The Correlation Between Leg Muscle Mass Index and Non-Alcoholic Fatty Liver Disease in Patients with Type 2 Diabetes Mellitus

Figures & data

Table 1 Baseline Characteristics of NALFD and Non-NAFLD

	NAFLD	Non-NAFLD	P
n(Male/Female)	160(96/64)	40(26/14)
Age(years)	52.61(50.94,54.27)	55.50(53.03,57.97)	0.098
Weight(kg)	71.43±12.53	58.13±7.46	<0.001
High(cm)	164.63(162.12,167.13)	164.58(162.28,166.87)	0.698
BMI(kg/m^2)	25.82±3.32	20.87±2.01	<0.001
BFP(%)	30.17(28.13,31.22)	20.37(18.37,22.37)	<0.001
ASMI	1.07(1.04,1.11)	1.22(1.16,1.28)	<0.001
LSMI	0.58(0.56,0.60)	0.68(0.64,0.72)	<0.001
SBP(mmHg)	129.06(126.41,131.70)	130.63(1123.46,137.79)	0.886
DBP(mmHg)	78.30(76.64,79.96)	78.25(74.42,82.08)	0.779
VFA(cm^2)	108.09(102.03,114.15)	63.69(54.47,72.92)	<0.001
ASFA(cm^2)	201.56±59.48	124.18±27.53	<0.001
Duration of diabetes(months)	83.60(71.28,95.92)	121.88(95.855,147.90)	0.004
FBG(mmol/L)	8.36(7.86,8.86)	8.01(6.56,9.47)	0.085
0’INS(μU/mL)	8.23±7.83	4.30±3.93	0.022
HOMA-IR	2.88(2.21,3.56)	1.48(0.86,2.09)	0.047
HbA1c(%)	9.22(8.90,9.55)	9.80(8.95,10.67)	0.301
ALT(U/L)	27.85±23.49	12.45±5.85	<0.001
AST(U/L)	23.12±17.08	14.56±5.08	0.002
γ-GT(U/L)	41.78±45.07	18.80±9.62	0.002
UA(umol/l)	323.04(308.53,337.54)	292.73(263.41,322.04)	0.015
TG(umol/l)	3.36(3.05,3.68)	3.41(1.82,4.99)	0.050
TC(umol/l)	3.79(3.39,4.19)	3.38(2.59,4.17)	0.104
HDL-c(umol/l)	0.95±0.21	1.13±0.33	<0.001
LDL-c(umol/l)	2.85(2.70,2.99)	2.62(2.39,2.86)	0.287
UA/CR(mg/g)	25.63(23.77,47.50)	39.78(18.13,61.44)	0.043
RbaPWV	1561.55(1515.03,1608.06)	1607.21(1484.78,1729.64)	0.520
LbaPWV	1559.78(1511.94,1607.63)	1617.15(1488.48,1745.81)	0.387
LSM(Kpa)	7.79(6.61,8.98)	5.53(5.02,6.03)	<0.001
CAP(dB/m)	286.56(282.46,290.66)	220.62(217.19,224.05)	<0.001

Notes: Continuous values consistent with normal distribution are shown as mean ± standard deviation. Categorical values are shown as frequency.

Abbreviations: BMI, body mass index; BFP, Body fat percentage; SBP, Systolic blood pressure; DBP, Diastolic blood pressure; CFA, visceral fat area; ASFA, Abdominal subcutaneous fat area; FBG, glucose 0 minutes; 0’INS, insulin 0 minutes; HbA1c, glycosylated hemoglobin; ALT, alanine aminotransferase; AST, aspartate aminotransferase; γ- GT, γ- Glutamyl transpeptidase; UA, serum uric acid; HDL-C, serum high-density lipoprotein; LDL-C, serum low-density lipoprotein; UA/CR, urine microalbumin/creatinine ratio; LS, liver stiffness measurement; CAP, controlled attenuation parameter.

Table 2 Comparison of General Information and Laboratory Parameters Between Quartile Groups of LSMI

