Risk Stratification for Sarcopenic Obesity in Subjects With Nonalcoholic Fatty Liver Disease

Area of Science:

• Hepatology
• Cardiology
• Metabolic Disorders

Background:

• Sarcopenic obesity (SO) and nonalcoholic fatty liver disease (NAFLD) are common metabolic conditions.
• The combined impact of SO severity in NAFLD on liver fibrosis and cardiovascular disease (CVD) risk is not well understood.

Purpose of the Study:

• To identify high-risk individuals with SO and NAFLD who are susceptible to significant liver fibrosis or CVD.
• To develop and validate a screening model for identifying these high-risk subjects.

Main Methods:

• A multicenter, retrospective study of 23,889 NAFLD patients undergoing health screening.
• Sarcopenia was assessed using multi-frequency bioelectric impedance analysis.
• High-risk SO was defined by fibrosis-4 index >2.67 or CVD risk score >20%; logistic regression was used for model development and validation.

Main Results:

• SO prevalence was 5.4%. Significant risk factors for high-risk SO included older age, male sex, sarcopenia index, and metabolic syndrome.
• The high-risk SO screening model identified individuals with significantly higher odds of significant liver fibrosis (aOR 2.38-3.72) or CVD (aOR 3.71-5.20).
• In longitudinal analysis, high-risk SO subjects had a 5.37-fold increased risk of significant liver fibrosis or CVD.

Conclusions:

• A high-risk screening model can effectively identify individuals with SO and NAFLD who are at increased risk for significant liver fibrosis or CVD.
• This model aids in early detection and potential intervention for high-risk patients.