title: Severity of non-alcoholic steatohepatitis is associated with substitution of adipose tissue in skeletal muscle.
abstract: OBJECTIVE
  The pathogenesis of non-alcoholic fatty liver disease (NAFLD) is now focusing on its organ cross-talk with not only adipose tissue but also systemic skeletal muscle. Cross-sectional and longitudinal studies were conducted to determine the role of intramuscular adipose tissue content (IMAC) measured by computed tomography on the severity of NAFLD/non-alcoholic steatohepatitis (NASH).
  
  
  METHODS
  Two hundred eight Japanese patients with NAFLD/NASH diagnosed by liver biopsy were enrolled into a cross-sectional study. Twenty-one patients were enrolled in a longitudinal study and received a programmed diet and exercise intervention, in some cases the combination of pharmacotherapy. We measured IMAC in the multifidus muscle and biochemical parameters, and conducted liver histology to assess NAFLD/NASH status.
  
  
  RESULTS
  Histopathological stage in terms of simple steatosis and Brunt's classification was significantly correlated with IMAC (P < 0.01). Multivariate logistic regression analysis indicated that risk factors associated with the severity of NASH were IMAC and aging (IMAC: odds ratio = 2.444, P < 0.05; Age: odds ratio = 2.355, P < 0.05). The interventions improved histopathological changes in 11 patients with NASH as well as IMAC.
  
  
  CONCLUSIONS
  These results suggest that skeletal muscle fat accumulation may have been linked to the pathogenesis and severity of NASH.
authors.affiliation: Department of Internal Medicine, Saga Medical School, Saga, Japan.
authors.forename: Yoichiro
authors.initials: Y
authors.lastname: Kitajima
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Hyogo
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Sumida
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Eguchi
authors.forename: Naofumi
authors.initials: N
authors.lastname: Ono
authors.forename: Takuya
authors.initials: T
authors.lastname: Kuwashiro
authors.forename: Kenichi
authors.initials: K
authors.lastname: Tanaka
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Takahashi
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Mizuta
authors.forename: Iwata
authors.initials: I
authors.lastname: Ozaki
authors.forename: Takahisa
authors.initials: T
authors.lastname: Eguchi
authors.forename: Yuki
authors.initials: Y
authors.lastname: Kimura
authors.forename: Kazuma
authors.initials: K
authors.lastname: Fujimoto
authors.forename: Keizo
authors.initials: K
authors.lastname: Anzai
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D003430:Cross-Sectional Studies; D005234:Fatty Liver / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy; D005260:Female; D006801:Humans; D050152:Intra-Abdominal Fat / Q000000981:diagnostic imaging / Q000473:pathology*; D008019:Life Style; D008099:Liver / Q000473:pathology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000000981:diagnostic imaging / Q000473:pathology*; D065626:Non-alcoholic Fatty Liver Disease; D012307:Risk Factors; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome
keywords: lifestyle modification; metabolic syndrome; non-alcoholic steatohepatitis