Associations Of Sarcopenia With Nonalcoholic Fatty Liver Disease And Gallstone Diseases

Background and objective Skeletal muscle is the largest non-fat component on tissue-organ level,which is central to nutrition,physiology and metabolism.With advancing age,skeletal muscle mass,muscle strength and physical performance decline progressively and generally,which eventually result in sarcopenia.Studies have found that sarcopenia was associated with movement-related diseases and cardio-metabolic diseases,such as fracture,physical disability,cardiovascular diseases,diabetes and nonalcoholic fatty liver disease(NAFLD).However,studies investigating the relationship between sarcopenia and NAFLD mostly focused on the associations of either muscle mass or muscle strength with NAFLD,but didn’t take both of them into consideration,and only a few studies explored the associations between sarcopenic obesity and NAFLD.In addition,several underlying mechanisms suggest that low muscle mass might link with gallstone diseases,while no studies have explored the relationship between low muscle mass and gallstone diseases.Moreover,gallstone diseases are defined as gallstones or cholecystectomy.Previous studies have found that cholecystectomy were associated with the development of metabolic disorders,such as insulin resistance,metabolic syndrome and NAFLD,all of which linked with low muscle mass.However,the relationship of cholecystectomy with low muscle mass remains unclear.Hence,the aims of the present study include:(a)investigating the associations of NAFLD with low muscle mass,low muscle strength,sarcopenia,and sarcopenic obesity,(b)investigating the associations of low muscle mass with gallstones,cholecystectomy and gallstone diseases.Methods A total of 5,132 participants aged between 18 and 80 from the baseline of Lanxi Cohort Survey were enrolled in our study.Skeletal muscle mass was measured by using dual-energy X-ray absorptiometry and muscle strength was evaluated by using an electronic hand dynamometer.Fatty liver disease and gallstone disease were detected and diagnosed by using abdominal ultrasonography.Multivariate logistic regression models were conducted to explore the associations of NAFLD with low muscle mass,low muscle strength,sarcopenia,and sarcopenic obesity.Multivariate logistic regression models were used to explore the associations of low muscle mass with gallstone disease.Multinomial logistic regression models were performed to investigate the associations of the low muscle mass with gallstones and cholecystectomy.Results 1.After adjusting for age,gender and other potential confounders,both low muscle mass and low muscle strength were positively associated with NAFLD.Compared with low muscle mass or low muscle strength alone,sarcopenia was associated with a higher risk of NAFLD.Compared with sarcopenia or obesity alone,sarcopenic obesity was associated with a higher risk of NAFLD.2.After adjusting for age,gender and other potential confounders,low muscle mass was not associated with gallstone disease.In the following analyses,participants with gallstone disease were divided into those with gallstones and those with cholecystectomy,and we found that cholecystectomy was associated with low muscle mass,while gallstone was not.Moreover,the associations between low muscle mass and cholecystectomy were much stronger for participants with longer duration since cholecystectomy.Conclusions 1.Both low muscle mass and low muscle strength were positively associated with NAFLD.Compared with low muscle mass or low muscle strength alone,sarcopenia was associated with increased risk of NAFLD,and this risk was further increased when sarcopenia was accompanied by obesity.These findings suggest that interventions focusing on increasing muscle mass and strength might be important for the prevention of NAFLD,especially in populations with obesity.2.Cholecystectomy was associated with low muscle mass,while gallstones were not.Moreover,the associations between low muscle mass and cholecystectomy were much stronger for participants with longer duration since cholecystectomy.These findings suggest that participants with cholecystectomy are prone to be accompanied by low muscle mass,and interventions increasing muscle mass should be taken by people with cholecystectomy,especially for those with long duration since cholecystectomy.