title: Low skeletal muscle mass is associated with non-alcoholic fatty liver disease in Korean adults: the Fifth Korea National Health and Nutrition Examination Survey.
abstract: BACKGROUND
  Sarcopenia and non-alcoholic fatty liver disease (NAFLD) share similar pathophysiological mechanisms, and the relationship between sarcopenia and NAFLD has been recently investigated. The study investigated whether low skeletal muscle mass is differentially associated with NAFLD by gender in Korean adults.
  
  
  METHODS
  We conducted a cross-sectional analysis of the data from the Fifth Korea National Health and Nutrition Examination Survey. The skeletal muscle index (SMI) was obtained by the appendicular skeletal muscle mass divided by the weight. NAFLD was defined as a fatty liver index (FLI) ≥60 in the absence of other chronic liver disease.
  
  
  RESULTS
  Among the included subjects, 18.3% (SE: 1.4%) in men and 7.0% (SE: 0.7%) in women were classified as having FLI-defined NAFLD. Most of the risk factors for FLI-defined NAFLD showed a significant negative correlation with the SMI in both genders. Multiple logistic regression analysis showed that low SMI was associated with FLI-defined NAFLD, independent of other metabolic and lifestyle parameters in both genders [males: odds ratio (OR)=1.35; 95% confidence interval (CI): 1.17-1.54; females: OR=1.36; 95% CI: 1.18-1.55]. The magnitude of the association between FLI-defined NAFLD and low SMI was higher in middle aged to elderly males (OR=1.50; 95% CI: 1.22-1.84) than in males less than 45 years of age (OR=1.25; 95% CI: 1.02-1.52) and in premenopausal females (OR=1.50; 95% CI: 1.12-2.03) than in postmenopausal females (OR=1.36; 95% CI: 1.20-1.54).
  
  
  CONCLUSIONS
  Low SMI is associated with the risk of FLI-defined NAFLD independent of other well-known metabolic risk factors in both genders. This association may differ according to age group or menopausal status. Further studies are warranted to confirm this relationship.
authors.affiliation: Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC 27709, USA. mark.park@nih.gov.
authors.forename: Hee Yeon
authors.initials: HY
authors.lastname: Kim
authors.forename: Chang Wook
authors.initials: CW
authors.lastname: Kim
authors.forename: Chung-Hwa
authors.initials: CH
authors.lastname: Park
authors.forename: Jong Young
authors.initials: JY
authors.lastname: Choi
authors.forename: Kyungdo
authors.initials: K
authors.lastname: Han
authors.forename: Anwar T
authors.initials: AT
authors.lastname: Merchant
authors.forename: Yong-Moon
authors.initials: YM
authors.lastname: Park
mesh_terms: D015502:Absorptiometry, Photon; D000328:Adult; D000367:Age Factors; D000886:Anthropometry; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D018482:Muscle, Skeletal / Q000000981:diagnostic imaging; D065626:Non-alcoholic Fatty Liver Disease / Q000175:diagnosis / Q000453:epidemiology*; D009749:Nutrition Surveys; D016017:Odds Ratio; D017698:Postmenopause; D011237:Predictive Value of Tests; D017697:Premenopause; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors; D055948:Sarcopenia / Q000175:diagnosis / Q000453:epidemiology*; D012737:Sex Factors