Adverse muscle composition is a significant risk factor for all-cause mortality in NAFLD.

Autor:	Linge J; AMRA Medical AB, Linköping, Sweden.; Division of Diagnostics and Specialist Medicine, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden., Nasr P; Department of Gastroenterology and Hepatology, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden., Sanyal AJ; Stravitz-Sanyal Institute of Liver Disease and Metabolic Health, Department of Internal Medicine, VCU School of Medicine, Richmond, VA, USA., Dahlqvist Leinhard O; AMRA Medical AB, Linköping, Sweden.; Division of Diagnostics and Specialist Medicine, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.; Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden., Ekstedt M; Department of Gastroenterology and Hepatology, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.; Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden.
Jazyk:	angličtina
Zdroj:	JHEP reports : innovation in hepatology [JHEP Rep] 2022 Dec 24; Vol. 5 (3), pp. 100663. Date of Electronic Publication: 2022 Dec 24 (Print Publication: 2023).
DOI:	10.1016/j.jhepr.2022.100663
Abstrakt:	Background & Aims: 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. Methods: 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). Results: 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/m 2 ) 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). Conclusions: 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. Impact and Implications: 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. Competing Interests: JL is an employee of AMRA Medical AB and reports other from BioMarin and Eli Lilly. AJS reports grants from Intercept, during the conduct of the study; other from Sanyal Bio, Genfit, Indalo, Tiziana, Durect, Exhalenz, Galmed, second genome, Cymabay, Prosciento, Labcorp, Medimmune, Astra Zeneca, Albireo; grants from Merck, Bristol Myers, Boehringer Ingelhiem, Immuron, Malinkrodt, Cumberland, Sequana; grants and personal fees from Novartis, Gilead, Conatus, Echosens; personal fees from Pfizer, Lilly, Novo Nordisk, Sanofi, Tern, Hemoshear, Glympse, Birdrock, Blade, Teva, Artham, Salix, NASH pharmaceuticals, outside the submitted work. ODL is an employee of and shareholder in AMRA Medical AB and reports other from Eli Lilly. ME is a member of the advisory board at AMRA Medical AB. Please refer to the accompanying ICMJE disclosure forms for further details. (© 2022 The Author(s).)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu