Nonalcoholic Fatty Liver Disease and Sarcopenia: Where Do We Stand?

Table 2

Clinical studies linking NAFLD and sarcopenia.

Author and year of publication	Study population	Study design	Method of NAFLD detection	Method of sarcopenia detection	Results
Hong et al. 2014 [32]	452 Korean participants	Cross-sectional	CT	DXA	Patients who had lower muscle mass had more than 5 times higher risk of NAFLD
Lee et al. 2016 [35]	2761 Korean participants	Cross-sectional	NAFLD liver fat score, CNS, HSI. Fibrosis by NFS, FIB-4, and Forns index	DXA	Sarcopenia was related to the significant fibrosis. This association was independent of obesity and insulin resistance.
Kim et al. 2016 [89]	3739 Korea participants	Cross-sectional	FLI	DXA, SMI	Low SMI was associated with FLI (i.e., NAFLD)
Hashimoto et al. 2016 [90]	145 Japanese patients with T2DM	Cross-sectional	TE with CAP	DXA, SMI	SMI had negative correlation with CAP values in men participants with T2DM. A 1% increment in SMI was associated with a decrease risk for steatosis by 20% in men with T2DM.
Wijarnpreecha et al. 2019 [91]	11325 US participants	Cross-sectional	US	BIA	Sarcopenia was an independent predictor of NAFLD and fibrosis
Lee et al. 2019 [92]	4398 Korea participants	Retrospective	US	BIA	An increase in fat mass and a loss of appendicular skeletal mass with aging were associated with incident NAFLD
Meng et al. 2016 [93]	20957 Chinese participants	Cross-sectional	US	Dynamometer	GS is negatively associated with NAFLD
Koo et al. 2017 [33]	309 Korean participants	Cross-sectional	Liver biopsy	BIA	The prevalence of sarcopenia was related to the severity of NAFLD; participants with sarcopenia had increased risk for NASH (OR 2.30; 95% CI 1.08–4.93) and significant fibrosis (OR 2.05; 95% CI 1.01–4.16), respectively
Petta et al. 2017 [94]	255 Italian participants	Cross-sectional	Liver biopsy	BIA	Sarcopenia independently associated with the severity of steatosis and fibrosis on liver histology
Kim et al. 2018 [24]	13165 Korean participants	Prospective	HSI	BIA	Increases in skeletal muscle mass over time had a beneficial effect in terms of NAFLD development and in terms of the resolution of existing NAFLD
Peng et al. 2019 [65]	2551 US participants	Cross-sectional	US	SMI—calculated as the absolute muscle mass (kg) divided by height^2 (meters) or total body mass (kg)	Steatosis defined by US was related to a decreased risk of sarcopenia when it is defined by height-adjusted SMI. Severe US defined steatosis was related to an increased risk of sarcopenia when sarcopenia is defined by the weight-adjusted SMI

NAFLD, nonalcoholic fatty liver disease; CT, computerized tomography; FLI, fatty liver index; DXA, dual energy X-ray absorptiometry; CNS, comprehensive NAFLD score; NFS, NAFLD fibrosis score; HIS, hepatic steatosis index; SMI, skeletal muscle index; TE, transient elastography; CAP, controlled attenuation parameter; US, ultrasound; BIA, bioimpedance analysis; GS, grip strength.