Association of low muscle strength with metabolic dysfunction-associated fatty liver disease: A nationwide study

Abstract

BACKGROUND

There is limited evidence regarding the association between muscle strength and metabolic dysfunction-associated fatty liver disease (MAFLD).

AIM

To investigate the association between muscle strength and MAFLD in the general population in Korea.

METHODS

This nationwide representative cross-sectional study included 31649 individuals aged ≥ 19 years who participated in the Korea National Health and Nutrition Examination Survey between 2015 and 2018. Odds ratios (ORs) and 95% confidence intervals (95%CIs) for MAFLD according to sex-specific quartiles of muscle strength, defined by relative handgrip strength, were calculated using multivariable logistic regression analysis. Additionally, multivariable logistic regression analysis was used to assess the association between muscle strength and probable liver fibrosis in patients with MAFLD.

RESULTS

Of all the participants, 29.3% had MAFLD. The prevalence of MAFLD was significantly higher in the lower muscle strength quartile groups for all participants, sexes, and age groups (P < 0.001). A 1.92-fold (OR = 1.92, 95%CI: 1.70–2.16) and 3.12-fold (OR = 3.12, 95%CI: 2.64–3.69) higher risk of MAFLD was observed in the lowest quartile (Q1) group than in the other groups (Q2–Q4) and the highest quartile (Q4) group, respectively. The ORs of MAFLD were significantly increased in the lower muscle strength quartile groups in a dose-dependent manner (P for trend < 0.001). These associations persisted in both sexes. An inverse association between muscle strength and the risk of MAFLD was observed in all subgroups according to age, obesity, and diabetes mellitus. In patients with MAFLD, the odds of severe liver fibrosis were higher in Q1 (OR = 1.83, 95%CI: 1.25–2.69) than in other groups (Q2–Q4).

CONCLUSION

Among Korean adults, low muscle strength was associated with an increased risk of MAFLD and liver fibrosis in patients with MAFLD.

Keywords: Muscle strength; Handgrip strength; Metabolic dysfunction-associated fatty liver disease; Liver fibrosis; Korea National Health and Nutrition Examination Survey

Core Tip: Limited evidence exists regarding the association between muscle strength and metabolic dysfunction-associated fatty liver disease (MAFLD). This nationwide cross-sectional study analyzed 17349 individuals in the general community who participated in the Korea National Health and Nutrition Examination Survey and measured their grip strength between 2015 and 2018. Among the participants, 29.3% had MAFLD. The prevalence of MAFLD was significantly higher in the lower muscle strength quartiles. The odds ratios of MAFLD were significantly increased in the lower muscle strength quartile groups in a dose-response manner. Among Korean adults, low muscle strength was associated with an increased risk of MAFLD and liver fibrosis in patients with MAFLD.