Abstract
Sarcopenia is a pathological condition affecting the development and progression of NAFLD. Urinary levels of titin-N fragment, a biomarker reflecting muscle damage, were measured in NAFLD subjects, and analyzed in a retrospective manner for possible correlations with NAFLD pathophysiology to assess their clinical relevance. This study enrolled 153 NAFLD subjects and 100 subjects without NAFLD, obesity or diabetes mellitus (non-NAFLD). NAFLD subjects had more decreased knee extension strength. NAFLD subjects had greater subcutaneous fat thickness and echo intensity (brightness) of the rectus femoris muscle on ultrasound images; higher levels of the intra- and extra-myocellular lipids (IMCL, EMCL) using 1H-MRS. Urinary titin-N fragment levels were increased with increasing age but not different between males and females. NAFLD subjects had higher titin-N fragment levels than non-NAFLD subjects. The levels were negatively correlated with skeletal muscle mass and knee extension strength and positively correlated with muscle echo intensity, EMCL, and liver fibrosis scores (NAFLD fibrosis score, FIB-4 index). Multivariate analysis revealed that factors affecting the levels were skeletal mass index, leg skeletal muscle mass, liver stiffness, and NAFLD fibrosis score. Urinary levels of titin-N fragment reflected skeletal muscle deterioration and functional decline, and was closely associated with hepatic pathological conditions in NAFLD subjects.
Highlights
Recent Japanese data on medical checkups show that the prevalence of adults with abnormal liver function has been rapidly increasing[1]
We have shown that abnormal body composition consisting of increased visceral fat mass and decreased skeletal muscle mass has an impact on the progression of NAFLD11
Body mass index (BMI), visceral fat area (VFA), and skeletal muscle mass were higher in nonalcoholic fatty liver disease (NAFLD) subjects than in non-NAFLD subjects in the young-age (≤30 years), middle-age (31–60 years), and old-age (≥61 years) groups (Table 2)
Summary
Recent Japanese data on medical checkups show that the prevalence of adults with abnormal liver function has been rapidly increasing[1]. In a longitudinal study, increases in muscle mass over time were associated with benefits either in the development of NAFLD or the improvement of NAFLD pathological conditions[10]. We have shown that abnormal body composition consisting of increased visceral fat mass and decreased skeletal muscle mass has an impact on the progression of NAFLD11. Recent studies have demonstrated that common factors such as insulin resistance, vitamin D deficiency, chronic inflammation, myokines, cytokines, and decreased physical activity are involved in the pathogenesis of both sarcopenia and NAFLD, and play specific roles, in these diseases, with overlapping pathophysiology and circulatory associations[14]
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