Lee GB, Huh Y, Lee SH, Han B, Kim YH, Kim DH, Kim SM, Choi YS, Cho KH, Nam GE. Association of low muscle strength with metabolic dysfunction-associated fatty liver disease: A nationwide study. World J Gastroenterol 2023; 29(45): 5962-5973 [PMID: 38131000 DOI: 10.3748/wjg.v29.i45.5962]
Corresponding Author of This Article
Ga Eun Nam, MD, PhD, Associate Professor, Department of Family Medicine, Korea University College of Medicine, 73 Goryeodae-ro, Seongbuk-gu, Seoul 02841, South Korea. silver79@korea.ac.kr
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Dec 7, 2023; 29(45): 5962-5973 Published online Dec 7, 2023. doi: 10.3748/wjg.v29.i45.5962
Association of low muscle strength with metabolic dysfunction-associated fatty liver disease: A nationwide study
Gyu Bae Lee, Youn Huh, Sang Hyun Lee, Byoungduck Han, Yang-Hyun Kim, Do-Hoon Kim, Seon Mee Kim, Youn Seon Choi, Kyung Hwan Cho, Ga Eun Nam
Gyu Bae Lee, Byoungduck Han, Yang-Hyun Kim, Do-Hoon Kim, Seon Mee Kim, Youn Seon Choi, Kyung Hwan Cho, Ga Eun Nam, Department of Family Medicine, Korea University College of Medicine, Seoul 02841, South Korea
Youn Huh, Department of Family Medicine, Uijeongbu Eulji Medical Center, EULJI University, Daejeon 11759, South Korea
Sang Hyun Lee, School of Electrical Engineering, Korea University, Seoul 02841, South Korea
Author contributions: Nam GE designed the study; Nam GE and Huh Y were responsible for developing the methodology; Nam GE, Huh Y, Lee GB, and Lee SH participated in the formal analysis and investigation; Lee GB wrote the original draft; Lee GB, Han B, Kim YH, Kim DH, Kim SM, Choi YS, Cho KH, and Nam GE participated in the review and editing; Nam GE acquired funding.
Institutional review board statement: The institutional review board of the Korea University Guro Hospital in Seoul, Republic of Korea approved the study protocol (No. 2022GR0322).
Informed consent statement: Signed informed consent was obtained from all participants.
Conflict-of-interest statement: The authors disclose no conflicts.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ga Eun Nam, MD, PhD, Associate Professor, Department of Family Medicine, Korea University College of Medicine, 73 Goryeodae-ro, Seongbuk-gu, Seoul 02841, South Korea. silver79@korea.ac.kr
Received: August 1, 2023 Peer-review started: August 1, 2023 First decision: September 30, 2023 Revised: October 30, 2023 Accepted: November 17, 2023 Article in press: November 17, 2023 Published online: December 7, 2023 Processing time: 121 Days and 15 Hours
Abstract
BACKGROUND
There is limited evidence regarding the association between muscle strength and metabolic dysfunction-associated fatty liver disease (MAFLD).
AIM
To investigate the association between muscle strength and MAFLD in the general population in Korea.
METHODS
This nationwide representative cross-sectional study included 31649 individuals aged ≥ 19 years who participated in the Korea National Health and Nutrition Examination Survey between 2015 and 2018. Odds ratios (ORs) and 95% confidence intervals (95%CIs) for MAFLD according to sex-specific quartiles of muscle strength, defined by relative handgrip strength, were calculated using multivariable logistic regression analysis. Additionally, multivariable logistic regression analysis was used to assess the association between muscle strength and probable liver fibrosis in patients with MAFLD.
RESULTS
Of all the participants, 29.3% had MAFLD. The prevalence of MAFLD was significantly higher in the lower muscle strength quartile groups for all participants, sexes, and age groups (P < 0.001). A 1.92-fold (OR = 1.92, 95%CI: 1.70–2.16) and 3.12-fold (OR = 3.12, 95%CI: 2.64–3.69) higher risk of MAFLD was observed in the lowest quartile (Q1) group than in the other groups (Q2–Q4) and the highest quartile (Q4) group, respectively. The ORs of MAFLD were significantly increased in the lower muscle strength quartile groups in a dose-dependent manner (P for trend < 0.001). These associations persisted in both sexes. An inverse association between muscle strength and the risk of MAFLD was observed in all subgroups according to age, obesity, and diabetes mellitus. In patients with MAFLD, the odds of severe liver fibrosis were higher in Q1 (OR = 1.83, 95%CI: 1.25–2.69) than in other groups (Q2–Q4).
CONCLUSION
Among Korean adults, low muscle strength was associated with an increased risk of MAFLD and liver fibrosis in patients with MAFLD.
Core Tip: Limited evidence exists regarding the association between muscle strength and metabolic dysfunction-associated fatty liver disease (MAFLD). This nationwide cross-sectional study analyzed 17349 individuals in the general community who participated in the Korea National Health and Nutrition Examination Survey and measured their grip strength between 2015 and 2018. Among the participants, 29.3% had MAFLD. The prevalence of MAFLD was significantly higher in the lower muscle strength quartiles. The odds ratios of MAFLD were significantly increased in the lower muscle strength quartile groups in a dose-response manner. Among Korean adults, low muscle strength was associated with an increased risk of MAFLD and liver fibrosis in patients with MAFLD.
