Association of fat-to-muscle ratio with non-alcoholic fatty liver disease: a single-centre retrospective study

Objectives: Sarcopenia is a known risk factor for
non-alcoholic fatty liver disease (NAFLD). Studies
evaluating the association between the fat-to-muscle ratio (FMR) and NAFLD
are limited. Therefore, the aim of our study was to investigate the
association between FMR and NAFLD. Design: A retrospective study
was conducted on the individuals who underwent health examination in
Wuhan Union Hospital between January 2020 and November 2021.
Clinical data were collected from electronic medical records. Setting: Our
study was conducted in a hospital in China. Participants: A total of 1,592
participants aged ≥40 years who underwent body composition analysis and
liver ultrasonography were retrospectively reviewed. Primary outcome
measures: Liver ultrasonography was used to assess
liver steatosis, and the Fibrosis-4 Index (FIB-4) was used to
calculate the risk scores for liver fibrosis. The
10-year atherosclerotic cardiovascular disease (ASCVD)
risk prediction model was used to calculate ASCVD risk scores.
Results: The FMR was significantly higher in individuals with NAFLD than
in those without NAFLD (P<0.001). The prevalence of NAFLD gradually
increased from FMR tertile 1 (reference) to tertile 2 (OR=1.49, 95% CI:
1.13–1.97) and tertile 3 (OR=2.85, 95% CI: 2.08–3.90). In addition,
patients with NAFLD in FMR tertile 3 had a significantly higher risk of
liver fibrosis (OR=4.48, 95% CI: 2.12–9.50) and ASCVD (OR=4.63, 95% CI:
2.62–8.19) than those in FMR tertile 1 after adjustment for multiple
confounders. Conclusion: In this study, we found a significant association
between FMR and NAFLD. A higher FMR indicates a higher risk of NAFLD in
the study population and a higher risk of liver fibrosis and ASCVD in
NAFLD patients.