Abstract
Recently, sarcopenia was identified as a risk factor for non-alcoholic fatty liver disease (NAFLD) in adults. We here investigated the association between skeletal muscle mass (SMM) and NAFLD in non-obese children and adolescents. A retrospective medical chart review was performed for individuals aged 9–15 years diagnosed with NAFLD. Healthy volunteers aged 9–15 years were recruited as controls. Participants were subject to laboratory tests, abdominal sonography, and multi-frequency bioelectrical impedance analysis. SMM data were calculated as the skeletal muscle-to-body fat ratio (MFR), and the diagnosis of fatty liver was established by abdominal sonography. The control and NAFLD groups included 73 and 53 individuals, respectively. No significant difference was observed in gender and body mass index (BMI) distribution between the groups. Mean MFR was significantly lower in individuals with NAFLD than in those without (0.83 vs. 1.04, p = 0.005). After adjusting for age, sex, BMI, and serum glucose, the risk of having NAFLD was significantly associated with a decreased MFR (p = 0.016). NAFLD is significantly associated with relatively low SMM in non-obese children and adolescents. Increasing SMM, such as weight training, can be suggested as one of the treatment strategies in pediatric NAFLD without obesity.
Highlights
Non-alcoholic fatty liver disease (NAFLD) is defined as steatosis with ≥5% fat infiltration in the liver in the absence of alcohol, drug, virus-associated, or other known liver pathology [1,2]
There was no significant difference between the two groups in the distribution of sex and body mass index (BMI)
There was a limitation to make an accurate definition of sarcopenia; the present study focused on analyzing the relationship between skeletal muscle mass (SMM) and NAFLD by setting SMM as a continuous variable rather than defining the sarcopenia by cutoff values
Summary
Non-alcoholic fatty liver disease (NAFLD) is defined as steatosis with ≥5% fat infiltration in the liver in the absence of alcohol-, drug-, virus-associated, or other known liver pathology [1,2]. The spectrum of NAFLD ranges from steatosis to steatohepatitis (non-alcoholic steatohepatitis, NASH), fibrosis, and cirrhosis [1,3,4]. Minor fat infiltration, can eventually lead to progressive liver disease, a major cause of liver-related mortality, such as liver cirrhosis or hepatocellular carcinoma [5]. NAFLD is the most common type of chronic liver disease in children and adolescents. Pediatric NAFLD is of particular concern because children have a long life expectancy and because it increases the risk of type-2 diabetes or cardiovascular disease in adulthood as well as liver-related morbidity [7]
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