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Sarcopenia Is Independently Associated with the Degree of Liver Fibrosis in Patients with Type 2 Diabetes Mellitus

Gut and Liver 2020년 14권 5호 p.626 ~ 635
성민제, 임태섭, 전미영, 이혜원, 김범경, 김도영, 안상훈, 한광협, 박준용, 김승업,
소속 상세정보
성민제 ( Sung Min-Je ) - Yonsei University College of Medicine Department of Internal Medicine
임태섭 ( Lim Tae-Seop ) - Yonsei University College of Medicine Department of Internal Medicine
전미영 ( Jeon Mi-Young ) - Yonsei University College of Medicine Department of Internal Medicine
이혜원 ( Lee Hye-Won ) - Yonsei University College of Medicine Department of Internal Medicine
김범경 ( Kim Beom-Kyung ) - Yonsei University College of Medicine Department of Internal Medicine
김도영 ( Kim Do-Young ) - Yonsei University College of Medicine Department of Internal Medicine
안상훈 ( Ahn Sang-Hoon ) - Yonsei University College of Medicine Department of Internal Medicine
한광협 ( Han Kwang-Hyub ) - Yonsei University College of Medicine Department of Internal Medicine
박준용 ( Park Jun-Yong ) - Yonsei University College of Medicine Department of Internal Medicine
김승업 ( Kim Seung-Up ) - Yonsei University College of Medicine Department of Internal Medicine

Abstract


Background/Aims: Sarcopenia is associated with liver fibrosis in patients with nonalcoholic fatty liver disease and chronic hepatitis B. We investigated the association between sarcopenia and hepatic fibrotic burden in patients with type 2 diabetes mellitus (T2DM).

Methods: Patients with T2DM who had received a comprehensive medical health checkup were recruited. Muscle mass was assessed using computed tomography. Fibrotic burden was assessed using the fibrosis-4 index (FIB-4). The study population was divided by quartile stratification of the lumbar skeletal muscle index (LSMI).

Results: Among 309 patients with T2DM, 75 (24.3%) had sarcopenia. These patients were significantly older and had higher FIB-4, whereas they had significantly lower body mass index (BMI) and LSMI than patients without sarcopenia (all p<0.05). The LSMI showed a significant negative correlation with the FIB-4 when analyzed in terms of quartile stratification (p=0.003). Multivariate analysis showed that female sex and higher BMI were independently associated with a reduced risk of sarcopenia (odds ratio [OR], 0.388; 95% confidence interval [CI], 0.199 to 0.755 and OR, 0.704; 95% CI, 0.618 to 0.801; all p<0.05), whereas a higher FIB- 4 was independently associated with an increased risk of sarcopenia (OR, 1.817; 95% CI, 1.180 to 2.797; p=0.007). Among patients with a BMI <25 kg/m2 (n=165), those with sarcopenia (n=54, 32.7%) had a significantly higher FIB-4 than those without (n=111, 67.3%; 1.66 vs 1.38, p=0.004).

Conclusions: Sarcopenia is independently associated with fibrotic burden in patients with T2DM. Further studies should investigate whether the improvement of sarcopenia can ameliorate liver fibrosis in patients with T2DM.

키워드

Sarcopenia; Liver fibrosis; Muscular atrophy; Diabetes mellitus; Fibrosis-4 index

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