■回顾性横断面研究将少肌症和肌萎缩症与代谢功能障碍相关的脂肪肝(MAFLD)联系起来。这里,我们想澄清肌少症之间的动态关系,肌肉骨化病,和MAFLD。
■一组48名肥胖患者随机接受饮食干预,包括16克/天的菊粉(益生元)或麦芽糊精(安慰剂)补充剂。干预前后,我们使用瞬时弹性成像(TE)评估肝脏脂肪变性和硬度;我们使用计算机断层扫描(CT)和生物电阻抗分析(BIA)评估骨骼肌指数(SMI)和骨骼肌脂肪指数(SMFI)(肌肉中绝对脂肪含量的替代指标).
■在基线时,肌少症在MAFLD患者中并不常见(4/48,8.3%)。高肝硬度患者的SMFI高于低肝硬度患者(640.6±114.3cm2/Hounsfield单位[HU]vs.507.9±103.0cm2/HU,p=0.001)。在多变量分析中,即使对多个混杂因素进行了调整,SMFI也与肝脏硬度密切相关(二元逻辑回归,p<0.05)。干预后,补充菊粉的患者体重减轻,但这与肝脏硬度降低无关.值得注意的是,干预后(菊粉或麦芽糊精),降低SMFI的患者,但不是那些增加SMI的人,肝脏硬度降低了12.7%(之前=6.36±2.15vs.后=5.55±1.97kPa,p=0.04)。
■肌萎缩症,但不是肌少症,在患有MAFLD的肥胖患者中,与肝脏硬度密切相关且独立相关。干预后,患者的肌肉骨化程度下降,减少他们的肝脏硬度,无论体重减轻或益生元治疗。应该研究肌浆病对肝脏疾病进展的潜在贡献。
■NCT03852069。
■在患有MAFLD的肥胖患者中,骨骼肌中的脂肪含量(或肌萎缩症)与肝脏硬度密切相关。在饮食干预之后,肌骨形成程度降低的患者肝脏硬度也降低。应该研究肌浆病对肝脏疾病进展的潜在贡献。
UNASSIGNED: Retrospective cross-sectional studies linked sarcopenia and myosteatosis with metabolic dysfunction-associated fatty liver disease (MAFLD). Here, we wanted to clarify the dynamic relationship between sarcopenia, myosteatosis, and MAFLD.
UNASSIGNED: A cohort of 48 obese patients was randomised for a dietary intervention consisting of 16 g/day of inulin (prebiotic) or maltodextrin (placebo) supplementation. Before and after the intervention, we evaluated liver steatosis and stiffness with transient elastography (TE); we assessed skeletal muscle index (SMI) and skeletal muscle fat index (SMFI) (a surrogate for absolute fat content in muscle) using computed tomography (CT) and bioelectrical impedance analysis (BIA).
UNASSIGNED: At baseline, sarcopenia was uncommon in patients with MAFLD (4/48, 8.3%). SMFI was higher in patients with high liver stiffness than in those with low liver stiffness (640.6 ± 114.3 cm2/ Hounsfield unit [HU] vs. 507.9 ± 103.0 cm2/HU, p = 0.001). In multivariate analysis, SMFI was robustly associated with liver stiffness even when adjusted for multiple confounders (binary logistic regression, p <0.05). After intervention, patients with inulin supplementation lost weight, but this was not associated with a decrease in liver stiffness. Remarkably, upon intervention (being inulin or maltodextrin), patients who lowered their SMFI, but not those who increased SMI, had a 12.7% decrease in liver stiffness (before = 6.36 ± 2.15 vs. after = 5.55 ± 1.97 kPa, p = 0.04).
UNASSIGNED: Myosteatosis, but not sarcopenia, is strongly and independently associated with liver stiffness in obese patients with MAFLD. After intervention, patients in which the degree of myosteatosis decreased reduced their liver stiffness, irrespective of body weight loss or prebiotic treatment. The potential contribution of myosteatosis to liver disease progression should be investigated.
UNASSIGNED: NCT03852069.
UNASSIGNED: The fat content in skeletal muscles (or myosteatosis) is strongly associated with liver stiffness in obese patients with MAFLD. After a dietary intervention, patients in which the degree of myosteatosis decreased also reduced their liver stiffness. The potential contribution of myosteatosis to liver disease progression should be investigated.