未经批准:不良肌肉组成(MC)(即,低肌肉体积和高肌肉脂肪)以前与非酒精性脂肪性肝病(NAFLD)的功能表现差和合并症有关。在这项研究中,我们旨在调查全因死亡率与肝脏脂肪的关系。NAFLD,和MC在英国生物库成像研究中。
UNASSIGNED:分析了40,174名参与者的磁共振图像的肝脏质子密度脂肪分数(PDFF),大腿无脂肌肉体积(FFMV)z评分,和使用AMRA®研究人员的肌肉脂肪浸润(MFI)。NAFLD的参与者是性别-,年龄-,和BMI与无NAFLD且饮酒量低的参与者相匹配。使用先前公布的截止值确定了不良MC。使用Cox回归调查全因死亡率。NAFLD内的模型是粗糙的,随后根据性别进行了调整,年龄,BMI(M1),手握力,身体活动,吸烟,酒精(M2),和以前的癌症,冠心病,2型糖尿病(M3)。
UNASSIGNED:共有5,069名参与者患有NAFLD。在3.9(±1.4)年的平均(±SD)随访期间,10138名参与者中有150人(53%为男性,年龄64.4[±7.6]岁,BMI29.7[±4.4]kg/m2)死亡。在匹配的数据集中,NAFLD和肝脏PDFF均不与全因死亡率相关,而所有MC变量均达到显著性。在NAFLD内,不良MC,MFI和FFMVz评分与全因死亡率显着相关,在M1和M2中仍然如此(粗风险比[HRs]2.84,95%CI1.70-4.75,p<0.001;1.15,95%CI1.07-1.24,p<0.001;0.70,95%CI0.55-0.88,p<0.001)。在M3中,不良MC和FFMVz评分的关系减弱(调整后的HR1.72,95%CI1.00-2.98,p=0.051;0.77,95%CI0.58-1.02,p=0.069),但MFI仍然显着(调整后的HR1.13,95%CI1.01-1.26,p=0.026)。
未经证实:NAFLD和肝脏PDFF均不能预测全因死亡率。不良MC是NAFLD患者全因死亡率的强预测因子。
UNASSIGNED:患有脂肪肝和肌肉健康状况不佳的人更经常遭受功能表现不佳和合并症的困扰。这项研究表明,他们的死亡风险也更高。研究结果表明,测量肌肉健康(患者的肌肉体积和肌肉中有多少脂肪)可以帮助早期发现高风险患者,并实现有针对性的预防护理。
UNASSIGNED: Adverse muscle composition (MC) (i.e., low muscle volume and high muscle fat) has previously been linked to poor functional performance and comorbidities in non-alcoholic fatty liver disease (NAFLD). In this study we aimed to investigate associations of all-cause mortality with liver fat, NAFLD, and MC in the UK Biobank imaging study.
UNASSIGNED: Magnetic resonance images of 40,174 participants were analyzed for liver proton density fat fraction (PDFF), thigh fat-free muscle volume (FFMV) z-score, and muscle fat infiltration (MFI) using the AMRA® Researcher. Participants with NAFLD were sex-, age-, and BMI-matched to participants without NAFLD with low alcohol consumption. Adverse MC was identified using previously published cut-offs. All-cause mortality was investigated using Cox regression. Models within NAFLD were crude and subsequently adjusted for sex, age, BMI (M1), hand grip strength, physical activity, smoking, alcohol (M2), and previous cancer, coronary heart disease, type 2 diabetes (M3).
UNASSIGNED: A total of 5,069 participants had NAFLD. During a mean (±SD) follow-up of 3.9 (±1.4) years, 150 out of the 10,138 participants (53% men, age 64.4 [±7.6] years, BMI 29.7 [±4.4] kg/m2) died. In the matched dataset, neither NAFLD nor liver PDFF were associated with all-cause mortality, while all MC variables achieved significance. Within NAFLD, adverse MC, MFI and FFMV z-score were significantly associated with all-cause mortality and remained so in M1 and M2 (crude hazard ratios [HRs] 2.84, 95% CI 1.70-4.75, p <0.001; 1.15, 95% CI 1.07-1.24, p <0.001; 0.70, 95% CI 0.55-0.88, p <0.001). In M3, the relationship was attenuated for adverse MC and FFMV z-score (adjusted HRs 1.72, 95% CI 1.00-2.98, p = 0.051; 0.77, 95% CI 0.58-1.02, p = 0.069) but remained significant for MFI (adjusted HR 1.13, 95% CI 1.01-1.26, p = 0.026).
UNASSIGNED: Neither NAFLD nor liver PDFF was predictive of all-cause mortality. Adverse MC was a strong predictor of all-cause mortality in individuals with NAFLD.
UNASSIGNED: Individuals with fatty liver disease and poor muscle health more often suffer from poor functional performance and comorbidities. This study shows that they are also at a higher risk of dying. The study results indicate that measuring muscle health (the patient\'s muscle volume and how much fat they have in their muscles) could help in the early detection of high-risk patients and enable targeted preventative care.