Abstract

BackgroundSarcopenic obesity, central obesity combined with decreased skeletal muscle mass, is identified to be associated with metabolic syndrome and cardiovascular diseases; however, its role in the occurrence of non-alcoholic fatty liver disease (NAFLD) among patients with type 2 diabetes mellitus (T2DM) remains unclear. Therefore, this study aimed to investigate the value of the skeletal-to-visceral ratio (SVR) in the prediction of NAFLD in T2DM.MethodsT2DM patients (n = 445) were recruited into the current study. Hepatic steatosis was diagnosed based on ultrasonic results, while skeletal muscle mass as well as visceral fat area (VFA) was estimated based on bioimpedance analysis measurements.ResultsNAFLD prevalence increased with the decreased SVR tertiles: statistically significant differences were observed in the highest tertiles (21.5% in men, and 30.4% in women) and the lowest tertiles (53.9% in men and 60.0% in women) (both P < 0.01). The decreased SVR tertiles were independently associated with the presence of NAFLD in female T2DM patients, with the odds ratio (OR) of 3.43 and 2.31 in the lowest and middle tertiles, respectively. Besides, the areas under the curve (AUC) for identifying NAFLD were 0.675 and 0.63 in men and women, respectively (P < 0.05).ConclusionsT2DM patients who have lower SVR levels are associated with higher risks of developing the NAFLD-related complications. Besides, SVR shows independent correlation with NAFLD in female T2DM patients, suggesting that SVR may be a useful index to predict the high risk of hepatic steatosis in T2DM.

Highlights

  • Sarcopenic obesity, central obesity combined with decreased skeletal muscle mass, is identified to be associated with metabolic syndrome and cardiovascular diseases; its role in the occurrence of non-alcoholic fatty liver disease (NAFLD) among patients with type 2 diabetes mellitus (T2DM) remains unclear

  • Non-alcoholic fatty liver disease (NAFLD) is a disorder characterized by excess hepatic accumulation of fat in subjects without alcohol abuse history (i.e., < 20 g alcohol is consumed daily) [1]

  • Patients suffering from kidney dysfunction, nutritional compromises, alcohol abuse (> 140 g/week) as well as history of chronic viral hepatitis B (CHB) or C (CHC) infection confirmed by serologic markers were excluded from the current study

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Summary

Introduction

Sarcopenic obesity, central obesity combined with decreased skeletal muscle mass, is identified to be associated with metabolic syndrome and cardiovascular diseases; its role in the occurrence of non-alcoholic fatty liver disease (NAFLD) among patients with type 2 diabetes mellitus (T2DM) remains unclear. Sarcopenia will lead to higher possibilities of developing metabolic disease as well as premature mortality [9, 10]. Accumulation of visceral fat has been identified to lead to a higher probability of developing NAFLD [10]. NAFLD was suggested to be related to sarcopenia obesity among the general population [12]. The connection of sarcopenia obesity with NAFLD remains unclear among T2DM patients

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