Journal article
Muscle Mass Is Linked to Liver Disease Severity in Pediatric Nonalcoholic Fatty Liver Disease
The Journal of pediatrics, Vol.223, pp.93-99.e2
08/2020
DOI: 10.1016/j.jpeds.2020.04.046
PMID: 32711755
Abstract
To investigate the association between muscle mass and liver disease severity in pediatric patients with non-alcoholic fatty liver disease (NAFLD).
This was a retrospective study of patients aged <20 years followed from 2009 to 2018. Muscle mass was estimated in all patients by measuring magnetic resonance imaging-based total psoas muscle surface area (tPMSA) and correcting for height (tPMSA index = tPMSA/height2). Two cohorts were studied, one with histological confirmation of NAFLD (n = 100) and the other with magnetic resonance imaging (MRI) evidence of hepatic steatosis (n = 236). Histology was scored using Nonalcoholic Steatohepatitis Clinical Research Network (NASH CRN) criteria. MRI-measured proton density fat fraction (PDFF) and liver stiffness were collected. Demographic, clinical, and socioeconomic status (using a validated Community Deprivation Index [CDI]) were assessed as covariates. Univariate regression analyses, followed by multivariable regression analyses, were used to determine the relationships between tPMSA index and NAS, MRI-PDFF, and liver stiffness, adjusting for clinical, demographic, and CDI variables.
In the multivariable regression analyses, higher steatosis score was associated with a lower tPMSA index (OR, 0.73; 95% CI, 0.56-0.96) and younger age (OR, 0.84; 95% CI, 0.73-0.97). Liver PDFF was also significantly associated with the tPMSA index (P = .029), sex (P = .019), and CDI (P = .005). In contrast, liver stiffness was not associated with tPMSA in multivariable analyses.
tPMSA index was independently associated with both imaging and histological features of hepatic steatosis severity in children. Future studies should directly explore the presence and directionality of causative links between muscle mass and steatosis, as well as whether interventions that enhance muscle mass can reduce disease severity in children with NAFLD.
Details
- Title: Subtitle
- Muscle Mass Is Linked to Liver Disease Severity in Pediatric Nonalcoholic Fatty Liver Disease
- Creators
- Toshifumi Yodoshi - University of Cincinnati Medical CenterSarah Orkin - University of Cincinnati Medical CenterAna-Catalina Arce Clachar - University of CincinnatiKristin Bramlage - University of Cincinnati Medical CenterQin Sun - University of Cincinnati Medical CenterLin Fei - University of Cincinnati Medical CenterAndrew F. Beck - University of Cincinnati Medical CenterStavra A. Xanthakos - University of Cincinnati Medical CenterAndrew T. Trout - Cincinnati Children's Hospital Medical CenterMarialena Mouzaki - University of Cincinnati Medical Center
- Resource Type
- Journal article
- Publication Details
- The Journal of pediatrics, Vol.223, pp.93-99.e2
- DOI
- 10.1016/j.jpeds.2020.04.046
- PMID
- 32711755
- NLM abbreviation
- J Pediatr
- ISSN
- 0022-3476
- eISSN
- 1097-6833
- Publisher
- Elsevier Inc
- Grant note
- T32 DK007727 / National Institutes of Health (https://doi.org/10.13039/100000002)
- Language
- English
- Date published
- 08/2020
- Academic Unit
- Stead Family Department of Pediatrics; Gastroenterology, Hepatology, Pancreatology, and Nutrition
- Record Identifier
- 9985214102202771
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