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. 2019 Dec 9;8(12):2175.
doi: 10.3390/jcm8122175.

Reduction of Fat to Muscle Mass Ratio Is Associated with Improvement of Liver Stiffness in Diabetic Patients with Non-Alcoholic Fatty Liver Disease

Takafumi Osaka  1   2 , Yoshitaka Hashimoto  1 , Takuro Okamura  1 , Takuya Fukuda  1 , Masahiro Yamazaki  1 , Masahide Hamaguchi  1 , Michiaki Fukui  1
Affiliations

Reduction of Fat to Muscle Mass Ratio Is Associated with Improvement of Liver Stiffness in Diabetic Patients with Non-Alcoholic Fatty Liver Disease

Takafumi Osaka et al. J Clin Med. .

Abstract

Body weight reduction leads to improvement of nonalcoholic fatty liver disease (NAFLD), but the contributions of body composition modification on its improvement have not been clarified yet. We performed a retrospective cohort study in a Japanese university hospital to clarify the effect of body fat reduction on the improvement of hepatic stiffness as well as hepatic steatosis. The skeletal muscle mass index (SMI, kg/m2), fat to muscle mass ratio, and the change in fat to muscle mass ratio after 1 year from baseline were calculated. Controlled attenuation parameter (CAP, dB/m) and liver stiffness measurement (LSM, kPa) were evaluated by elastography. Primary outcome was set as the association of the change of fat to muscle mass ratio after 1 year from baseline with the change of liver stiffness measurement. One hundred and seventeen patients (59 men and 58 women) completed the study. The average age was 63.5 years, and baseline CAP and LSM were 273.4 ± 53.5 dB/m and 6.3 ± 3.4 kPa, respectively. After 1 year, body mass index (BMI), SMI, and LSM decreased. Multiple regression analyses demonstrated that change in fat to muscle mass ratio was associated with the change in CAP (ß = 0.38, p < 0.001) or LSM (ß = 0.21, p = 0.026). The reduction of fat to muscle mass ratio was associated with improvement in liver stiffness, but the reduction of BMI was not.

Keywords: body composition; fatty liver; liver stiffness; skeletal muscle mass; type 2 diabetes.

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Conflict of interest statement

Masahiro Yamazaki, Masahide Hamaguchi and Michiaki Fukui have received grants, honoraria and research supports from AstraZeneca plc., Astellas Pharma Inc., Bayer Yakuhin, Ltd., Daiichi Sankyo Co., Ltd., Eli Lilly Japan K.K., Johnson & Johnson k.k. Medical Company, Kyowa Hakko Kirin Company Ltd., Kissei Pharmaceutical Co., Ltd., MSD K.K., Kowa Company, Ltd., Mitsubishi Tanabe Pharma Corporation, MOCHIDA PHARMACEUTICAL CO.,LTD., Nippon Boehringer Ingelheim Co., Ltd., Nippon Chemiphar Co., Ltd. Novo Nordisk Pharma Ltd., Ono Pharmaceutical Co., Ltd., Sanwa Kagaku Kenkyusho Co., Ltd., Sanofi K.K., Sumitomo Dainippon Pharma Co., Ltd., Taisho Toyama Pharmaceutical Co., Ltd., Takeda Pharmaceutical Co., Ltd., TEIJIN PHARMA LIMITED and TERUMO CORPORATION. The sponsors were not involved in the study design; in the collection, analysis, interpretation of data; in the writing of this manuscript; or in the decision to submit the article for publication. The authors, their immediate families, and any research foundations with which they are affiliated have not received any financial payments or other benefits from any commercial entity related to the subject of this article. The authors declare that although they are affiliated with a department that is supported financially by pharmaceutical company, the authors received no current funding for this study and this does not alter their adherence to all the journal policies on sharing data and materials. The other authors have nothing to disclose.

Figures

Figure 1
Figure 1
Patient inclusion, exclusion, and disposition.
Figure 2
Figure 2
The difference of the change in BMI or fat-to-muscle ratio among the live stiffness status. (a) The difference of the change in BMI or among the live stiffness status. There was no difference of the change in BMI among the groups (p = 0.069, by one-way ANOVA). (b) The difference of the change in fat-to-muscle ratio among the live stiffness status (p < 0.001, by one-way ANOVA). The change in fat-to-muscle ratio of group 3 was higher than that of group 2 (p < 0.001, by Tukey–Kramer HSD test), that of group 1 (p < 0.001, by Tukey–Kramer HSD test) and group 0 (p < 0.001, by Tukey–Kramer HSD test). The change in fat-to-muscle ratio of group 0 was higher than that of group 1 (p = 0.036, by Tukey–Kramer HSD test). * p < 0.05.
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