	Quartiles of LSMI				P
	Q1:≤0.50	Q2:0.50–0.60	Q3: 0.60–0.70	Q4: >0.70
n(Male/Female)	51(3/48)	50(23/27)	51(50/1)	48(46/2)	<0.001
Age(years)	53.48±9.17	50.43±9.72	49.04±10.43	50.14±10.81	0.002
Weight(kg)	64.00(55.90,72.15)	58.00(53.20,73.00)	71.60(62.05,80.90)	69.80(65.10,74.60)	<0.001
High(cm)	158.00(152.00,166.50)	163.00(160.25,172.75)	166.00(161.00,171.25)	173.00(163.50,177.00)	<0.001
BMI(kg/m^2)	26.60(23.20,29.10)	24.60(21.88,26.75)	25.30(23.20,28.00)	22.40(20.10,24.35)	<0.001
BFP(%)	37.50(32.90,40.50)	28.40(23.40,33.50)	26.00(22.70,28.50)	22.30(18.30,24.35)	0.004
ASM(kg)	21.70(19.65,24.35)	22.90(22.10,26.00)	29.20(25.90,33.15)	31.40(27.90,32.55)	<0.001
LSM(kg)	11.40(10.20,12.96)	12.65(11.64,14.66)	15.75(14.59,17.66)	17.52(15.79,18.53)	<0.001
VFA(cm^2)	101.04±27.01	96.95±52.95	106.20±43.18	85.29±29.18	0.006
ASFA(cm^2)	207.00(151.50,261.00)	170.00(127.00,230.00)	167.00(138.00,232.00)	156.00(125.50,146.50)	0.040
HOMA-IR	4.21±5.55	2.16±1.49	2.07±1.48	2.01±1.90	0.047
ALT(U/L)	22.20(14.60,34.55)	16.60(10.25,32.20)	15.50(10.25,43.50)	15.90(11.10,18.35)	0.055
AST(U/L)	17.00±20.96	17.40±17.89	14.00±14.29	14.00±6.39	0.016
γ-GT(U/L)	31.44±26.20	47.86±69.30	59.08±59.27	25.86±15.47	0.029
TG(umol/l)	2.81(1.80,4.43)	3.47(2.01,4.42)	3.15(1.65,4.62)	2.11(1.30,4.52)	0.083
TC(umol/l)	3.61(2.35,4.84)	4.92(2.01,5.70)	3.78(2.71,5.70)	3.36(2.17,4.01)	0.130
HDL-c(umol/l)	0.96(0.82,1.14)	0.96(0.87,1.19)	0.85(0.74,1.01)	0.95(0.81,1.08)	0.126
LDL-c(umol/l)	2.90(2.11,3.48)	3.19(2.67,3.72)	2.49(1.98,3.17)	2.85(2.10,3.26)	0.311
LSM(Kpa)	6.70(5.99,8.84)	6.17(5.04,7.16)	6.24(5.08,7.73)	5.00(4.49,6.73)	0.004
CAP(dB/m)	294.67(270.87,305.74)	265.05(249.27,302.74)	272.19(246.40,300.72)	253.00(232.78,288.18)	<0.001

Abbreviations: BMI, body mass index; HbA1c, glycosylated hemoglobin; ALT, alanine aminotransferase; AST, aspartate aminotransferase; γ- GT, γ- Glutamyl transpeptidase; TC, total cholesterol; TG, triglyceride; HDL-C, serum high-density lipoprotein; LDL-C, serum low-density lipoprotein.

Figure 1 Prevalence of nonalcoholic fatty liver disease (NAFLD) across quartile groups of LSMI.

Table 3 Spearman Correlation Between LSMI and SMI and NAFLD

Item	Gender	Age	BMI	BFP	VFA	ASFA	ALT	AST	CAP	LSM
LSMI
r	−0.741	−0.193	−0.369	−0.774	−0.108	−0.222	−0.163	−0.224	−0.142	−0.273
P	<0.001	0.006	<0.001	<0.001	0.148	0.003	0.023	0.001	0.044	<0.001
ASMI
r	−0.738	−0.193	−0.349	−0.818	−0.094	−0.226	0.178	−0.238	−0.142	−0.27
P	<0.001	0.006	<0.001	<0.001	0.21	0.003	0.012	<0.001	0.044	<0.001

Table 4 Odds Ratios of the Risk for NAFLD in Type 2 Diabetes Mellitus

Variables	β	OR(95% CI)	P
Age	−0.029	0.971(0.937.1.007)	0.110
BMI	0.737	2.090(1.638,2.668)	<0.001
BFP	0.244	1.277(1.176,1.386)	<0.001
VFA	0.042	1.043(1.027,1.060)	<0.001
ASFA	0.046	1.048(1.030,1.065)	<0.001
HOMA-IR	0.477	1.612(1.078,2.411)	0.020
ALT	0.159	1.173(1.090,1.262)	<0.001
AST	0.150	1.161(1.067,1.264)	<0.001
LSMI	−5.900	0.003(0.000,0.053)	<0.001
ASMI	−3.860	0.021(0.003,0.147)	<0.001
CAP	0.428	1.534(1.195,1.971)	<0.001

Figure 2 (A) LSMI, SMI predicts ROC curve for NAFLD. (B) LSMI combined with SMI predicts ROC curve NAFLD.

Table 5 Linear Regression Analysis of Factors Influencing Indicators of NAFLD

Variable	β	SE	β’	t	95% CI	P
Male(n=122)
LSMI	−1.628	0.319	−0.422	−5.099	−0.996~-2.260	<0.001
Female(n=78)
LSMI	−1.543	0.414	−0.393	−3.723	−0.717~-2.368	<0.001