Data obtained from studies in adult non-elderly and elderly individuals have suggested an association between nonalcoholic fatty liver disease (NAFLD) and sarcopenia. Pacifico and colleagues assessed the link between NAFLD and skeletal muscle mass in overweight/obese children and adolescents.

Investigators recruited 234 overweight/obese youths in the study. NAFLD was diagnosed using ultrasonography, after excluding infectious and metabolic disorders. Forty patients with NAFLD also underwent a liver biopsy assessment. Dual-energy X-ray absorptiometry helped assess total and regional lean body mass and total fat mass. Relative muscle mass (RMM) was defined as the percent of muscle mass (kg) relative to the sum of muscle and fat (kg) mass. Appendicular skeletal muscle mass (ASM) was calculated as the sum of muscle masses of the four limbs (kg), expressed as percent of body weight.

All the participants were segregated on the basis of tertiles of RMM. The prevalence of abdominal obesity, dyslipidemia, insulin resistance, metabolic syndrome, NAFLD and biopsy-proven nonalcoholic steatohepatitis (NASH) was shown to be significantly higher in the lowest tertile of RMM. Controlling for age, sex and Tanner stage, subjects in the lowest tertile of RMM were found to have a heightened risk for NAFLD (OR= 2.80, 95% CI=1.57-5.02) in comparison with those in the other two tertiles. The association was sustained after adjustments for clinical and metabolic variables. It was also noted that the risk of NAFLD in the lowest tertile of ASM/weight index was significantly higher in comparison with those in the other two tertiles after adjusting for the above confounders.

The study demonstrated an independent link between low muscle mass and NAFLD/NASH in overweight/obese youths. Quantification of muscle mass may be beneficial for identifying among obese children those who have a high metabolic risk and need of intensive lifestyle interventions to prevent NAFLD and its progression.

Source: Pacifico L, Perla FM, Andreoli G, et al. Nonalcoholic Fatty Liver Disease Is Associated With Low Skeletal Muscle Mass in Overweight/Obese Youths. Front Pediatr. 2020 Apr 15;8:158.