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Thématique :
- Foie
Originalité :
Réexamen
Solidité :
Très solide
Doit faire évoluer notre pratique :
Immédiatement
 
 
Nom du veilleur :
Professeur Christine SILVAIN
Coup de coeur :
 
 
Hepatology
  2016/03  
 
  2016 Mar;63(3):776-86.  
  doi: 10.1002/hep.28376  
 
  Sarcopenia is associated with significant liver fibrosis independently of obesity and insulin resistance in nonalcoholic fatty liver disease: Nationwide surveys (KNHANES 2008-2011).  
 
  Lee YH, Kim SU, Song K, Park JY, Kim do Y, Ahn SH, Lee BW, Kang ES, Cha BS, Han KH  
  http://www.ncbi.nlm.nih.gov/pubmed/26638128  
 
 

Sarcopenia is associated with nonalcoholic fatty liver disease (NAFLD). This study investigated whether sarcopenia is associated with significant liver fibrosis in subjects with NAFLD. Data from the Korean National Health and Nutrition Examination Surveys 2008-2011 database were analyzed. NALFD was defined by NAFLD liver fat score, comprehensive NAFLD score, or hepatic steatosis index. Degree of liver fibrosis was assessed by NAFLD fibrosis score (NFS), FIB-4, and Forns index. Significant liver fibrosis was defined as FIB-4 ≥2.67 and the highest quartile values of NFS and Forns index. Sarcopenia index (= total appendicular skeletal muscle mass [kg]/body mass index (kg/m(2) ]) was calculated using dual-energy X-ray absorptiometry. Using the NAFLD liver fat score, NAFLD was identified in 2761 (28.5%) of 9676 subjects. Of subjects with NAFLD, sarcopenia was identified in 337 (12.2%). Sarcopenia was significantly associated with significant liver fibrosis assessed in fibrosis prediction models (all P < 0.05). In subgroups stratified according to body mass index and homeostasis model assessment of insulin resistance, a significant association between sarcopenia and significant liver fibrosis by NFS was consistently present (odds ratio = 1.76-2.68 depending on the subgroup, all P < 0.05). Multivariate logistic regression analysis demonstrated an independent association between SI and significant liver fibrosis by NFS after adjusting for other confounders (odds ratio = 0.52-0.67, all P < 0.01). Other NAFLD (comprehensive NAFLD score, hepatic steatosis index) and fibrosis prediction models (FIB-4 and Forns index) produced similar results.

CONCLUSION:

Sarcopenia is associated with significant liver fibrosis in subjects with NAFLD, and the association is independent of obesity and insulin resistance. (Hepatology 2016;63:776-786).

 
Question posée
 
A partir d’une database coréenne de la NAFLD (liver fat score, comprehensive NALFD score, index de stéatose hépatique) et de la fibrose hépatique (NAFLD fibrosis score, FIB-4, index de Forns) : étude de la sarcopénie par absorptiométrie.
 
Question posée
 
En présence de NALFLD, la sarcopénie est présente dans 12,2% des cas et associée significativement à la fibrose hépatique indépendamment de l’obésité et de l’insulino-résistance.
 
Commentaires

Se souvenir que la sarcopénie n’est pas rare chez les sujets en surpoids. Le mécanisme expliquant la relation avec la fibrose hépatique est toujours discuté.

 
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