COMMENT:
Indeed, sarcopenia and frailty are known features of metabolic and advanced-stage hepatic dysfunction. Moreover, poor muscle health is linked with higher mortality in cirrhotic patients and has been hypothesised to affect outcomes post-liver transplantation. Despite this, adverse muscle composition (MC)’s prevalence and importance in earlier stages of liver disease, including non-alcoholic fatty liver disease (NAFLD), remains to be thoroughly investigated.
This study explores all-cause mortality’s link with NAFLD, liver fat, and MC in the UK Biobank imaging study.
Indeed, sarcopenia and frailty are known features of metabolic and advanced-stage hepatic dysfunction. Moreover, poor muscle health is linked with higher mortality in cirrhotic patients and has been hypothesised to affect outcomes post-liver transplantation. Despite this, adverse muscle composition (MC)’s prevalence and importance in earlier stages of liver disease, including non-alcoholic fatty liver disease (NAFLD), remains to be thoroughly investigated.
This study explores all-cause mortality’s link with NAFLD, liver fat, and MC in the UK Biobank imaging study.
KEY LEARNINGS:
Adverse muscle composition (MC) is characterised by low thigh fat-free muscle volume (FFMV) and high muscle fat infiltration (MFI). Compared to controls, patients with NAFLD displayed lower FFMV z-scores but similar MFI and prevalence of low functional performance. Importantly, neither NAFLD nor liver proton density fat fraction predicted all-cause mortality. In contrast, adverse MC-related variables, i.e. FFMV z-scores and MFI, were significantly and independently associated with all-cause mortality in patients with NAFLD. For MFI, this relationship persisted after adjusting for confounders. However, FFMV’s association with all-cause mortality became non-significant after adjusting for relevant comorbidities, including previous cancer diagnosis, coronary heart disease, and type 2 diabetes. Nevertheless, these findings support the use of muscle measurements as prognostic biomarkers for liver disease progression.
