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Dryad

Association of fat-to-muscle ratio with non-alcoholic fatty liver disease: a single-centre retrospective study

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Abstract

Objectives: Sarcopenia is a known risk factor for non-alcoholic fatty liver disease (NAFLD). Studies evaluating the association between the fat-to-muscle ratio (FMR) and NAFLD are limited. Therefore, the aim of our study was to investigate the association between FMR and NAFLD.

Design: A retrospective study was conducted on the individuals who underwent health examination in Wuhan Union Hospital between January 2020 and November 2021. Clinical data were collected from electronic medical records.

Setting: Our study was conducted in a hospital in China.

Participants: A total of 1,592 participants aged ≥40 years who underwent body composition analysis and liver ultrasonography were retrospectively reviewed.

Primary outcome measures: Liver ultrasonography was used to assess liver steatosis, and the Fibrosis-4 Index (FIB-4) was used to calculate the risk scores for liver fibrosis. The 10-year atherosclerotic cardiovascular disease (ASCVD) risk prediction model was used to calculate ASCVD risk scores.

Results: The FMR was significantly higher in individuals with NAFLD than in those without NAFLD (P<0.001). The prevalence of NAFLD gradually increased from FMR tertile 1 (reference) to tertile 2 (OR=1.49, 95% CI: 1.13–1.97) and tertile 3 (OR=2.85, 95% CI: 2.08–3.90). In addition, patients with NAFLD in FMR tertile 3 had a significantly higher risk of liver fibrosis (OR=4.48, 95% CI: 2.12–9.50) and ASCVD (OR=4.63, 95% CI: 2.62–8.19) than those in FMR tertile 1 after adjustment for multiple confounders.

Conclusion: In this study, we found a significant association between FMR and NAFLD. A higher FMR indicates a higher risk of NAFLD in the study population and a higher risk of liver fibrosis and ASCVD in NAFLD patients.