Abstract
[Purpose]This study examined the association of hand-grip strength (HGS) and non-alcoholic fatty liver disease (NAFLD) index in older adults.[Methods]This was a cross-sectional study involving 538 older adults with mean age of 74.3±6.4 years. Body composition parameters including height, percent body fat, body mass index (BMI), waist circumference (WC), was determined using body composition analyzer. HGS was assessed using a dynamometer, and NAFLD was diagnosed by the simple NAFLD score (SNS), hepatic steatosis index (HSI), NAFLD fibrosis score (NFS), and fibrosis 4 calculator (FIB-4). Based on relative HGS, subjects were classified as High HGS, Mid HGS, and Low HGS group. Based on SNS, HSI, NFS and FIB-4 score, subjects were classified as High risk and Low risk group. Logistic regression analyses were used to determine the odds ratio (OR) and 95% confidence interval (CI) of HGS levels for having steatosis and fibrosis.[Results]There were linear decreases in NAFLD index such as SNS (P<.001), HSI (P<.001), NFS (P=.001), and FIB-4 (P=.041) across incremental HGS levels. Compared to the High HGS group (reference), the Low HGS group had significantly higher ORs of having SNS (OR=4.583, 95% CI=2.608-8.054, P<.001), HSI (OR=11.697, 95% CI=5.261-26.005, P<.001), and NFS (OR=1.709, 95% CI=1.005-2.907, P=.048).[Conclusion]The current findings suggest that a lifestyle intervention consisting of a normal weight and physical fitness should be promoted as a preventive means against NAFLD associated with HGS.
Highlights
The declining birth rate and prolonged average lifespan have accelerated the global aging phenomenon
The results show a significant linear decrease in age (P < 0.001), body mass index (BMI) (P < 0.001), waist circumference (P < 0.001), body fat (P < 0.001), dyslipidemia (P = 0.011), diabetes (P = 0.029), TG (P = 0.001), and fasting blood glucose (FBG) (P = 0.011) with increasing hand-grip strength (HGS) levels, whereas a significant linear increase was observed for high-density lipoprotein cholesterol (HDL-C) (P = 0.001) and platelets (P = 0.005)
With increasing HGS levels, the simple NAFLD score (SNS) (P < 0.001) and hepatic steatosis index (HSI) (P < 0.001) which indicate hepatic steatosis related to non-alcoholic fatty liver disease (NAFLD) and the NAFLD fibrosis score (NFS) (P = 0.001) and fibrosis 4 calculator (FIB-4) (P = 0.041) which indicate hepatic fibrosis showed significant decreases
Summary
The declining birth rate and prolonged average lifespan have accelerated the global aging phenomenon. The aging phenomenon is related to an increased prevalence of various chronic diseases such as arthritis, stroke, angina, lung diseases, and hypertension and be closely associated with an increased prevalence of non-alcoholic fatty liver disease (NAFLD) in the elderly[2,3]. The precise mechanism of NAFLD pathogenesis remains unclear, the ‘two-hit’ theory is considered as the most promising mechanism[7] This theory includes the ‘1st-hit’, in which excessive accumulation of triglycerides in the healthy liver leads to simple steatosis, and the ‘2nd-hit’, in which oxidative stress and excessive production of inflammatory cytokines drive simple steatosis towards steatohepatitis. In older adults, the side effects of drug therapy and risks of weight loss have highlighted the importance of enhanced physical strength based on regular physical activities and exercise as the most effective alternative for treating NAFLD11
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