross-sectional study was conducted involving 10,916 individuals who underwent bioelectrical impedance analysis, along with anthropometric and biochemical measurements, from January 2022 to June 2023. According to the VSR distribution, sex-specific quartiles of VSR within the study population were defined. Linear trend tests were performed for the categorized VSR variables. Logistic regression models were performed to estimate the odds ratio and 95% confidence intervals between VSR distribution and MASLD prevalence stratified by sex.

RESULTS

The prevalence of MASLD was 37.94% in the overall population (56.34% male), and it gradually increased with higher VSR levels in both genders (P < 0.001). Logistic regression analysis demonstrated a significant association between VSR and MASLD prevalence after adjusting for confounders. The odds ratio (95% confidence interval) for MASLD, comparing the lowest to the highest VSR quartile, was 3.159 (2.671, 3.736) for men and 2.230 (1.764, 2.819) for women (all P < 0.001). Restricted cubic splines also indicated significant non-linear relationships between VSR and MASLD prevalence.

CONCLUSIONS

VSR is positively associated with the prevalence of MASLD in this Chinese population, with a notably higher risk for men as VSR increases compared to women.