Sarcopenia in Nonalcoholic Fatty Liver Disease and All-Cause and Cause-Specific Mortality in the United States. Liver international : official journal of the International Association for the Study of the Liver Kim, D., Wijarnpreecha, K., Sandhu, K. K., Cholankeril, G., Ahmed, A. 2021


BACKGROUND & AIMS: Nonalcoholic fatty liver disease (NAFLD) has been associated with sarcopenia. However, mortality in the setting of NAFLD-related sarcopenia remains undefined. We aim to determine the all-cause and cause-specific mortality from sarcopenia among adults with NAFLD in the United States (US).METHODS: 11,065 individuals in the Third National Health and Nutrition Examination Survey were studied and linked mortality through 2015 was analyzed. NAFLD was diagnosed based on presence of ultrasonographic hepatic steatosis without other known liver diseases. Sarcopenia was defined as skeletal muscle index determined by bioelectrical impedance analysis. The Cox proportional hazard model was used to assess all-cause mortality and cause-specific mortality, and hazard ratio (HR) adjusted for known risk factors.RESULTS: During a median follow-up of 23 years or more, sarcopenia was associated with increased all-cause mortality (HR 1.27, 95% confidence interval [CI] 1.11-1.44). Only in individuals with NAFLD, sarcopenia was associated with a higher risk for all-cause mortality, while this association was absent in those without NAFLD. Individuals with both sarcopenia and NAFLD had a higher risk for all-cause mortality (HR 1.28 95% CI 1.06-1.55) compared with those without sarcopenia and NAFLD. Furthermore, sarcopenia was associated with a higher risk for cancer- and diabetes-related mortality among those with NAFLD. This association was not noted in those without NAFLD.CONCLUSION: In this nationally representative sample of US adults, sarcopenia was associated with a higher risk for all-cause, cancer- and diabetes-related mortality in individuals with NAFLD.

View details for DOI 10.1111/liv.14852

View details for PubMedID 33641244