Abstract
Although both liver and muscle are metabolically active endocrine organs, and non-alcoholic fatty liver disease (NAFLD) and sarcopenia may share common pathogenic determinants, there have been few clinical studies of the relationship between NAFLD and muscle strength, especially in the elderly. We conducted a nationally representative population-based, cross-sectional study using data from the Korea National Health and Nutrition Examination Survey, which involved 1,897 men aged ≥50 years and 2,206 postmenopausal women. NAFLD was defined using the hepatic steatosis index (HSI) and low muscle strength was defined using the Korea-specific cut-off point of hand grip strength (HGS). Men and women with NAFLD had 7.3% and 7.9% lower HGS than controls, respectively. The odds ratios for low muscle strength in the presence of NAFLD were 2.51 in men and 2.34 in women. HSI inversely correlated with HGS in both men and women. Consistently, compared with men and women in the lowest HSI quartile, those in the highest quartile had 7.6% and 12.4% lower HGS, respectively, and were 5.63- and 3.58-times more likely to have low muscle strength, respectively. These results provide the first clinical evidence that NAFLD can be associated with muscular impairment in older adults, as demonstrated by lower muscle strength.
Highlights
Hand grip strength (HGS) is a measure of the maximum static force that a hand can apply around a dynamometer
The participants with non-alcoholic fatty liver disease (NAFLD) were younger and had higher weight, body mass index (BMI), systolic and diastolic blood pressure (BP), serum triglycerides, fasting plasma glucose, glycated hemoglobin A1c (HbA1c), serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), and hepatic steatosis index (HSI) than those without NAFLD, but there were no differences in height, smoking habit, resistance exercise, or serum total cholesterol between the two groups
Crude analyses showed that men with NAFLD had significantly higher hand grip strength (HGS) than those without, but the difference in HGS according to NAFLD status was not identified in women
Summary
Hand grip strength (HGS) is a measure of the maximum static force that a hand can apply around a dynamometer. Given its predictive validity and simplicity, the intriguing suggestion has been made that grip strength might have potential as a screening tool in middle-aged and older adults [5, 8]. Muscle strength is known to be better than muscle mass in predicting adverse outcomes [3, 9, 10], and the recently revised guidelines issued by the European Working Group on Sarcopenia in Older People (EWGSOP) focused on low muscle strength as the primary measure of sarcopenia [11]. The importance of muscle strength is increasingly recognized in research and clinical practice to improve human muscle health
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