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Psoas Muscle Index, Systemic Inflammation, and Liver Fibrosis in MAFLD: A Case-Control Study
Lijuan Yu1, Nan Jiang2, Huichun Wu3
1Department of General Practice, The First Affiliated Hospital of Soochow University, Suzhou, 215006, People's Republic of China.
Objective:
Investigating psoas muscle index (PMI) as a potential biomarker for metabolic dysfunction-associated fatty liver disease (MAFLD) and hepatic fibrosis through a case-control study.
Methods:
This case-control study enrolled 80 MAFLD patients and 80 healthy controls from our hospital (2023-2024). Abdominal CT-derived PMI, inflammatory markers, and FIB-4 scores were assessed. ROC and logistic regression analyses evaluated PMI's diagnostic potential for MAFLD and associated fibrosis.
Results:
A total of 160 patients met the inclusion criteria. Compared with the non-MAFLD group, the PMI and systemic inflammatory indicators in the MAFLD group were higher. In MAFLD patients, PMI was significantly correlated with systemic inflammation indicators, including the platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), and systemic immune-inflammation index (SII) (P<0.001, P=0.038, and P<0.001, respectively). ROC curve analysis showed that the areas under the ROC curve (AUC) of PMI and other systemic inflammatory indicators (PLR, NLR, LMR, SII) for diagnosing MAFLD were 0.615, 0.526, 0.956, 0.803, and 0.674, respectively. The AUC of PMI combined with LMR, NLR, and LMR plus NLR for diagnosing MAFLD were 0.547, 0.585, and 0.572, respectively. FIB-4 was linearly correlated with PMI and systemic inflammatory indicators (PLR, NLR, SII) (r=-0.208, P=0.008; r=-0.211, P=0.007; r=0.327, P<0.001; r=0.164, P=0.039). The combination of PMI and systemic inflammatory indicators (PLR, NLR, SII) demonstrated a good diagnostic ability for liver fibrosis in MAFLD (AUC=0.602, P=0.003).
Conclusion:
PMI significantly correlates with systemic inflammation and hepatic fibrosis in MAFLD patients, serving as a diagnostic biomarker. Combined with inflammatory markers, it improves non-invasive screening efficacy for MAFLD/fibrosis. This study pioneers incorporating muscle metabolism into MAFLD diagnosis, with potential for primary care translation. Dynamic PMI monitoring may assess "muscle-liver axis" targeted therapies.
Insights
The psoas muscle index (PMI) shows promise as a biomarker for metabolic dysfunction-associated fatty liver disease (MAFLD) and liver fibrosis. Combining PMI with inflammatory markers enhances non-invasive screening for MAFLD and fibrosis.
Area of Science:
- Hepatology
- Metabolic Syndrome
- Biomarker Discovery
Background:
- Metabolic dysfunction-associated fatty liver disease (MAFLD) is a growing health concern.
- Identifying reliable biomarkers for MAFLD and its progression, such as hepatic fibrosis, is crucial.
- The role of muscle mass and metabolism in liver disease is increasingly recognized.
Purpose of the Study:
- To investigate the psoas muscle index (PMI) as a potential biomarker for MAFLD.
- To assess the correlation between PMI and systemic inflammatory markers in MAFLD patients.
- To evaluate the diagnostic performance of PMI for MAFLD and hepatic fibrosis.
Main Methods:
- A case-control study included 80 MAFLD patients and 80 healthy controls.
- Abdominal CT scans were used to calculate PMI.
- Inflammatory markers (PLR, NLR, SII), FIB-4 scores, and ROC/logistic regression analyses were performed.
Main Results:
- MAFLD patients exhibited higher PMI and inflammatory indicators compared to controls.
- PMI significantly correlated with systemic inflammation markers (PLR, NLR, SII) and FIB-4 scores.
- PMI demonstrated diagnostic potential for MAFLD and hepatic fibrosis, particularly when combined with inflammatory markers.
Conclusions:
- PMI is a significant biomarker correlating with systemic inflammation and hepatic fibrosis in MAFLD.
- Combining PMI with inflammatory markers improves non-invasive screening for MAFLD and fibrosis.
- This study highlights the potential of muscle metabolism in MAFLD diagnosis and management.
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