P0949 - Prevalence of Nonalcoholic Fatty Liver Disease and Fibrosis Among US Adults with Sarcopenia: A 2017-2018 United States National Health and Nutrition Examination Surveys (NHANES) Assessment

Sunday, October 22, 2023

3:30 PM – 7:00 PM PT

Location: Exhibit Hall

Has Audio

Presenting Author(s)

David S. Kim, MD

Rutgers New Jersey Medical School
Newark, NJ

David S. Kim, MD, Catherine Ye, MD, Mohamed Ismail, DO, Nikolaos T.. Pyrsopoulos, MD, PhD, MBA
Rutgers New Jersey Medical School, Newark, NJ

Introduction: NAFLD is closely associated with sarcopenia, but the exact relationship between the two diseases remains unclear. In this study, we described the association between sarcopenia and fibrosis in participants with NAFLD using non-invasive models.

Methods: The National Health and Nutrition Examination Survey 2017–2018 was utilized for analysis. Participants with valid interview, laboratory, dual-energy X-ray absorptiometry, and Fibroscan® results were included. Sarcopenia was defined using FNIH guidelines (appendicular skeletal muscle mass (ASM)/BMI < 0.789 and < 0.512 for males and females, respectively). NAFLD was defined as controlled attenuation parameter (CAP) scores ≥ 263 dB/m in the absence of excessive alcohol use or other causes of chronic liver disease. Advanced fibrosis and cirrhosis were defined as liver stiffness measurement (LSM) ≥ 9.6 kPa and ≥ 11.0 kPa, respectively.

Results: Among 3,700 participants, 699 (18.9%) had sarcopenia. Prevalence of NAFLD was 60.7% and 36.2% for participants with and without sarcopenia, respectively (P = 0.001). Compared to non-sarcopenic participants with NAFLD, sarcopenic participants with NAFLD were significantly older, had a higher percentage of Hispanic ethnicity, BMI, and percentage of current smokers (P < 0.05). Additionally, sarcopenic participants with NAFLD had significantly higher CAP scores than non-sarcopenic participants with NAFLD (P = 0.022). Sarcopenic participants and non-sarcopenic participants had statistically similar LSM, prevalence of advanced fibrosis, and ASCVD scores.

Discussion: Sarcopenic participants had significantly higher prevalence of NAFLD compared to non-sarcopenic participants, but advanced fibrosis and ASCVD scores were similar between sarcopenic and non-sarcopenic participants with NAFLD. Our study indicated that many demographic differences exist between sarcopenic and non-sarcopenic participants, such as age, Hispanic ethnicity, BMI, smoking status, and CAP scores. Sarcopenia is an important risk factor for the development of NAFLD and can be an important marker for early identification.

Table 1. Baseline characteristics
Variables	Sarcopenic NAFLD (unweighted n=134, 17.3%)	Non-sarcopenic NAFLD (unweighted n=639, 82.7%)	P value
Demographic variables
Age, years	42.1 (2.7)	39.4 (1.2)	0.003
Male gender	68.5%	53.4%	0.190
Race
Hispanic	44.1%	18.6%	0.029
White	42.1%	55.8%
Black	3.5%	9.5%
Other	10.3%	16.0%
BMI	36.5 (1.1)	31.9 (0.6)	< 0.001
Hypertension	22.0%	21.3%	0.927
Diabetes	26.5%	16.7%	0.304
Current smoking	56.5%	22.8%	0.018
Laboratory variables
Platelet count, 10⁹/L	277.3 (44.6)	249.8 (16.4)
Aspartate aminotransferase, IU/L	46.4 (5.1)	33.1 (1.7)	0.242
Alanine aminotrasferase, IU/L	45.4 (9.2)	33.1 (2.8)	0.163
Serum albumin, g/dL	3.9 (0.2)	4.0 (0.1)	0.931
Total bilirubin, mg/dL	0.6 (0.1)	0.4 (< 0.1)	0.917
LDL-cholesterol, mg/dL	108.8 (6.2)	106.5 (4.8)	0.490
HbA1c, %	6.3 (0.3)	5.7 (0.1)	0.106
Liver fibrosis
Liver stiffness, kPa	7.4 (0.8)	8.0 (1.1)	0.961
Advanced fibrosis			0.924
Liver steatosis
Controlled attenuation parameter, dB/m	351.8 (14.9)	341.9 (9.9)	0.022
ASCVD score	7.8 (0.1)	4.5 (0.1)	0.112

Table: Variables are expressed as mean (standard error), or %.
NAFLD, nonalcoholic fatty liver disease; BMI, body mass index; LDL, low-density lipoprotein; HbA1c, hemoglobin A1c; kPa, kilopascal; ASCVD, atherosclerotic cardiovascular disease.

Disclosures:

David Kim indicated no relevant financial relationships.

Catherine Ye indicated no relevant financial relationships.

Mohamed Ismail indicated no relevant financial relationships.

Nikolaos Pyrsopoulos: CytoSorbents – Grant/Research Support. Durect – Grant/Research Support. Gilead – Grant/Research Support. Grifols – Grant/Research Support. Mallinckrodt Pharmaceuticals – Consultant. Ocelot Bio – Grant/Research Support. Salix – Grant/Research Support.

David S. Kim, MD, Catherine Ye, MD, Mohamed Ismail, DO, Nikolaos T.. Pyrsopoulos, MD, PhD, MBA. P0949 - Prevalence of Nonalcoholic Fatty Liver Disease and Fibrosis Among US Adults with Sarcopenia: A 2017-2018 United States National Health and Nutrition Examination Surveys (NHANES) Assessment, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.